Felix Michael R J, Burdine James N, Wendel Monica L, Alaniz Angie
Community Health Development Specialist, Allentown, PA, USA.
J Prim Prev. 2010 Apr;31(1-2):9-19. doi: 10.1007/s10935-010-0206-8.
The purpose of this article is to propose a set of ideas for reinventing America's health care system, one community at a time. Community health development is proposed as a strategy and approach to population health improvement, the ultimate goal of health care reform. The practice of community health development, particularly the partnership approach, provides guidance about how this approach might be employed as a national health care reform strategy. Examples of two communities successfully using the partnership approach illustrate the methods described. Six specific recommendations for policy makers and public administrators in the new administration resulting from our experience with community health development are presented. First, adopt and apply community health development (CHD) as the American approach for facilitating population health improvement and building community capacity. Second, the partnership approach should be promoted as a model for communities to use in implementing CHD. Third, make the community-level the focus for planning, implementing, evaluating, and sustaining a full continuum of health and human services. Fourth, formally recognize the social determinants of health as a key component of a new population/community health status model and as a public policy driver for health care reform, marketplace issues, and population health status improvement at all levels of society. Fifth is a call for a national strategy for the recruitment, training, education, and support of individuals to facilitate this community movement. Sixth, Congress and the Obama Administration adopt and apply CHD as a national strategy and utilize American community-based experiences to bring about a national plan.
本文旨在一次针对一个社区，提出一套重塑美国医疗体系的构想。社区健康发展被提议作为一种改善人群健康的战略和方法，这也是医疗改革的最终目标。社区健康发展的实践，尤其是伙伴关系方法，为如何将此方法用作国家医疗改革战略提供了指导。两个成功运用伙伴关系方法的社区案例说明了所描述的方法。基于我们在社区健康发展方面的经验，针对新政府中的政策制定者和公共管理者提出了六项具体建议。第一，采用并应用社区健康发展（CHD）作为促进人群健康改善和建设社区能力的美国式方法。第二，应推广伙伴关系方法，作为社区实施CHD的典范。第三，将社区层面作为规划、实施、评估和维持完整的健康与人类服务连续统一体的重点。第四，正式承认健康的社会决定因素是新的人群/社区健康状况模型的关键组成部分，也是医疗改革、市场问题以及社会各层面人群健康状况改善的公共政策驱动因素。第五，呼吁制定一项国家战略，用于招募、培训、教育和支持个人以推动这一社区行动。第六，国会和奥巴马政府采用并应用CHD作为国家战略，并利用美国基于社区的经验制定一项国家计划。
