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Women, men, and health 女人、男人和健康
Pub Date : 2021-11-01 DOI: 10.1093/med/9780198816805.003.0085
D. Cooper, H. Tabana
This chapter explores the ways in which sex and gender influence health. There are important differences between men and women in their risk of premature death and in the main causes of death. In virtually every country around the world men have a lower life expectancy than women, although the gap in life expectancy is narrower in low-income countries. Similarly, women and men have different patterns of ill health across the life course, and again the gap varies between countries. Both sex and gender play a part in these variations. Sex, or biological factors, influence risks of different diseases and health conditions, and also affects survival following diagnosis. However, socially constructed gender-linked factors are also important and also affect exposure to social and environmental risk factors. In addition, gendered differences in men and women’s use of healthcare, and inequalities in access to services and how appropriate these are, impact on health outcomes.
本章探讨性和社会性别影响健康的方式。男性和女性在过早死亡的风险和主要死亡原因方面存在重大差异。在世界上几乎每个国家,男性的预期寿命都低于女性,尽管低收入国家的预期寿命差距较小。同样,妇女和男子在整个生命过程中健康状况不佳的模式也不同,各国之间的差距也不尽相同。性别和社会性别都在这些变化中发挥作用。性别或生物因素影响不同疾病和健康状况的风险,也影响诊断后的生存。然而,社会建构的与性别有关的因素也很重要,也影响社会和环境风险因素的暴露。此外,男女在利用保健服务方面的性别差异,以及在获得服务方面的不平等以及这些服务的适当程度方面的不平等,都影响到健康结果。
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引用次数: 0
Governance and management of public health programmes 公共卫生方案的治理和管理
Pub Date : 2021-11-01 DOI: 10.1093/med/9780198816805.003.0051
Zhi-yong Hou, Na He
Governance is central to improve health systems performance and achieve Universal Health Coverage. Good governance can enable the effective use of health finances, workforce, medicines, and information to deliver better health services and outcomes. Theories of principal-agent and network governance are introduced to better understand health governance at system level. In health governance system, the government, private sector, and civil society are the governing triangle, and form a whole-of-society governance approach for health. We introduce the governing triangle and its role in health governance, governance mechanisms and tools, and the levels of governance, respectively. The triangle plays health governance functions at four levels to collectively pursue health goals: the supranational or national or organizational or programme levels. At each level, tools of governance are central to health governance functions and enabling relationships among triangles. Tools of governance can be classified into nine governance dimensions: accountability, regulation, participation, and consensus in decision-making, formulating policy/strategic direction, organizational adequacy/system design, generating information/intelligence, partnerships for coordination and collaboration, engagement of community, communication, and transparency. Assessment frameworks are further introduced for evaluating whether health governance is effective. And several cases of health governance are introduced for better understanding.
治理对于改善卫生系统绩效和实现全民健康覆盖至关重要。善治能够有效利用卫生资金、人力、药品和信息,提供更好的卫生服务和成果。引入委托代理理论和网络治理理论,以更好地理解系统层面的健康治理。在卫生治理体系中,政府、私营部门和民间社会是治理三角,形成了全社会的卫生治理方式。我们分别介绍了治理三角及其在健康治理、治理机制和工具以及治理级别中的作用。三角在四个层面发挥卫生治理职能,共同追求卫生目标:超国家或国家或组织或规划层面。在每个级别上,治理工具都是健康治理功能和实现三角形之间关系的核心。治理工具可以分为九个治理维度:问责制、监管、参与和决策共识、制定政策/战略方向、组织充分性/系统设计、生成信息/情报、协调和协作伙伴关系、社区参与、沟通和透明度。进一步引入评估框架,以评估卫生治理是否有效。为了更好地理解,本文还介绍了几个卫生治理案例。
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引用次数: 0
Tobacco 烟草
Pub Date : 2021-11-01 DOI: 10.1093/med/9780198816805.003.0078
T. Lam, S. Ho
Tobacco is the most important and avoidable public health problem, killing 5.4 million users per year. At least one in two and up to two in three smokers die prematurely from smoking. Such great and easily understood risks should be more effectively communicated to promote smoking cessation. This chapter describes how raising tobacco tax, banning smoking in public places, and forbidding tobacco advertising, promotion, and sponsorship have effectively reduced smoking rates in many countries. However, many low- and middle-income countries still lack the necessary resources or political will to implement tobacco control. Further progress may come from large and effective pictorial warnings; banning the display of tobacco products at retail outlets; extending smoking bans in public places; innovative use of the mass media; very brief warnings by doctors to promote cessation; telephone quitlines; and capitalizing on the risk perception towards third-hand smoke.
