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[社区健康受限:来自地方公共卫生的思考与经验。]

[Confined community health: Reflections and experiences from the local public health.].

机构信息

Agencia de Salud Pública de Barcelona. Barcelona. España.

CIBER Epidemiologia y Salud Pública. España.

出版信息

Rev Esp Salud Publica. 2020 Oct 30;94:e202010131.

Abstract

This paper aims to share the reflections related to the community actions in which the Agència de Salut Pública de Barcelona has been involved during the emergency of COVID-19. The tasks carried out can be arranged in three stages, frequently overlapping: detection of needs and problems; contact with key stakeholders to assess what to do and how to do it; adaptation of the interventions to the "new normal" and generation of new responses. The emerging problems included: not being able to do the confinement (due to homelessness, material conditions, living in a situation of violence); digital gap (lack of knowledge, devices, access to Wifi); greater exposure to COVID-19 in the essential but precarious, feminized and racialized jobs (care, cleaning, food shops) that are the most frequent in the neighborhoods in where we work; language and cultural barriers that preclude to follow recommendations; to lose employment; insufficient income to cover basic needs; social isolation; and the deterioration of emotional health caused by the situation. During the process, some interventions were adapted to be delivered on-line. Solidarity networks and local resources were key to meet basic needs, but also other needs related to lack of digital knowledge or device. Community action in health, from a critical, intersectional and local perspective, and with intersectoral work and community participation, can contribute to: facilitate a contextualized response in the event of a health crisis; mitigate the effects derived from its economic and social crisis.

摘要

本文旨在分享巴塞罗那公共卫生机构在新冠疫情紧急状态期间参与的社区行动相关思考。所开展的任务可分为三个阶段,且常相互重叠:需求与问题的发现;与关键利益相关者接触,以评估做什么及如何做;使干预措施适应“新常态”并产生新的应对措施。出现的问题包括:无法实施隔离(由于无家可归、物质条件、生活在暴力环境中);数字鸿沟(缺乏知识、设备、无法接入无线网络);在我们工作的社区中最常见的基本但不稳定、女性化和种族化的工作(护理、清洁、食品店)中,接触新冠病毒的风险更高;语言和文化障碍妨碍人们遵循建议;失业;收入不足以满足基本需求;社会隔离;以及疫情导致的心理健康恶化。在此过程中,一些干预措施调整为在线提供。团结网络和当地资源是满足基本需求以及与缺乏数字知识或设备相关的其他需求的关键。从批判性、交叉性和地方性视角出发,并通过跨部门工作和社区参与开展的社区卫生行动,有助于:在发生健康危机时促成因地制宜的应对措施;减轻其经济和社会危机带来的影响。

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