Czeresnia D
Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ 21045-900, Brasil.
Cad Saude Publica. 1999 Oct-Dec;15(4):701-9. doi: 10.1590/s0102-311x1999000400004.
In this article the author presents a point of view which she considers central to understanding the difference between prevention - associated with the traditional discourse of public health - and health promotion, an idea in connection with which proposals are now being presented for rethinking and redirecting public health practices. This perspective relates to the limits of the health and disease concepts in relation to the concrete experiences of health and illness. On the one hand, practical awareness of this limit implies far-reaching changes in the way scientific knowledge is related to (and used in) the formulation and organization of health practices; on the other, health promotion projects also avail themselves of the concepts guiding the discourse of prevention. This leads to certain difficulties that appear as inconsistencies or gray areas in the operationalization of promotion projects, which do not always succeed in asserting their nature as distinct from traditional preventive practices.
在本文中，作者提出了一种观点，她认为这一观点对于理解预防（与传统公共卫生话语相关联）和健康促进之间的差异至关重要，目前正围绕这一观点提出一些建议，以重新思考和调整公共卫生实践。这一观点涉及健康与疾病概念相对于健康和疾病具体体验的局限性。一方面，对这一局限性的实际认识意味着科学知识与健康实践的制定和组织相关联（并应用于其中）的方式会发生深远变化；另一方面，健康促进项目也利用指导预防话语的概念。这导致了一些困难，这些困难在促进项目的实施过程中表现为不一致或灰色地带，促进项目并不总能成功确立其与传统预防实践不同的性质。