烟草是最重要和可避免的公共卫生问题,每年造成540万使用者死亡。至少有二分之一、最多三分之二的吸烟者过早死于吸烟。这些巨大而容易理解的风险应该更有效地传播,以促进戒烟。本章描述了提高烟草税,禁止在公共场所吸烟,禁止烟草广告,促销和赞助如何有效地降低了许多国家的吸烟率。然而,许多低收入和中等收入国家仍然缺乏实施烟草控制的必要资源或政治意愿。进一步的进展可能来自大规模和有效的图片警告;禁止在零售商店展示烟草制品;扩大公共场所禁烟令;创新利用大众传媒;医生非常简短的警告,以促进戒烟;戒烟热线电话;利用人们对三手烟的风险认知。
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引用次数: 0
Urbanization and health 城市化与健康
Pub Date : 2021-11-01 DOI: 10.2471/blt.10.010410
Jason Corburn
A majority the world’s population (4.2 billion) are now living in cities and municipal regions. According to the UN, 55% of the world was living in cities in 2018 and over 68% were expected to live in urban areas by 2050. Urbanization is a dynamic and evolving physical, social, and economic transformation that shapes the health and well-being of populations living in cities and around the world. City living can be healthy, since they can offer more population groups the health benefits of life-supporting infrastructure such as clean water and sanitation, education, and social services, as well as greater cultural, religious, and political expression and freedoms. This chapter briefly reviews the historical debates around the connections between human health and urbanization and highlights some challenges for addressing twenty-first century urbanization. Twenty-first century urbanization presents new challenges for urban health.
世界上大多数人口(42亿)现在都居住在城市和市区。根据联合国的数据,2018年,全球55%的人口居住在城市,到2050年,预计将有超过68%的人口居住在城市。城市化是一种动态的、不断演变的物质、社会和经济转型,影响着城市和世界各地居民的健康和福祉。城市生活可以是健康的,因为城市可以为更多的人口群体提供生活支持基础设施的健康益处,如清洁水和卫生设施、教育和社会服务,以及更大的文化、宗教和政治表达和自由。本章简要回顾了围绕人类健康与城市化之间关系的历史辩论,并强调了解决21世纪城市化的一些挑战。21世纪的城市化对城市卫生提出了新的挑战。
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引用次数: 3
The right to health supports global public health 健康权支持全球公共卫生
Pub Date : 2021-11-01 DOI: 10.1093/med/9780198816805.003.0019
Carmel Williams, A. Blaiklock, P. Hunt
In this chapter, we explain how human rights, including the right to health, are important for global public health. We introduce key human rights concepts and principles, and illustrate three approaches to the right to health: judicial, policy, and empowerment. We propose that human rights and public health are natural allies with a complementary and supportive relationship. We describe the meaning of the right to the highest attainable standard of health and its place in international, regional, and national laws. We outline ten key elements of the right to health and how the right can be operationalized in public health practice. We demonstrate this with two case studies of critically important global public health issues—climate change and children’s health, and overseas development assistance—as well as one of an emerging challenge in health, the digitization of health through Big Data.
