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多部门协作与社会民主在解决健康社会决定因素方面的比较

Multisector Collaboration vs. Social Democracy for Addressing Social Determinants of Health.

机构信息

University of North Carolina at Chapel Hill School of Medicine.

出版信息

Milbank Q. 2024 Jun;102(2):280-301. doi: 10.1111/1468-0009.12685. Epub 2023 Dec 29.

Abstract

Policy Points Multisector collaboration, the dominant approach for responding to health harms created by adverse social conditions, involves collaboration among health care insurers, health care systems, and social services organizations. Social democracy, an underused alternative, seeks to use government policy to shape the civil (e.g., civil rights), political (e.g., voting rights), and economic (e.g., labor market institutions, property rights, and the tax-and-transfer system) institutions that produce health. Multisector collaboration may not achieve its goals, both because the collaborations are difficult to accomplish and because it does not seek to transform social conditions, only to mitigate their harms. Social democracy requires political contestation but has greater potential to improve population health and health equity.

摘要

政策要点

多部门协作是应对不良社会条件造成的健康危害的主要方法,需要医疗保险机构、医疗保健系统和社会服务组织之间的协作。社会民主是一种未被充分利用的替代方法,它试图利用政府政策来塑造产生健康的公民(例如,公民权利)、政治(例如,投票权)和经济(例如,劳动力市场机构、财产权和税收-转移制度)制度。多部门协作可能无法实现其目标,这既是因为协作难以实现,也是因为它不寻求改变社会条件,而只是减轻其危害。社会民主需要政治竞争,但更有潜力改善人口健康和健康公平。

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