Marmot Michael
International Centre for Health and Society, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.
Lancet. 2005;365(9464):1099-104. doi: 10.1016/S0140-6736(05)71146-6.
The gross inequalities in health that we see within and between countries present a challenge to the world. That there should be a spread of life expectancy of 48 years among countries and 20 years or more within countries is not inevitable. A burgeoning volume of research identifies social factors at the root of much of these inequalities in health. Social determinants are relevant to communicable and non-communicable disease alike. Health status, therefore, should be of concern to policy makers in every sector, not solely those involved in health policy. As a response to this global challenge, WHO is launching a Commission on Social Determinants of Health, which will review the evidence, raise societal debate, and recommend policies with the goal of improving health of the world's most vulnerable people. A major thrust of the Commission is turning public-health knowledge into political action.
我们在各国内部以及国家之间所看到的健康方面的巨大不平等给全世界带来了挑战。各国之间预期寿命相差48岁,各国内部相差20岁甚至更多,这种情况并非不可避免。越来越多的研究表明,社会因素是造成这些健康不平等现象的主要根源。社会决定因素与传染病和非传染病都相关。因此,健康状况应受到各个部门政策制定者的关注,而不仅仅是那些参与卫生政策制定的人。作为对这一全球挑战的回应,世卫组织正在发起一个健康问题社会决定因素委员会,该委员会将审查相关证据,引发社会辩论,并提出政策建议,目标是改善世界上最弱势群体的健康状况。该委员会的一项主要工作重点是将公共卫生知识转化为政治行动。