McLeroy K R, Bibeau D, Steckler A, Glanz K
Department of Public Health Education, University of North Carolina, Greensboro 27412.
Health Educ Q. 1988 Winter;15(4):351-77. doi: 10.1177/109019818801500401.
During the past 20 years there has been a dramatic increase in societal interest in preventing disability and death in the United States by changing individual behaviors linked to the risk of contracting chronic diseases. This renewed interest in health promotion and disease prevention has not been without its critics. Some critics have accused proponents of life-style interventions of promoting a victim-blaming ideology by neglecting the importance of social influences on health and disease. This article proposes an ecological model for health promotion which focuses attention on both individual and social environmental factors as targets for health promotion interventions. It addresses the importance of interventions directed at changing interpersonal, organizational, community, and public policy, factors which support and maintain unhealthy behaviors. The model assumes that appropriate changes in the social environment will produce changes in individuals, and that the support of individuals in the population is essential for implementing environmental changes.
在过去20年里，美国社会对通过改变与慢性病风险相关的个人行为来预防残疾和死亡的兴趣急剧增加。这种对健康促进和疾病预防重新燃起的兴趣并非没有受到批评者的质疑。一些批评者指责生活方式干预的支持者忽视了社会因素对健康和疾病的重要影响，从而宣扬了一种指责受害者的意识形态。本文提出了一种健康促进的生态模型，该模型将注意力集中在个体和社会环境因素上，将其作为健康促进干预的目标。它强调了针对人际、组织、社区和公共政策等因素进行干预的重要性，这些因素支持并维持着不健康的行为。该模型假定，社会环境的适当改变将引起个体的变化，而且人群中个体的支持对于实现环境改变至关重要。
