Coburn David, Denny Keith, Mykhalovskiy Eric, McDonough Peggy, Robertson Ann, Love Rhonda
Department of Public Health Sciences, University of Toronto, Ontario, Canada.
Am J Public Health. 2003 Mar;93(3):392-6. doi: 10.2105/ajph.93.3.392.
An internationally influential model of population health was developed in Canada in the 1990s, shifting the research agenda beyond health care to the social and economic determinants of health. While agreeing that health has important social determinants, the authors believe that this model has serious shortcomings; they critique the model by focusing on its hidden assumptions. Assumptions about how knowledge is produced and an implicit interest group perspective exclude the sociopolitical and class contexts that shape interest group power and citizen health. Overly rationalist assumptions about change understate the role of agency. The authors review the policy and practice implications of the Canadian population health model and point to alternative ways of viewing the determinants of health.
20世纪90年代，加拿大建立了一个具有国际影响力的人口健康模型，将研究议程从医疗保健扩展到健康的社会和经济决定因素。虽然作者们认同健康具有重要的社会决定因素，但他们认为该模型存在严重缺陷；他们通过关注其隐含假设对该模型进行了批判。关于知识如何产生的假设以及隐含的利益集团视角排除了塑造利益集团权力和公民健康的社会政治和阶级背景。关于变革的过度理性主义假设低估了能动性的作用。作者们审视了加拿大人口健康模型的政策和实践影响，并指出了看待健康决定因素的其他方式。