在本章中,我们将解释包括健康权在内的人权对全球公共卫生的重要性。我们介绍了主要的人权概念和原则,并说明了实现健康权的三种途径:司法、政策和赋权。我们认为,人权和公共卫生是天然盟友,具有互补和支持的关系。我们阐述享有能达到的最高标准健康的权利的含义及其在国际、区域和国家法律中的地位。我们概述了健康权的十个关键要素,以及如何在公共卫生实践中落实这一权利。我们通过两个极其重要的全球公共卫生问题的案例研究——气候变化和儿童健康,以及海外发展援助——以及卫生领域一个新兴挑战——通过大数据实现卫生数字化,来证明这一点。
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引用次数: 1
The political economy of non-communicable diseases 非传染性疾病的政治经济学
Pub Date : 2021-11-01 DOI: 10.1093/med/9780198816805.003.0095
A. Thow, R. Lencucha, K. S. Reddy
Non-communicable diseases are the major cause of death and disability globally, but are largely preventable. The five major modifiable risk factors are tobacco use, alcohol use, unhealthy diets, physical inactivity, and air pollution—all of which have a strong environmental component. Implementation of policy to address non-communicable diseases (NCDs), however, has focused on individual responsibility rather than creating supportive environments for health promotion and NCD prevention, in part because of industry influence. A political economy perspective is helpful in considering how economic interests intersect with political decisions to shape the environments in which individuals live. When ‘environments of risk’ are considered from a political economy perspective, it enables us to critically assess sociopolitical factors that generate product environments characterized by health-harming products, built environments that condition physical inactivity over physical activity, and marginalization of pollution reduction. The enormous size and reach of these ‘industries of risk’ translates into significant political power. Industry actively exerts power in formal decision-making forums (‘decision-making power’), shapes the agenda in political debates (‘non-decision-making power’), and exercises ideological power in ways that are contrary to NCD prevention. Despite the power wielded by industry interests in the policy process, there has been innovation and meaningful policy change for NCD prevention. Key strategies include: assembling strong, local evidence to underpin policy; developing strong coalitions of actors with public health interests; preparing for push-back from industry; and developing specific proposals for healthier economic policy.
非传染性疾病是全球死亡和残疾的主要原因,但在很大程度上是可以预防的。五大可改变的风险因素是吸烟、饮酒、不健康饮食、缺乏身体活动和空气污染——所有这些因素都有很强的环境成分。然而,防治非传染性疾病政策的执行侧重于个人责任,而不是为促进健康和预防非传染性疾病创造支持性环境,部分原因是行业的影响。政治经济学的观点有助于考虑经济利益如何与政治决策相交叉,从而塑造个人生活的环境。当从政治经济学的角度考虑“风险环境”时,它使我们能够批判性地评估产生以危害健康的产品为特征的产品环境的社会政治因素,使身体不活动超过身体活动的建筑环境,以及减少污染的边缘化。这些“风险产业”的巨大规模和影响力转化为巨大的政治力量。工业界积极地在正式的决策论坛上施加权力(“决策权”),在政治辩论中塑造议程(“非决策权”),并以与非传染性疾病预防相反的方式行使意识形态权力。尽管行业利益集团在政策过程中掌握着权力,但在预防非传染性疾病方面已经出现了创新和有意义的政策变化。主要战略包括:收集有力的当地证据来支持政策;发展具有公共卫生利益的行为体的强大联盟;准备应对来自工业界的反击;制定更健康的经济政策的具体建议。
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引用次数: 0
Health of older people 老年人的健康
Pub Date : 2021-11-01 DOI: 10.1093/med/9780198816805.003.0091
S. Sinha, B. Ellis
Declines in mortality and fertility have largely contributed to population ageing and an accompanying epidemiological transition from infectious to chronic diseases. Significant improvements in life expectancy have occurred overall, although these have not been equally distributed between socioeconomic groups or across countries. Ageing is associated with increased health and social care needs due to the increased risk and prevalence of chronic diseases, dementia, multimorbidity, and disability that demand different types of and approaches to care. Older people benefit from a wide range of preventive interventions that reduce morbidity earlier in life, and prevent disability later on, as well as gerontological and geriatric expertise related to the delivery of care, support, and services to meet their unique needs. This chapter considers the phenomenon of population ageing, the unique health needs of older people, and specific approaches to providing health and social care to them.
