Hernández Luis Jorge, Ocampo Jovana, Ríos Diana Sofía, Calderón Claudia
L.H.: MD. Ph.D. Salud Pública. Universidad de los Andes. Bogotá, Colombia.
J.O.: MD. Ph.D. Salud Pública. Universidad de los Andes. Bogotá, Colombia.
Rev Salud Publica (Bogota). 2017 May-Jun;19(3):393-395. doi: 10.15446/rsap.v19n3.68470.
Public health has developed based on multiple approaches, including the guidelines of the health systems, the community or the individuals. This paper intends to identify the conceptual models of public health that arise after analyzing health or disease categories, as well as the level at which social response occurs: the individual or a family, biophysical and social environment; hygienist or preventive mode. Considering that the concept of model is not only a representation of reality, but an ontological position that allows to understand society and the State, all models are part of a theory and converge with other theories to create a framework of analysis. In consequence, three models of the health-disease process are presented. First, the Canadian model that establishes four determinants -lifestyle, environment, biological factors and health services-. Second, the social determinants model of the World Health Organization (WHO) that establishes three determinants based on risk approach: structural, intermediate and proximal. Finally, the historical-social or social determination model, which looks for the roots of social inequalities that affect health. The development of the Colombia Health System has considered these health models. Today, the Comprehensive Health Care Policy, and its Comprehensive Health Care Model, bases its approach within a model of determinants established by the PAHO.
公共卫生是基于多种方法发展起来的,包括卫生系统、社区或个人的指导方针。本文旨在确定在分析健康或疾病类别以及社会反应发生的层面(个人或家庭、生物物理和社会环境;卫生主义或预防模式)之后出现的公共卫生概念模型。鉴于模型的概念不仅是对现实的一种呈现,更是一种能够理解社会和国家的本体论立场,所有模型都是一种理论的一部分,并与其他理论相互融合以创建一个分析框架。因此,本文提出了三种健康 - 疾病过程模型。第一,加拿大模型,该模型确定了四个决定因素——生活方式、环境、生物因素和卫生服务。第二,世界卫生组织(WHO)的社会决定因素模型,该模型基于风险方法确定了三个决定因素:结构性、中间性和近端性。最后,历史 - 社会或社会决定模型,该模型探寻影响健康的社会不平等的根源。哥伦比亚卫生系统的发展考虑了这些健康模型。如今,综合卫生保健政策及其综合卫生保健模式将其方法建立在泛美卫生组织确立的决定因素模型之内。