Lucyk Kelsey
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Dr NW (TRW3), Calgary, AB, Canada T2N 4Z6.
SSM Popul Health. 2018 Sep 13;6:178-183. doi: 10.1016/j.ssmph.2018.09.007. eCollection 2018 Dec.
The 'social determinants of health' (SDOH) approach in Canada is widely acknowledged as having emerged through contributions such as the 1974 Lalonde Report or 1986 Ottawa Charter. Drawing on original oral histories, I consider this history through the reflections of past and present leaders in Canadian public health. Through this rich information, I identified three phases in the recent history of the SDOH, from a social awareness (1960s-1970s, when participants underwent training and gained exposure to social and health inequities), to a loose collection of theoretical and empirical concepts (1970s-1990s, when the evidence base on health inequities and the mechanisms behind them began to solidify), to a distinct research approach (2000s-present, when high profile events led to acceptance of the SDOH approach) that encompassed the spirit of its previous iterations. This paper will be of interest to health researchers and professionals, decision-makers, and trainees as they contemplate their own role in this ongoing history.
加拿大的“健康的社会决定因素”(SDOH)方法被广泛认为是通过1974年的《拉隆德报告》或1986年的《渥太华宪章》等贡献而出现的。借助原始口述历史,我通过加拿大公共卫生领域过去和现在的领导者的反思来审视这段历史。通过这些丰富的信息,我确定了SDOH近期历史中的三个阶段,从社会意识阶段(20世纪60年代至70年代,当时参与者接受培训并开始接触社会和健康不平等现象),到理论和实证概念的松散集合阶段(20世纪70年代至90年代,当时关于健康不平等及其背后机制的证据基础开始巩固),再到一种独特的研究方法阶段(21世纪至今,当时备受瞩目的事件导致SDOH方法被接受),该阶段包含了其先前各阶段的精神。本文将对健康研究人员和专业人员、决策者以及学员有所帮助,因为他们在思考自己在这段不断发展的历史中的角色。