McBeath W H
American Public Health Association, Washington, DC 20005.
Am J Public Health. 1991 Dec;81(12):1560-5. doi: 10.2105/ajph.81.12.1560.
The approach of a millennial passage invites public health to a review of past performance and a preview of future prospects toward assuring a healthy public. Since the 1974 Canadian Lalonde report, the best national plans for health progress have emphasized disease prevention and health promotion. WHO's multinational Health for All by the Year 2000 promotes basic health services essential to leading a socially and economically productive life. Healthy People 2000, the latest US guide, establishes three goals: increase healthy life span, reduce health disparities, and achieve universal access to preventive services. Its objectives can be used to excite public understanding, equip program development, evaluate progress, and encourage public accountability for health initiatives. Needed is federal leadership in defining requisite action and securing necessary resources. Elsewhere a "new public health" emphasizes community life-style and multisectoral "healthy public policy." In the United States, a national health program is needed to achieve equity in access to personal health care. Even more essential is equitable sharing in basic health determinants in society--nutritious food, basic education, safe water, decent housing, secure employment, adequate income, and peace. Vital to such a future is able and active leadership now from governments and public health professionals.
千禧年的到来促使公共卫生领域回顾过去的表现,并展望未来确保公众健康的前景。自1974年加拿大的拉隆德报告以来,各国制定的最佳健康发展计划都强调疾病预防和健康促进。世界卫生组织的跨国性“2000年人人享有健康”倡议推动了对过上社会和经济上富有成效生活至关重要的基本卫生服务。美国最新的指南《健康人民2000》确立了三个目标:延长健康寿命、减少健康差距以及实现预防服务的普遍可及性。其目标可用于激发公众的理解、为项目开发提供指导、评估进展情况以及鼓励公众对健康倡议负责。联邦政府需要发挥领导作用,明确必要的行动并确保获得所需资源。在其他地方,“新公共卫生”强调社区生活方式和多部门的“健康公共政策”。在美国,需要一项国家健康计划来实现个人医疗保健可及性的公平。更重要的是在社会基本健康决定因素方面实现公平共享,这些因素包括营养食品、基础教育、安全饮用水、体面住房、稳定就业、充足收入以及和平。对于这样的未来至关重要的是政府和公共卫生专业人员现在要有能干且积极的领导。