死亡率和生育率的下降在很大程度上促成了人口老龄化以及随之而来的从传染病向慢性病的流行病学转变。总体而言,预期寿命出现了显著改善,尽管这些改善在不同社会经济群体或国家之间的分布并不均匀。老龄化与健康和社会护理需求增加有关,因为慢性病、痴呆、多病和残疾的风险和流行率增加,需要不同类型和方法的护理。老年人受益于各种预防干预措施,这些措施可减少生命早期的发病率,并预防以后的残疾,老年人还受益于与提供护理、支持和服务有关的老年学和老年医学专业知识,以满足他们的独特需求。本章审议了人口老龄化现象、老年人的独特保健需要以及向他们提供保健和社会护理的具体办法。
{"title":"Health of older people","authors":"S. Sinha, B. Ellis","doi":"10.1093/med/9780198816805.003.0091","DOIUrl":"https://doi.org/10.1093/med/9780198816805.003.0091","url":null,"abstract":"Declines in mortality and fertility have largely contributed to population ageing and an accompanying epidemiological transition from infectious to chronic diseases. Significant improvements in life expectancy have occurred overall, although these have not been equally distributed between socioeconomic groups or across countries. Ageing is associated with increased health and social care needs due to the increased risk and prevalence of chronic diseases, dementia, multimorbidity, and disability that demand different types of and approaches to care. Older people benefit from a wide range of preventive interventions that reduce morbidity earlier in life, and prevent disability later on, as well as gerontological and geriatric expertise related to the delivery of care, support, and services to meet their unique needs. This chapter considers the phenomenon of population ageing, the unique health needs of older people, and specific approaches to providing health and social care to them.","PeriodicalId":206715,"journal":{"name":"Oxford Textbook of Global Public Health","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125051400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The history and development of public health in low- and middle-income countries 中低收入国家公共卫生的历史和发展
Pub Date : 2021-11-01 DOI: 10.1093/med/9780198816805.003.0003
T. Sein
The history and development of public health in low- and middle-income countries (LMICs) shows that important breakthroughs in public health interventions have led to great improvements in economic development. Health determines economic productivity and prosperity, and the physical and emotional well- being of the people. The mindset of the population afflicted with a high infant mortality rate usually lacks the secure knowledge of its children’s longevity, witnesses higher fertility rates, and experiences the quality- quantity trade- off in child- rearing. Ever since the health- for- all movement was initiated over three decades ago, health, equity, and social justice remain the main themes of social and health policy. It is essential for all public health professionals to sustain these values, especially those in LMICs and the international community.
低收入和中等收入国家公共卫生的历史和发展表明,公共卫生干预措施的重大突破导致了经济发展的巨大改善。健康决定着经济的生产力和繁荣,也决定着人们的身心健康。婴儿死亡率高的人群的心态通常缺乏孩子长寿的可靠知识,目睹了更高的生育率,并在抚养孩子方面经历了质与量的权衡。自从三十多年前发起人人享有卫生保健运动以来,卫生、公平和社会正义一直是社会和卫生政策的主题。所有公共卫生专业人员,特别是中低收入国家和国际社会的公共卫生专业人员,都必须坚持这些价值观。
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引用次数: 0
Principles of infectious disease control 传染病控制原则
Pub Date : 2021-11-01 DOI: 10.1093/med/9780198816805.003.0097
R. Kim-Farley
Infectious diseases remain a leading cause of morbidity, disability, and mortality worldwide. Lower respiratory infections are the third leading causes of death worldwide and their control is a constant challenge that faces health workers and public health officials in both industrialized and developing countries. This chapter provides a global and comprehensive view of the principles of infectious disease control through examination of the magnitude of disease burden, the chain of infection (agent, transmission, and host) of infectious diseases, the varied approaches to their prevention and control (measures applied to the host, vectors, infected humans, animals, environment, and agents), and the factors conducive to their eradication as well as emergence and re-emergence.
