Health Promot J Austr. 2014 Apr;25(1):42-5. doi: 10.1071/HE13106.
There has been a growing national and global focus on the need to address social determinants of health to better achieve equitable health outcomes. In Australia, this focus is now being embedded into state, territory and Commonwealth government health policies. In this paper I use the National Primary Health Care Strategic Framework as a case study to examine the way in which 'health equity' and other related terms have been framed within a current national health policy context.
Using a critically reflective approach, I argue that primary health care and health promotion professionals need to capitalise on the inclusion of terms such as 'action on social determinants of health', 'health equity' and 'reducing inequity' through emerging national health policies, such as the National Primary Health Care Strategic Framework. Yet, there is also a need to proceed with caution. The way in which these terms are framed appears to deviate from the principles, values and ideologies on which they are historically based. The implications for contemporary health promotion practice in Australia are discussed.
Primary health care and health promotion professionals working in both policy and practice contexts are encouraged to engage in critical reflective practice when interpreting and considering the implementation requirements of national health policies that incorporate a health equity focus. So what? To build health equity in Australia, primary health care and health promotion professionals will be required to engage in the skilful reframing of current primary health care policy discourses relating to health equity during health promotion planning, implementation and evaluation processes.
越来越多的国家和全球关注需要解决健康的社会决定因素,以更好地实现公平的健康结果。在澳大利亚,这种关注现在正被纳入州、地区和联邦政府的卫生政策。在本文中,我使用国家初级卫生保健战略框架作为案例研究,考察了“卫生公平”和其他相关术语在当前国家卫生政策背景下的框架方式。
我采用批判性反思的方法,认为初级卫生保健和健康促进专业人员需要利用“对健康决定因素的行动”、“卫生公平”和“减少不公平”等术语,通过新兴的国家卫生政策,如国家初级卫生保健战略框架。然而,也需要谨慎行事。这些术语的框架方式似乎偏离了它们历史基础上的原则、价值观和意识形态。本文讨论了这些术语对澳大利亚当代健康促进实践的影响。
鼓励在政策和实践环境中工作的初级卫生保健和健康促进专业人员在解释和考虑纳入卫生公平重点的国家卫生政策的实施要求时,进行批判性反思实践。那么,在澳大利亚建立卫生公平,初级卫生保健和健康促进专业人员将需要在健康促进规划、实施和评估过程中,对与卫生公平相关的当前初级卫生保健政策话语进行巧妙的重新框架。