粮食主权、粮食安全与健康公平：一项元叙事映射练习
Food sovereignty, food security and health equity: a meta-narrative mapping exercise.
作者信息
Weiler Anelyse M, Hergesheimer Chris, Brisbois Ben, Wittman Hannah, Yassi Annalee, Spiegel Jerry M
机构信息
Sociology, University of Toronto, Toronto, ON, Canada, Faculty of Land and Food Systems, University of British Columbia, Vancouver, BC, Canada, Global Health Research Program, School of Population and Public Health, University of British Columbia Sociology, University of Toronto, Toronto, ON, Canada, Faculty of Land and Food Systems, University of British Columbia, Vancouver, BC, Canada, Global Health Research Program, School of Population and Public Health, University of British Columbia.
Sociology, University of Toronto, Toronto, ON, Canada, Faculty of Land and Food Systems, University of British Columbia, Vancouver, BC, Canada, Global Health Research Program, School of Population and Public Health, University of British Columbia.
出版信息
Health Policy Plan. 2015 Oct;30(8):1078-92. doi: 10.1093/heapol/czu109. Epub 2014 Oct 6.
There has been growing policy interest in social justice issues related to both health and food. We sought to understand the state of knowledge on relationships between health equity--i.e. health inequalities that are socially produced--and food systems, where the concepts of 'food security' and 'food sovereignty' are prominent. We undertook exploratory scoping and mapping stages of a 'meta-narrative synthesis' on pathways from global food systems to health equity outcomes. The review was oriented by a conceptual framework delineating eight pathways to health (in)equity through the food system: 1--Multi-Scalar Environmental, Social Context; 2--Occupational Exposures; 3--Environmental Change; 4--Traditional Livelihoods, Cultural Continuity; 5--Intake of Contaminants; 6--Nutrition; 7--Social Determinants of Health and 8--Political, Economic and Regulatory context. The terms 'food security' and 'food sovereignty' were, respectively, paired with a series of health equity-related terms. Combinations of health equity and food security (1414 citations) greatly outnumbered pairings with food sovereignty (18 citations). Prominent crosscutting themes that were observed included climate change, biotechnology, gender, racialization, indigeneity, poverty, citizenship and HIV as well as institutional barriers to reducing health inequities in the food system. The literature indicates that food sovereignty-based approaches to health in specific contexts, such as advancing healthy school food systems, promoting soil fertility, gender equity and nutrition, and addressing structural racism, can complement the longer-term socio-political restructuring processes that health equity requires. Our conceptual model offers a useful starting point for identifying interventions with strong potential to promote health equity. A research agenda to explore project-based interventions in the food system along these pathways can support the identification of ways to strengthen both food sovereignty and health equity.
政策对与健康和食品相关的社会正义问题的关注日益增加。我们试图了解关于健康公平（即社会产生的健康不平等）与食品系统之间关系的知识状况，其中“粮食安全”和“粮食主权”概念较为突出。我们对从全球食品系统到健康公平结果的途径进行了“元叙事综合”的探索性范围界定和映射阶段。该综述以一个概念框架为导向，该框架描绘了通过食品系统实现健康（不）公平的八条途径：1——多尺度环境、社会背景；2——职业暴露；3——环境变化；4——传统生计、文化延续；5——污染物摄入；6——营养；7——健康的社会决定因素；8——政治、经济和监管背景。“粮食安全”和“粮食主权”这两个术语分别与一系列与健康公平相关的术语配对。健康公平与粮食安全的组合（1414次引用）大大超过了与粮食主权的配对（18次引用）。观察到的突出交叉主题包括气候变化、生物技术、性别、种族化、本土性、贫困、公民身份和艾滋病毒，以及食品系统中减少健康不平等的制度障碍。文献表明，在特定背景下基于粮食主权的健康方法，如推进健康的学校食品系统、促进土壤肥力、性别平等和营养以及解决结构性种族主义问题，可以补充健康公平所需的长期社会政治结构调整过程。我们的概念模型为确定具有强大促进健康公平潜力的干预措施提供了一个有用的起点。沿着这些途径探索食品系统中基于项目的干预措施的研究议程可以支持确定加强粮食主权和健康公平的方法。
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