传染病仍然是全世界发病、残疾和死亡的主要原因。下呼吸道感染是全世界第三大死亡原因,控制下呼吸道感染是工业化国家和发展中国家卫生工作者和公共卫生官员面临的一项持续挑战。本章通过检查疾病负担的大小、传染病的感染链(媒介、传播和宿主)、预防和控制传染病的各种方法(适用于宿主、媒介、受感染的人、动物、环境和媒介的措施)以及有助于根除传染病以及出现和重新出现的因素,提供了传染病控制原则的全球和全面观点。
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引用次数: 0
Measuring the health of populations 衡量人口健康状况
Pub Date : 2021-11-01 DOI: 10.1093/med/9780198816805.003.0040
T. Vos, C. Murray, Alan D. Lopez
Over the last two decades, the global health landscape has undergone rapid transformation. People around the world are living longer than ever before, and populations are getting older. Many countries have made remarkable progress in preventing child deaths. As a result, disease burden is increasingly defined by disability as opposed to being dominated by premature mortality. The leading causes of death and disability are shifting from communicable diseases in children to non-communicable diseases in adults. These global trends differ across regions and by level of development. Notably, in sub-Saharan Africa, communicable, maternal, and newborn diseases and nutritional deficiencies continue to dominate. While low- and middle-income countries are tackling this ‘unfinished agenda’ of largely poverty-related diseases, increasingly they also need to prepare their health services for a growing burden of non-communicable diseases and injuries. In high-income countries, health budgets are steadily increasing relative to gross domestic product due to ageing of the population, an ever-expanding array of medical technologies, and greater demands of consumers for healthcare services. For governments and other healthcare providers to be able to respond to these challenges, high-quality comparable data on the size and trends in mortality and morbidity are essential. In 2007, the Bill & Melinda Gates Foundation funded the Global Burden of Diseases, Injuries, and Risk Factors Study 2010, which endeavoured to rethink methods and assumptions underlying population health measurement while making use of the vastly improved health data and computational resources. This chapter describes the methods underlying the Global Burden of Disease (GBD) study.
在过去二十年中,全球卫生格局发生了迅速变化。世界各地人们的寿命比以往任何时候都长,人口也在老龄化。许多国家在预防儿童死亡方面取得了显著进展。因此,疾病负担越来越多地被残疾界定,而不是以过早死亡为主。造成死亡和残疾的主要原因正在从儿童的传染性疾病转向成人的非传染性疾病。这些全球趋势因区域和发展水平而异。值得注意的是,在撒哈拉以南非洲,传染病、孕产妇和新生儿疾病以及营养缺乏继续占主导地位。虽然低收入和中等收入国家正在处理这一主要与贫困有关的疾病的“未完成议程”,但它们也越来越需要为其卫生服务做好准备,以应对日益沉重的非传染性疾病和伤害负担。在高收入国家,由于人口老龄化、医疗技术种类不断扩大以及消费者对保健服务的需求增加,卫生预算相对于国内生产总值正在稳步增加。要使政府和其他医疗保健提供者能够应对这些挑战,关于死亡率和发病率的规模和趋势的高质量可比数据至关重要。2007年,比尔和梅林达·盖茨基金会资助了《2010年全球疾病、伤害和风险因素负担研究》,该研究在利用大大改进的健康数据和计算资源的同时,努力重新思考人口健康测量的方法和假设。本章描述了全球疾病负担(GBD)研究的基本方法。
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引用次数: 0
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Oxford Textbook of Global Public Health
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