Reflections on evolvement of health promotion policies for chronic disease control and prevention in China: a literature study
-
摘要: 当前中国约有89 %的死亡归因于慢性非传染性疾病(NCDs),NCDs是造成中国人群疾病负担最为严重的一类疾病。世界卫生组织自上世纪80年代以来倡导采用健康促进的策略改善人群健康。纵观健康促进政策的演变过程可发现,开展综合的行动(包括制定健康公共政策、构建支持性环境、强化社区行动、发展个人技能和调整卫生服务方向)可以有效缓解NCDs导致的疾病负担,而健康融入万策(HiAP)的实施框架可以为推动政府承诺并落实对人群健康的维护、为多部门协作解决影响健康的复杂社会决定因素提供路径。Abstract: It is estimated that 89% of mortalities could be attributed to chronic and non-communicable diseases (NCDs) currently in China and NCDs are the most serious diseases which cause the disease burden in Chinese population. Since 1980s, World Health Organization has been advocating the application of health promotion strategies to improve population health. Recapitulating the evolution of health promotion policies, we can find that comprehensive actions (such as developing healthy public policy, creating supportive environments for health, strengthening community action, building up personal skills, and reorienting health services) can effectively reduce the burden caused by NCDs. The implementation framework of health in all policies is in favor of the government commitments on maintaining population health, by which it can lead to a path for multi-sectoral cooperation to solve complex social determinants that affect health.
-
表 1 WHO健康促进大会发布的政策汇总
政策名称 时间和地点 简要描述 1 《健康促进渥太华宪章》[6] 1986年,加拿大渥太华 提出健康促进的定义
指出健康促进的五大行动领域2 《阿德莱德健康公共政策建议》[7] 1988年,澳大利亚阿德莱德 提出制定健康公共政策的意义
指出健康公共政策优先覆盖的领域3 《松兹瓦尔健康支持性环境声明》[8] 1991年,瑞典松兹瓦尔 提出支持性环境的定义
指出支持性环境建设的优先维度4 《雅加达宣言》[9] 1997年,印度尼西亚雅加达 第一次由发展中国家主办的会议
明确综合干预策略的有效性5 《健康促进墨西哥部长声明》[10] 2000年,墨西哥墨西哥城 重申实施健康促进的必要性
敦促联合国对健康促进的落实6 《健康促进曼谷宪章》[11] 2005年,泰国曼谷 响应了全球化的发展背景
指出从承诺到行动之间存在的鸿沟7 《内罗毕呼吁行动》[12] 2009年,肯尼亚内罗毕 提出落实健康促进的切入点 8 《赫尔辛基健康融入万策声明》[13] 2013年,芬兰赫尔辛基 提出“健康融入万策”的定义
制定“健康融入万策”的框架9 《上海宣言》[14] 2016年,中国上海 响应了可持续发展的背景
明确健康和福祉是可持续发展的核心
指出健康促进的三大重点(政府治理能力、健康城市、健康素养) -
[1] World Health Organization. Noncommunicable diseases progress monitor 2015[EB/OL]. (2015 – 09)[2021 – 03 – 01]. https://www.who.int/nmh/publications/ncd-progress-monitor-2015/en/. [2] World Health Organization. The top 10 causes of death[EB/OL]. [2020 – 12 – 09]. https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death. [3] World Health Organization. Noncommunicable diseases country profiles 2018[EB/OL]. [2020 – 01 – 01]. https://www.who.int/publications/i/item/ncd-country-profiles-2018. [4] Nutbeam D. Health promotion glossary[J]. Health Promotion International, 1998, 13(4): 349 – 364. doi: 10.1093/heapro/13.4.349 [5] Green BN, Johnson CD, Adams A. Writing narrative literature reviews for peer-reviewed journals: secrets of the trade[J]. Journal of Chiropractic Medicine, 2006, 5(3): 101 – 117. doi: 10.1016/S0899-3467(07)60142-6 [6] World Health Organization. Ottawa charter for health promo-tion[EB/OL]. [2012 – 06 – 16]. https://www.who.int/publications/i/item/ottawa-charter-for-health-promotion. [7] World Health Organization. Adelaide recommendations on healthy public policy[EB/OL]. [2020 – 01 – 01]. https://www.who.int/healthpromotion/conferences/previous/adelaide/en/. [8] World Health Organization. Sundsvall statement on supportive environments for health[EB/OL]. [2020 – 01 – 01]. https://www.who.int/healthpromotion/conferences/previous/sundsvall/en/. [9] World Health Organization. Jakarta declaration on leading health promotion into the 21st century[EB/OL]. [2020 – 01 – 01]. https://www.who.int/teams/health-promotion/enhanced-wellbeing/fourth-conference/jakarta-declaration. [10] World Health Organization. Mexico ministerial statement for the promotion of health[EB/OL]. [2020 – 01 – 01]. https://www.who.int/teams/health-promotion/enhanced-wellbeing/fifth-global-conference/mexico-ministerial-statement. [11] World Health Organization. The bangkok charter for health promotion in a globalized world[EB/OL]. [2020 – 01 – 01]. https://www.who.int/teams/health-promotion/enhanced-wellbeing/sixth-global-conference/the-bangkok-charter. [12] World Health Organization. Promoting health and development: