Department of Primary Care & Public Health Sciences, King's College London, London.
Sociol Health Illn. 2014 Jan;36(1):15-27. doi: 10.1111/1467-9566.12037. Epub 2013 Aug 5.
This article challenges the generally accepted thesis that the emergence and dominance of chronic illness over the last half century is due to the receding tide of acute infectious diseases and an ageing population. Instead, through an analysis of contemporary reports in the Journal of the American Medical Association, it is argued that the construct of chronic illness emerged as part of a new focus on the downstream consequences of disease and as a means of transferring what had been seen as the natural processes of ageing and senescence into an explanatory model based on pathological processes. The widely accepted idea of an epidemiological transition in illness prevalence has served to conceal the ways in which medicine has extended its remit and suppressed alternative explanatory frameworks.
本文质疑了一个普遍接受的论点，即过去半个世纪中慢性病的出现和主导地位是由于急性传染病的消退和人口老龄化。相反，通过对《美国医学会杂志》上的当代报道的分析，本文认为慢性病的概念的出现是将疾病的下游后果作为一个新的关注点的一部分，也是将被视为自然衰老过程的内容转移到基于病理过程的解释模型的一种手段。人们普遍认为疾病流行的流行病学转变的观点掩盖了医学扩大其职权范围和抑制替代解释框架的方式。
