Department of Health Management and Policy, University of Michigan, Ann Arbor, MI, USA.
European Observatory on Health Systems and Policies, Brussels, Belgium.
Glob Public Health. 2021 Aug-Sep;16(8-9):1209-1222. doi: 10.1080/17441692.2021.1916831. Epub 2021 Apr 20.
It is easy but mistaken to think that public health emergency measures and social policy can be separated. This paper compares the experiences of Brazil, Germany, India and the United States during their 2020 responses to the COVID-19 pandemic to show that social policies such as unemployment insurance, flat payments and short-time work are crucial to the effectiveness of non-pharmaceutical interventions as well as to their political sustainability. Broadly, public health measures that constrain economic activity will only be effective and sustainable if paired with social policy measures that enable people to comply without sacrificing their livelihoods and economic wellbeing. Tough public health policies and generous social policies taken together proved a success in Germany. Generous social policies uncoupled from strong public health interventions, in Brazil and the US during the summer of 2020, enabled lockdown compliance but failed to halt the pandemic, while tough public health measures without social policy support rapidly collapsed in India. In the COVID-19 and future pandemics, public health theory and practice should recognise the importance of social policy to the immediate effectiveness of public health policy as well as to the long-term social and economic impact of pandemics.
认为公共卫生紧急措施和社会政策可以分开是很容易但也是错误的。本文比较了巴西、德国、印度和美国在 2020 年应对 COVID-19 大流行期间的经验，表明失业救济金、定额付款和缩短工时等社会政策对于非药物干预措施的有效性以及其政治可持续性至关重要。广义而言，如果将限制经济活动的公共卫生措施与使人们能够在不牺牲生计和经济福祉的情况下遵守的社会政策措施相结合，那么这些限制经济活动的公共卫生措施才会有效且可持续。在德国，严格的公共卫生政策和慷慨的社会政策结合在一起取得了成功。在 2020 年夏季，巴西和美国实行了慷慨的社会政策，没有强有力的公共卫生干预措施，这使得民众能够遵守封锁措施，但未能阻止疫情蔓延，而没有社会政策支持的严格公共卫生措施在印度迅速崩溃。在 COVID-19 和未来的大流行中，公共卫生理论和实践应该认识到社会政策对于公共卫生政策的即时有效性以及大流行对社会和经济的长期影响的重要性。
