McMichael Anthony J, McKee Martin, Shkolnikov Vladimir, Valkonen Tapani
National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, Australia 0200.
Lancet. 2004 Apr 3;363(9415):1155-9. doi: 10.1016/S0140-6736(04)15902-3.
Health trends over much of the past century have been generally, and notably, positive throughout the world. In several regions, however, life expectancy has declined over the past 1-2 decades. This trend suggests that the expectation that emerged in the 1960s and 1970s of worldwide gains and convergence in population health status is not guaranteed by a general deterministic process. National populations can now be clearly grouped into those that have achieved rapid gains in life expectancy; those whose gains are slower or are perhaps plateauing; and those in which the trends have reversed. Over the past two centuries, outside times of war and famine, such reversals have been rare. Exploration of these varied population health trends elucidates better the close relation between population health and the processes of economic, social, and technological change. Such analysis has shown that the health status of human populations should be a guiding criterion in the debate on sustainable development.
在过去一个世纪的大部分时间里，全球的健康趋势总体上，尤其是显著地呈现出积极态势。然而，在过去的10到20年里，有几个地区的预期寿命出现了下降。这一趋势表明，20世纪60年代和70年代出现的全球人口健康状况提升和趋同的预期，并不能由一个普遍的确定性过程来保证。现在，各国人口可以明确地分为几类：预期寿命迅速提高的国家；增长较慢或可能趋于平稳的国家；以及趋势出现逆转的国家。在过去的两个世纪里，除了战争和饥荒时期，这种逆转很少见。对这些不同的人口健康趋势进行探索，能更好地阐明人口健康与经济、社会和技术变革过程之间的密切关系。这样的分析表明，人口的健康状况应该成为可持续发展辩论中的一个指导标准。
