Köhler Lennart
Nordic School of Public Health, Gothenburg, Sweden.
Epidemiology and Social Medicine, Department of Public Health, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Health Promot Int. 2018 Oct 1;33(5):912-920. doi: 10.1093/heapro/dax023.
These reflections from a Child Public Health perspective underline the dramatic changes in children's conditions in Europe over this last century, including a considerable improvement in health. However, we still face problems, disturbing facts and alarming signs. There are important gaps in our knowledge about essential areas of children's health panorama and about particularly vulnerable sub-groups of children, which are less healthy, less well cared for and not enjoying the good conditions of life. We also see an evident lack of the child's perspective, implying acknowledgement and action on the views of the children themselves. Moreover, in spite of the generally improving standard, societal inequity in economy, education and health is increasing and the recent economic crises have struck hard on families with children. There are many good signs implying continuing progress for children and their conditions and also an improved respect for their rights. But with the increasing segregation in our societies, the risk is imminent that the health problems will increase, and that some groups get left far behind. Although actions on this field are primarily a political responsibility, people working with children can make a difference. There are also many examples of projects, particularly on local levels, where professionals act to promote children's health, prevent their ill-health and facilitate their health behaviour, rather than to repair their diseases. Children's particular needs and protection is now generally accepted, and the growing concern for their rights opens a window to the future for a more powerful child health advocacy.
从儿童公共卫生的角度进行的这些思考突显了上个世纪欧洲儿童状况的巨大变化，包括健康状况的显著改善。然而，我们仍然面临问题、令人不安的事实和警示信号。在儿童健康全貌的关键领域以及特别脆弱的儿童亚群体方面，我们的认知存在重大差距，这些儿童健康状况较差、照料不足且无法享受良好的生活条件。我们还明显看到缺乏儿童视角，这意味着对儿童自身观点的认可和行动。此外，尽管总体标准在提高，但经济、教育和健康方面的社会不平等却在加剧，近期的经济危机对有孩子的家庭造成了沉重打击。有许多积极迹象表明儿童及其状况将持续进步，对他们权利的尊重也有所提高。但随着社会隔离的加剧，健康问题增加以及一些群体被远远抛在后面的风险迫在眉睫。虽然该领域的行动主要是政治责任，但从事儿童工作的人员可以发挥作用。也有许多项目实例，特别是在地方层面，专业人员致力于促进儿童健康、预防疾病并推动健康行为，而不是治疗疾病。儿童的特殊需求和保护现在已得到普遍认可，对其权利的日益关注为更有力的儿童健康倡导开启了一扇通向未来的窗口。
