Faculty of Health Sciences, School of Nursing, Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Scand J Public Health. 2011 Mar;39(6 Suppl):43-9. doi: 10.1177/1403494810393558.
This commentary argues that contextual influences on health inequities need to be more thoroughly interrogated in future studies of population health interventions.
Case examples were chosen to illustrate several aspects of context: its historical, global, and dynamic nature; its multidimensional character; and its macro- and micro-level influences. These criteria were selected based on findings from an extensive literature review undertaken for the Public Health Agency of Canada and from two invitational symposia on multiple intervention programmes, one with a focus on equity, the other with a focus on context.
Contextual influences are pervasive yet specific, and diffuse yet structurally embedded. Historical contexts that have produced inequities have contemporary influences. The global forces of context cross jurisdictional boundaries. A complex set of social actors intersect with socio-political structures to dynamically co-create contextual influences.
These contextual influences raise critical challenges for the field of population health intervention research. These challenges must be addressed if we are going to succeed in the calls for action to reduce health inequities. Implications for future public health research and research-funding agencies must be carefully considered.
本述评认为，在未来的人群健康干预研究中，需要更深入地探讨健康不平等的背景影响因素。
选择案例示例来说明背景的几个方面：其历史性、全球性和动态性；其多维度特征；以及其宏观和微观层面的影响。这些标准是基于加拿大公共卫生局进行的广泛文献回顾以及两次关于多种干预计划的特邀研讨会的发现而选择的，一次重点是公平，另一次重点是背景。
背景影响因素普遍存在但具有特定性，分散存在但结构上嵌入。导致不平等的历史背景具有当代影响。背景的全球力量跨越了司法管辖边界。一系列复杂的社会行为体与社会政治结构相交织，共同创造出动态的背景影响因素。
这些背景影响因素给人群健康干预研究领域带来了严峻的挑战。如果我们要成功应对减少健康不平等的行动呼吁，就必须解决这些挑战。必须仔细考虑对未来公共卫生研究和研究资助机构的影响。
