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一个危险的弯道:历史在美国脊柱侧凸筛查计划中的作用。

A dangerous curve: the role of history in America's scoliosis screening programs.

机构信息

Department of the History and Sociology of Science, University of Pennsylvania, Philadelphia, 19104, USA.

出版信息

Am J Public Health. 2012 Apr;102(4):606-16. doi: 10.2105/AJPH.2011.300531. Epub 2012 Feb 16.

Abstract

In 2004, the US Preventive Services Task Force called for an end to scoliosis screening in US public schools. However, screening endures, although most nations have ended their screening programs. Why? Explanations range from America's unique fee-for-service health care system and its encouragement of high-cost medical specialism to the nation's captivation with new surgeries and technologies. I highlight another, more historical, reason: the persistence of the belief that spinal curvature is a sign of a progressive disease or disability. Despite improved health and the mid-20th-century discovery of antibiotics and vaccines that all but eradicated the diseases historically associated with scoliosis (e.g., polio and tuberculosis), the health fears associated with spinal curvature never fully dissipated. Scoliosis is still seen as a "dangerous curve," although the exact nature of the health risk remains unclear.

摘要

2004 年,美国预防服务工作组呼吁在美国公立学校停止脊柱侧凸筛查。然而,尽管大多数国家已经结束了他们的筛查项目,这种筛查仍在继续。为什么呢?解释范围从美国独特的按服务收费的医疗保健系统和对高成本医疗专业的鼓励,到美国对新手术和技术的着迷。我强调另一个更历史的原因:脊柱弯曲是一种进行性疾病或残疾的迹象的信念持续存在。尽管健康状况有所改善,而且在 20 世纪中叶发现了抗生素和疫苗,几乎根除了与脊柱侧凸相关的疾病(例如,小儿麻痹症和肺结核),但与脊柱弯曲相关的健康担忧从未完全消失。脊柱侧凸仍然被视为“危险曲线”,尽管健康风险的确切性质仍不清楚。

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