Kaplan G A, Lynch J W
Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor 48109-2029, USA.
Prev Med. 1999 Dec;29(6 Pt 2):S30-5. doi: 10.1006/pmed.1999.0540.
Economic policy is an important determinant of population health; it is part of health policy. True primordial prevention of cardiovascular disease (CVD) may require regulation of the domestic and international market forces which produce and distribute CVD risk factors and their determinants. Because the market does not bear the cost of the legacy of poor health that it generates, primordial prevention of CVD may need to concern itself with societal mechanisms for holding these market forces accountable. Indeed, this approach is now an important part of the public health lexicon for preventing smoking. No program of primordial prevention of smoking could possibly ignore the national and international economic interests of the tobacco industry. We need to start thinking about primordial prevention of CVD risk factors such as low physical activity, high-fat diet, and psychosocial stress in the same way.
经济政策是人口健康的重要决定因素；它是卫生政策的一部分。真正对心血管疾病（CVD）进行原级预防可能需要对产生和传播心血管疾病风险因素及其决定因素的国内外市场力量进行监管。由于市场并不承担其造成的健康不佳遗留问题的成本，对心血管疾病的原级预防可能需要关注让这些市场力量承担责任的社会机制。事实上，这种方法现在是预防吸烟公共卫生词汇的重要组成部分。任何吸烟原级预防计划都不可能忽视烟草行业的国家和国际经济利益。我们需要开始以同样的方式思考对诸如身体活动不足、高脂肪饮食和心理社会压力等心血管疾病风险因素的原级预防。
