Galvão Luiz A C, Haby Michelle M, Chapman Evelina, Clark Rachel, Câmara Volney Magalhães, Luiz Ronir Raggio, Becerra-Posada Francisco
Rev Panam Salud Publica. 2016 Mar;39(3):157-165.
Objective To identify reported interventions that facilitate sustainable development and have had a positive impact on health in four areas: sustainable food production; sustainable energy use; sustainable jobs ("decent work"); and prevention of toxic exposure to chemicals. Methods Systematic review methods were used to synthesize evidence from multiple systematic reviews and economic evaluations. A comprehensive search was conducted of at least 14 databases and 8 websites for each of the four overviews, using pre-defined protocols, including clear inclusion criteria. To qualify as "sustainable," interventions needed to aim (explicitly or implicitly) to positively impact at least two dimensions of the integrated framework for sustainable development and had to include measures of health impact. Results In total, 47 systematic reviews and 10 economic evaluations met the inclusion criteria. The most promising interventions, such as agricultural policies, were identified for each of the four topics. While the evidence for the interventions is not strong because of the limited number of studies, there is no evidence of a definite negative impact on health. The only possible exception is that of taxes and subsidies-though this intervention also has the potential to be pro-equity with higher relative impacts for lower income groups. Conclusions The evidence found for effective interventions is useful for guiding countries toward the best options for non-health sector interventions that can positively impact health. This overviews shows that intersectoral work benefits every sector involved.
目的 确定已报道的有助于可持续发展并在四个领域对健康产生积极影响的干预措施:可持续粮食生产;可持续能源利用;可持续就业(“体面工作”);以及预防化学品中毒暴露。方法 采用系统评价方法,综合多个系统评价和经济评估的证据。针对四个综述中的每一个,使用预定义方案,包括明确的纳入标准,对至少14个数据库和8个网站进行全面检索。要符合“可持续”的条件,干预措施需要(明确或隐含地)旨在对可持续发展综合框架的至少两个维度产生积极影响,并且必须包括健康影响的衡量指标。结果 共有47项系统评价和10项经济评估符合纳入标准。针对四个主题中的每一个,都确定了最有前景 的干预措施,如农业政策。由于研究数量有限,干预措施的证据并不充分,但没有证据表明对健康有明确的负面影响。唯一可能的例外是税收和补贴——尽管这种干预措施也有可能促进公平,对低收入群体的相对影响更大。结论 所发现的有效干预措施的证据有助于指导各国选择能够对健康产生积极影响的非卫生部门干预的最佳方案。本综述表明,部门间合作使每个相关部门都受益。