斯宾诺莎、因果解放与社区健康促进。

IF 2.5 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH American Journal of Health Promotion Pub Date : 2024-10-02 DOI:10.1177/08901171241286876
Edwin B Fisher
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引用次数: 0

摘要

如果说在一个有着与进化一样悠久历史的社区实施的新计划给人们的健康带来了好处,这又有什么意义呢?对社区方法的评估往往试图分离出干预措施的因果作用。这其中的核心假设是,存在可以证明和隔离的原因。本尼迪克特-斯宾诺莎(Benedict Spinoza,1632-1677 年)否定了 "原因 "的概念,认为所有事物,即 "物质",都不是原因,而只是存在。自然界中事物的行为可以相互影响,如山体的侵蚀,但它们的实质,即山体,只是存在而已。在斯宾诺莎看来,生活的满足感来自于实现我们的 "物质 "并按照我们的 "物质 "行事,但这需要支持这种实现和行动的社区。因此,社区及其所包含的巨大影响是人类福祉的核心。对社区的干预并不会带来福利,而是与社区的历史、文化和众多其他特征一起,成为社区如何影响其成员的一部分。其启示包括:a) 全面扩展社会生态模式,以涵盖多种影响因素--包括创新项目--以及它们之间的相互作用;c) 采用多种研究方法,找出社区如何采用和融入创新项目以促成变革的实用经验,而不是列出一系列本应改变社区的干预措施。
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Spinoza, Liberation From Causation, and Community Health Promotion.

What sense does it make to say that a new program implemented in a community with roots as old as evolution caused an observed health benefit? Evaluation of community approaches has often sought to isolate the causal roles of interventions. Central to this is the assumption that there are causes to be proven and isolated. Benedict Spinoza (1632-1677) dismissed the concept of cause, arguing that all things, "substances," are not caused but simply are. Actions of things in nature can influence each other, e.g., erosion of a mountain, but their substance, the mountains simply are. For Spinoza, satisfaction in life comes from realizing and acting in accord with our substance, but this requires communities that support such realization and action. Thus, communities and the vast influences they contain are central to human welfare. Interventions within them do not cause benefits but join with the history, culture, and numerous other features of the community in becoming part of how the community influences its members. Implications include a) expanding the social ecological model fully to embrace multiple influences - including innovative programs - and interactions among them, and c) varied research methods to identify practical lessons about how communities may adopt and incorporate innovations to engender change, rather than a catalogue of interventions that are supposed to change them.

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来源期刊
American Journal of Health Promotion
American Journal of Health Promotion PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
4.40
自引率
3.70%
发文量
184
期刊介绍: The editorial goal of the American Journal of Health Promotion is to provide a forum for exchange among the many disciplines involved in health promotion and an interface between researchers and practitioners.
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