Card Claire, Epp Tasha, Lem Michelle
Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK S7N 5B4. Email:
Western College of Veterinary Medicine, and School of Public Health (joint appointment), University of Saskatchewan, 52 Campus Drive, Saskatoon, SK S7N 5B4. Email:
J Vet Med Educ. 2018 Winter;45(4):437-447. doi: 10.3138/jvme.0317-047r. Epub 2018 Oct 4.
An understanding of the One Health and EcoHealth concepts by students is dependent on medical pedagogy and medical pedagogy having similarities that allow a common discourse. Medical pedagogy includes a focus on the social, political, and economic forces that affect human health, while this discourse is largely absent from veterinary medical pedagogy. There is, however, a gradient in health that human and animal populations experience. This health gradient in human populations, which runs from low to high according to the World Health Organization, is largely explained by "the conditions in which people are born, grow, live, work, and age." Regarding the human health gradient, other authors have broadened the list of conditions to include access to health care systems used to prevent disease and treat illness, and the distribution of power, money, and resources, which are shaped by social, economic, and political forces. In human medicine, these conditions are collectively termed the (SDH). Veterinarians who work with the public encounter people and their animals at both the low and the high end of the health gradient. This article explores the concept of the parallel social determinants of animal health (SDAH) using examples within urban, rural, and remote communities in North America as well as abroad. We believe that in order to understand the One Health paradigm it is imperative that veterinary pedagogy include information on, and competence in, SDH and SDAH to ultimately achieve improvements in human, animal, and environmental health and wellbeing.
学生对“同一健康”和“生态健康”概念的理解取决于医学教学法,且医学教学法存在一些相似之处,从而促成了共同的论述。医学教学法关注影响人类健康的社会、政治和经济力量,而兽医学教学法在很大程度上缺乏此类论述。然而,人类和动物群体在健康方面存在一个梯度变化。根据世界卫生组织的标准,人类群体的这种健康梯度从低到高,很大程度上是由“人们出生、成长、生活、工作和衰老的环境”所决定的。关于人类健康梯度,其他作者扩充了环境条件的范围,将获得用于预防疾病和治疗疾病的医疗保健系统,以及由社会、经济和政治力量塑造的权力、金钱和资源的分配也纳入其中。在人类医学中,这些条件统称为社会决定因素(SDH)。与公众打交道的兽医在健康梯度的低端和高端都会接触到人和他们的动物。本文通过北美以及国外城市、农村和偏远社区的实例,探讨动物健康的平行社会决定因素(SDAH)的概念。我们认为,为了理解“同一健康”范式,兽医学教学法必须包含有关社会决定因素和动物健康平行社会决定因素的信息及能力,以最终实现人类、动物和环境健康与福祉的改善。