Wallack L, Winkleby M
Department of Social and Administrative Health Sciences, School of Public Health, University of California, Berkeley 94720.
Soc Sci Med. 1987;25(8):923-30. doi: 10.1016/0277-9536(87)90263-2.
Personal health and well-being are gaining priority on the American agenda. A renewed interest in health promotion has been facilitated by the need to contain health care costs, realization of the limits of medicine in preventing illness, and a deeply rooted societal ethic of personal responsibility for individual health. Although the health status of Americans has changed significantly for the better during this century, further improvements are necessary, especially among high risk subgroups within the population who have not been effectively reached by traditional health promotion strategies. Past efforts, aimed at individuals modifying their risk factors, have neglected to address environmental factors that contribute to disease risk. This points to the need for an integrated approach where problems are addressed as properties of the systems in which individuals behave. This paper reviews selected health trends in the United States, discusses limitations of the current approach to health promotion, presents a comprehensive definition of prevention, and provides principles for planning that may facilitate improved health status in this country.
个人健康与幸福在美国议程上正日益受到重视。控制医疗成本的需求、对医学在预防疾病方面局限性的认识以及社会对个人健康负有责任这一根深蒂固的伦理观念，推动了人们对健康促进的新兴趣。尽管本世纪美国人的健康状况已显著改善，但仍有必要进一步提升，尤其是在传统健康促进策略未能有效覆盖的高风险亚群体中。过去旨在让个人改变风险因素的努力，忽略了那些导致疾病风险的环境因素。这表明需要一种综合方法，将问题作为个体行为所处系统的属性来处理。本文回顾了美国选定的健康趋势，讨论了当前健康促进方法的局限性，给出了预防的全面定义，并提供了有助于改善该国健康状况的规划原则。
