Lutz Andrea, Zuercher Karin, Nanchen David, Pasche Myriam
Département de promotion de la santé et préventions, Unisanté, Centre universitaire de médecine générale et santé publique, 1011 Lausanne.
Rev Med Suisse. 2019 Oct 30;15(669):1987-1990.
This article addresses the issue of health inequalities and the measures allowing to reduce them. Starting from the observation that, in Switzerland like in the rest of the world, health gaps between the riches and the poorest are still very marked, this article questions the role that health promotion and prevention can play in the fight against this phenomenon. The main approaches allowing to reduce inequalities are presented and illustrated with examples : the universal approach, the targeted approach and proportionate universalism. This last approach appears as the ideal towards which all health promotion and prevention actions should converge in order to reduce health inequalities all along the social gradient. However, its translation into prevention measures remains subject to interpretation. Therefore, the article ends with a set of recommendations for the elaboration of measures aiming to reduce health inequalities.
本文探讨了健康不平等问题以及减少这些不平等的措施。从观察到的现象出发，即在瑞士如同世界其他地方一样，富人与最贫困者之间的健康差距仍然十分显著，本文质疑了健康促进与预防在应对这一现象中所能发挥的作用。文中介绍了减少不平等的主要方法，并举例说明：普遍方法、针对性方法和相称普遍主义。最后这种方法似乎是所有健康促进与预防行动都应趋向的理想目标，以便在整个社会梯度上减少健康不平等。然而，将其转化为预防措施仍有待解读。因此，本文最后提出了一系列关于制定旨在减少健康不平等措施的建议。
