Raphael Dennis
School of Health Policy and Management, Faculty of Health, York University, 4700 Keele Street, Toronto, Ont. M3J 1P3, Canada.
Health Policy. 2007 Nov;84(1):101-11. doi: 10.1016/j.healthpol.2007.04.002. Epub 2007 May 23.
International interest in the social determinants of health and their public policy antecedents is increasing. Despite evidence that the USA presents one of the worst population health profiles and public policy environments in support of health among wealthy developed nations - a result of systemic inequities in income, influence, and power - the USA public health gaze is firmly - and narrowly - focused on issues of access to health care, racial and ethnic disparities in healthcare, and individual behavioral risk factors. Reasons for the USA's neglect of structural and public policy issues are explored and Ten Tips for American Public Health Researchers and Workers are presented.
国际上对健康的社会决定因素及其公共政策前身的关注正在增加。尽管有证据表明，在美国这个富裕的发达国家中，其人口健康状况和支持健康的公共政策环境是最差的之一——这是收入、影响力和权力方面系统性不平等的结果——但美国公共卫生的关注点却坚定且狭隘地集中在医疗保健可及性问题、医疗保健中的种族和族裔差异以及个人行为风险因素上。本文探讨了美国忽视结构性和公共政策问题的原因，并为美国公共卫生研究人员和工作者提供了十条建议。
