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应对健康领域的社会经济不平等:欧洲经验分析

Tackling socioeconomic inequalities in health: analysis of European experiences.

作者信息

Mackenbach Johan P, Bakker Martijntje J

机构信息

Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 1738, 3000 DR, Rotterdam, Netherlands.

出版信息

Lancet. 2003 Oct 25;362(9393):1409-14. doi: 10.1016/S0140-6736(03)14639-9.

Abstract

Effective strategies must be developed to reduce socioeconomic inequalities in health. Most efforts take place in isolation, and only the UK experience has been discussed widely in international published work. We therefore analysed policy developments on health inequalities in different European countries between 1990 and 2001. We noted that countries are in widely different phases of awareness of, and willingness to take action on, inequalities in health. We identified innovative approaches in five main areas: policy steering mechanisms; labour market and working conditions; consumption and health-related behaviour; health care; and territorial approaches. National advisory committees in the UK, the Netherlands, and Sweden have proposed comprehensive strategies to reduce health inequalities. Variations between these packages suggest that policymaking in this area still is largely intuitive and would benefit from incorporation of more rigorous evidence-based approaches. Further international exchanges of experiences with development, implementation, and evaluation of policies and interventions to reduce health inequalities can help to enhance learning speed.

摘要

必须制定有效的策略来减少健康方面的社会经济不平等现象。大多数努力都是孤立进行的,只有英国的经验在国际发表的作品中得到了广泛讨论。因此,我们分析了1990年至2001年间不同欧洲国家在健康不平等问题上的政策发展情况。我们注意到,各国在对健康不平等问题的认识阶段以及采取行动的意愿方面存在很大差异。我们在五个主要领域确定了创新方法:政策指导机制;劳动力市场和工作条件;消费与健康相关行为;医疗保健;以及地域方法。英国、荷兰和瑞典的国家咨询委员会已经提出了减少健康不平等的综合战略。这些方案之间的差异表明,该领域的政策制定在很大程度上仍然是凭直觉的,若能纳入更严格的循证方法将受益匪浅。进一步就减少健康不平等的政策和干预措施的制定、实施和评估进行国际经验交流,有助于提高学习速度。

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