Navarro Vicente
Department of Health Policy and Management, Johns Hopkins University, Baltimore, MD 21205, USA.
Int J Health Serv. 2007;37(1):1-14. doi: 10.2190/H454-7326-6034-1T25.
Unfortunately, most nation states have taken "health policy" to mean "medical care policy." Medical care, however, is only one variable in a nation's health equation. The article describes what the main components of a national health policy should be, including (1) the political, economic, social, and cultural determinants of health, the most important determinants of health in any country; (2) the lifestyle determinants, which have been the most visible types of public interventions; and (3) the socializing and empowering determinants, which link the first and second components of a national health policy: the individual interventions and the collective interventions. The author discusses the indicators that should be used for each component and for each intervention. The feasibility of this approach depends to a large degree on the political will of the national authorities and the broad understanding of the actual determinants of health. A good first step is the National Health Policy plan developed by the Swedish social democratic government. This article builds on and expands on that model.
不幸的是，大多数民族国家将“卫生政策”等同于“医疗保健政策”。然而，医疗保健只是一个国家健康等式中的一个变量。本文描述了国家卫生政策的主要组成部分应该是什么，包括：（1）健康的政治、经济、社会和文化决定因素，这是任何国家健康最重要的决定因素；（2）生活方式决定因素，这是最明显的公共干预类型；（3）社会化和赋权决定因素，它将国家卫生政策的第一和第二组成部分联系起来：个体干预和集体干预。作者讨论了应针对每个组成部分和每种干预措施使用的指标。这种方法的可行性在很大程度上取决于国家当局的政治意愿以及对健康实际决定因素的广泛理解。瑞典社会民主党政府制定的《国家卫生政策计划》是很好的第一步。本文在此模型的基础上进行了拓展。
