Department of Political Studies, Queen's University, Kingston, Ontario, K7L 3N6, Canada.
Aging Dis. 2024 Apr 1;15(2):449-458. doi: 10.14336/AD.2023.0721.
Despite unprecedented investments in public health and biomedical research, improvements in life expectancy and healthy life expectancy have stagnated in the United States. Part of the reason for this development can be traced back to the influence of "Protean" over "Post-Protean" public health, the names that can be given to two contrasting visions of public health advanced in the early twentieth century. Protean public health prescribes "waging a war" against disease and was successful in reducing the early-life mortality risks from infectious disease. But Protean public health has proven less effective in improving the quality of life of older persons. Post-Protean public health prioritizes the experimental method and research into the indirect methods of improving health. It articulated a vision of public heath that was given a more concrete specification by Alex Comfort in what is now referred to as the Geroscience Hypothesis. To improve the health prospects of aging populations the dominance of Protean public health must be relaxed, to enable the benefits of Post-Protean public health to be realized. Doing so means shifting public health's aspirations towards increasing the healthspan vs "saving lives" by extending the duration of time older persons can survive by managing the multi-morbidities of late life.
尽管在公共卫生和生物医学研究方面投入了前所未有的资金，但美国的预期寿命和健康预期寿命的提高却停滞不前。这种情况的部分原因可以追溯到“多变型”对“后多变型”公共卫生的影响，这两个名称可以用来描述 20 世纪早期提出的两种截然不同的公共卫生愿景。多变型公共卫生提倡“与疾病作斗争”，成功降低了传染病导致的早期死亡风险。但多变型公共卫生在改善老年人的生活质量方面效果不佳。后多变型公共卫生优先考虑实验方法和研究改善健康的间接方法。它阐述了一种公共卫生愿景，这一愿景在 Alex Comfort 的著作中得到了更具体的说明，现在被称为衰老科学假说。为了改善老龄化人口的健康前景，必须放松多变型公共卫生的主导地位，以实现后多变型公共卫生的效益。这样做意味着将公共卫生的愿望转向通过管理晚年的多种疾病来增加健康寿命，而不是通过延长老年人能够生存的时间来“延长生命”。