closing the implementation gap[EB/OL]. [2020 – 01 – 01]. https://www.who.int/mediacentre/events/meetings/7gchp/en/. [13] World Health Organization. The helsinki statement-building on our heritage, looking to our future[EB/OL]. [2020 – 01 – 01]. https://www.who.int/healthpromotion/conferences/8gchp/statement_2013/en/. [14] World Health Organization. Shanghai declaration on promoting health in the 2030 agenda for sustainable development[EB/OL]. [2016 – 11 – 21]. https://www.who.int/publications/i/item/WHO-NMH-PND-17.5. [15] Nichols P, Ussery-Hall A, Griffin-Blake S, et al. The evolution of the steps program, 2003-2010: transforming the federal public health practice of chronic disease prevention[J]. Preventing Chronic Disease, 2012, 9: E50. [16] Alla F. Should the ottawa charter still be the reference 30 years later?[J]. Sante Publique, 2016, 28(6): 717 – 720. doi: 10.3917/spub.166.0717 [17] Scriven A, Speller V. Global issues and challenges beyond Ottawa: the way forward[J]. Promotion and Education, 2007, 14(4): 194 – 198. doi: 10.1177/10253823070140040201 [18] Thomas B, Gostin LO. Tackling the global NCD crisis: innovations in law and governance[J]. Journal of Law, Medicine and Ethics, 2013, 41(1): 16 – 27. doi: 10.1111/jlme.12002 [19] Thow AM, Jones A, Hawkes C, et al. Nutrition labelling is a trade policy issue: lessons from an analysis of specific trade concerns at the World Trade Organization[J]. Health Promotion International, 2018, 33(4): 561 – 571. [20] Nagata T, Setoguchi S, Hemenway D, et al. Effectiveness of a law to reduce alcohol-impaired driving in Japan[J]. Injury Prevention Journal of the International Society for Child and Adolescent Injury Prevention, 2008, 14(1): 19 – 23. doi: 10.1136/ip.2007.015719 [21] UN. Political declaration of the high-level meeting of the general assembly on the prevention and control of non-communicable diseases[EB/OL]. [2011 – 09 – 19]. https://www.un.org/en/ga/ncdmeeting2011/. [22] Stokols D. Translating social ecological theory into guidelines for community health promotion[J]. American Journal of Health Promotion, 1996, 10(4): 282 – 298. doi: 10.4278/0890-1171-10.4.282 [23] Busza J, Walker D, Hairston A, et al. Community-based approaches for prevention of mother to child transmission in resource-poor settings: a social ecological review[J]. Journal of the International AIDS Society, 2012, 15(S2): 17373. [24] Poland B, Krupa G, McCall D. Settings for health promotion: an analytic framework to guide intervention design and implementa-tion[J]. Health Promotion Practice, 2009, 10(4): 505 – 516. doi: 10.1177/1524839909341025 [25] Whitelaw S, Baxendale A, Bryce C, et al. ‘Settings’ based health promotion: a review[J]. Health Promotion International, 2001, 16(4): 339 – 353. doi: 10.1093/heapro/16.4.339 [26] Chu C, Breucker G, Harris N, et al. Health-promoting workplaces-international settings development[J]. Health Promotion International, 2000, 15(2): 155 – 167. doi: 10.1093/heapro/15.2.155 [27] Dooris M. Holistic and sustainable health improvement: the contribution of the settings-based approach to health promotion[J]. Perspectives in Public Health, 2009, 129(1): 29 – 36. doi: 10.1177/1757913908098881 [28] Zhou MG, Wang HD, Zeng XY, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990 – 2017: a systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet, 2019, 394(10204): 1145 – 1158. doi: 10.1016/S0140-6736(19)30427-1 [29] 吴韶嫣, 李跃平. “健康中国”建设中各省市健康政策研究[J]. 中国公共卫生, 2019, 35(9): 1105 – 1109. doi: 10.11847/zgggws1124696 [30] Kumar S, Preetha G. Health promotion: an effective tool for global health[J]. Indian Journal of Community Medicine: Official Publication of Indian Association of Preventive and Social Medicine, 2012, 37(1): 5 – 12. [31] 李洁. 从“制度”到“生活”: 新中国70年来公共卫生政策演变[J]. 中国公共卫生, 2019, 35(10): 1281 – 1284. doi: 10.11847/zgggws1124670 [32] 中共中央国务院. “健康中国2030”规划纲要[EB/OL]. [2016 – 10 – 25]. http://www.gov.cn/zhengce/2016-10/25/content_5124174.htm.
点击查看大图
表(1)
计量
- 文章访问数: 841
- HTML全文浏览量: 288
- PDF下载量: 109
- 被引次数: 0