Abdalla Salma M, Maani Nason, Ettman Catherine K, Galea Sandro
Boston University School of Public Health, Boston, USA.
Brown University School of Public Health, Providence, USA.
Development (Rome). 2020;63(2-4):200-204. doi: 10.1057/s41301-020-00255-z. Epub 2020 Nov 10.
The global response to COVID-19 has been uneven and disappointing in the vast majority of countries. The United States has borne the largest absolute burden of disease globally, as COVID-19 exploited pre-existing poor population health among Americans to spread rapidly, with devastating consequences. Why does the country that spends the most on healthcare in the world have one of the worst responses to COVID-19? We argue that this is because the United States conception of health is predominantly focused on healthcare, an overwhelming investment in developing drugs and treatments, and an underinvestment in the foundational conditions that keep people healthy. COVID-19 has exposed the limits of this approach to health. In order to prevent COVID-19 and future such pandemics, we must create the conditions that can keep population-level health threats at bay. This means addressing the conditions that shape health, including economics, employment, community networks, racial disparities, how we treat older adults, and the physical layout of our communities. To do so means acknowledging health as a public good, as a transnational project with countries working together to build a healthier world. It also means acknowledging that everyone has a right to health. These aspirations should become core to the global community's health aspirations in the post-COVID-19 era.
在绝大多数国家，全球对新冠疫情的应对参差不齐且令人失望。美国承担了全球最大的绝对疾病负担，因为新冠病毒利用了美国民众先前存在的健康状况不佳，得以迅速传播，造成了毁灭性后果。为何这个在医疗保健方面投入最多的国家，对新冠疫情的应对却是最糟糕的之一呢？我们认为，这是因为美国的健康观念主要聚焦于医疗保健，在研发药物和治疗方法上投入巨大，而在维持民众健康的基础条件方面投入不足。新冠疫情暴露了这种健康观念的局限性。为了预防新冠疫情及未来类似的大流行，我们必须创造条件，遏制对人群健康的威胁。这意味着要解决影响健康的各种条件，包括经济、就业、社区网络、种族差异、我们对待老年人的方式以及社区的物质布局。这样做意味着承认健康是一种公共利益，是一个跨国项目，各国共同努力建设一个更健康的世界。这也意味着承认每个人都有健康权。这些愿望应成为全球社会在新冠疫情后时代健康愿景的核心。
