a Public Health , Universidad Nacional de Colombia , Bogotá , Colombia.
Glob Public Health. 2019 Jun-Jul;14(6-7):847-862. doi: 10.1080/17441692.2018.1551913. Epub 2018 Nov 30.
In an effort to provide an overview of the conceptual debates shaping the mobilisation around social determinants of health and health inequities and challenge the apparent consensus for equity in health, this essay compares two of the most influential approaches in the field: the WHO Commission on Social Determinants of Health approach (CSDH), strongly influenced by European Social Medicine, and the Latin American Social Medicine and Collective Health (LASM-CH) 'Social determination of the health-disease process' approach, hitherto largely invisibilized. It is argued that the debates shaping the equity in health agenda do not merely reflect conceptual differences, but essentially different ethical-political proposals that define the way health inequities are understood and proposed to be transformed. While the health equity agenda probably also gained momentum due to the broad political alliance it managed to consolidate, it is necessary to make differences explicit as this allows for an increase in the breadth and specificity of the debate, facilitating the recognition of contextually relevant proposals towards the reduction of health inequities.
为了全面了解围绕社会决定因素和健康不平等现象的动员所形成的概念性辩论,并对健康公平的明显共识提出挑战,本文比较了该领域两个最有影响力的方法:世界卫生组织社会决定因素健康委员会(CSDH)方法,深受欧洲社会医学的影响,以及拉丁美洲社会医学和集体卫生(LASM-CH)“健康-疾病过程的社会决定”方法,迄今为止在很大程度上被忽视。有人认为,形成健康公平议程的辩论不仅反映了概念上的差异,而且还反映了基本的伦理政治建议,这些建议定义了对健康不平等的理解方式,并提出了对其进行改革的方式。虽然健康公平议程可能也由于其成功巩固的广泛政治联盟而获得了动力,但有必要明确差异,因为这可以增加辩论的广度和针对性,促进对减少健康不平等的相关建议的认可。