Roy Michael J
Yunus Centre for Social Business and Health/Glasgow School for Business and Society, Glasgow Caledonian University, Glasgow, UK.
Crit Public Health. 2017 Aug 8;27(4):455-464. doi: 10.1080/09581596.2016.1249826. Epub 2016 Oct 25.
The 'assets-based approach' to health and well-being has, on the one hand, been presented as a potentially empowering means to address the social determinants of health while, on the other, been criticised for obscuring structural drivers of inequality and encouraging individualisation and marketisation; in essence, for being a tool of neoliberalism. This study looks at how this apparent contestation plays out in practice through a critical realist-inspired examination of practitioner discourses, specifically of those working within communities to address social vulnerabilities that we know impact upon health. The study finds that practitioners interact with the assets-based policy discourse in interesting ways. Rather than unwitting tools of neoliberalism, they considered their work to be about mitigating the worst effects of poverty and social vulnerability in ways that enhance collectivism and solidarity, concepts that neoliberalism arguably seeks to disrupt. Furthermore, rather than a different, innovative, way of working, they consider the assets-based approach to simply be a re-labelling of what they have been doing anyway, for as long as they can remember. So, for practitioners, rather than a 'new' approach to public health, the assets-based public health movement seems to be a return to recognising and appreciating the role of community within public health policy and practice; ideals that predate neoliberalism by quite some considerable time.
基于资产的健康与福祉方法,一方面被视为解决健康社会决定因素的一种潜在赋权手段,另一方面却因掩盖不平等的结构性驱动因素、鼓励个体化和市场化而受到批评;从本质上讲,它被指责为新自由主义的工具。本研究通过对从业者话语进行批判性现实主义启发的考察,具体是对那些在社区工作以解决我们所知会影响健康的社会脆弱性问题的从业者话语进行考察,来审视这种明显的争议在实践中是如何展开的。研究发现,从业者以有趣的方式与基于资产的政策话语互动。他们并不认为自己是新自由主义的不知情工具,而是认为自己的工作是通过增强集体主义和团结来减轻贫困和社会脆弱性的最恶劣影响,而集体主义和团结这些概念正是新自由主义试图破坏的。此外,他们并不认为基于资产的方法是一种不同的、创新的工作方式,而是认为从他们能记得起的时候起,这种方法只不过是对他们一直在做的事情换了个说法而已。所以,对从业者来说,基于资产的公共卫生运动似乎不是公共卫生的一种“新”方法,而是回归到承认和重视社区在公共卫生政策和实践中的作用;这些理念在新自由主义出现之前就已经存在了相当长的时间。