Truglio Joseph, Graziano Michelle, Vedanthan Rajesh, Hahn Sigrid, Rios Carlos, Hendel-Paterson Brett, Ripp Jonathan
Mount Sinai School of Medicine, New York, NY, USA.
Mt Sinai J Med. 2012 Jul-Aug;79(4):464-74. doi: 10.1002/msj.21327.
Noncommunicable diseases, including cardiovascular disease, chronic respiratory disease, diabetes, cancer, and mental illness, are the leading causes of death and disability worldwide. These diseases are chronic and often mediated predominantly by social determinants of health. Currently there exists a global-health workforce crisis and a subsequent disparity in the distribution of providers able to manage chronic noncommunicable diseases. Clinical competency in global health and primary care could provide practitioners with the knowledge and skills needed to address the global rise of noncommunicable diseases through an emphasis on these social determinants. The past decade has seen substantial growth in the number and quality of US global-health and primary-care training programs, in both undergraduate and graduate medical education. Despite their overlapping competencies, these 2 complementary fields are most often presented as distinct disciplines. Furthermore, many global-health training programs suffer from a lack of a formalized curriculum. At present, there are only a few examples of well-integrated US global-health and primary-care training programs. We call for universal acceptance of global health as a core component of medical education and greater integration of global-health and primary-care training programs in order to improve the quality of each and increase a global workforce prepared to manage noncommunicable diseases and their social mediators.
包括心血管疾病、慢性呼吸道疾病、糖尿病、癌症和精神疾病在内的非传染性疾病是全球死亡和残疾的主要原因。这些疾病是慢性的，并且通常主要由健康的社会决定因素介导。目前存在全球卫生人力危机，以及能够管理慢性非传染性疾病的医疗服务提供者分布不均的问题。全球卫生和初级保健方面的临床能力可以通过强调这些社会决定因素，为从业者提供应对全球非传染性疾病增加所需的知识和技能。在过去十年中，美国本科和研究生医学教育中的全球卫生和初级保健培训项目在数量和质量上都有了大幅增长。尽管它们的能力有重叠，但这两个互补领域最常被视为不同的学科。此外，许多全球卫生培训项目缺乏正式的课程。目前，美国只有少数几个全球卫生和初级保健培训项目整合良好的例子。我们呼吁普遍接受全球卫生作为医学教育的核心组成部分，并加强全球卫生和初级保健培训项目的整合，以提高各自的质量，并增加一支准备好管理非传染性疾病及其社会调节因素的全球卫生人力队伍。
