Carstairs Catherine
College of Arts, University of Guelph, Guelph, ON, Canada.
Can J Public Health. 2025 Aug;116(Suppl 1):15-21. doi: 10.17269/s41997-025-01063-z. Epub 2025 Sep 17.
The Lalonde Report, A New Perspective on the Health of Canadians, is rightly celebrated as an important Canadian contribution to the development of health promotion. It introduced the "Health Field Concept"-the idea that health was the result of human biology, health care systems, the environment, and lifestyle. Although the health field concept was new, the report drew on a long tradition within public health of blaming individuals for their own health problems. With less evidence, some scholars have also made the case for the Lalonde Report contributing to the social determinants of health. But A New Perspective paid little attention to the systemic barriers that prevented people from eating well, exercising, drinking less, or quitting smoking. While it occasionally acknowledged the constraints of poverty, the focus was much more on people's individual responsibility to improve their health. This paper contextualizes the Lalonde Report in the longer history of public health campaigns in Canada and shows the extent to which the Lalonde Report was a product of its time, age, and authors. At the end, the paper will address the intellectual origins of the social determinants of health and argue that the Lalonde Report made only a marginal contribution to the social determinants of health.
《拉隆德报告：加拿大人健康的新视角》被誉为加拿大对健康促进发展的一项重要贡献，这是当之无愧的。它引入了“健康领域概念”——即健康是人类生物学、医疗保健系统、环境和生活方式共同作用的结果。尽管健康领域概念是全新的，但该报告借鉴了公共卫生领域长期以来将个人自身健康问题归咎于个人的传统。一些学者在证据不足的情况下，也认为《拉隆德报告》对健康的社会决定因素有所贡献。但《新视角》几乎没有关注到那些阻碍人们合理饮食、锻炼、少饮酒或戒烟的系统性障碍。虽然它偶尔承认贫困的限制，但重点更多地放在人们改善自身健康的个人责任上。本文将《拉隆德报告》置于加拿大公共卫生运动的更长历史背景中，展示了《拉隆德报告》在多大程度上是其时代、年代和作者的产物。最后，本文将探讨健康社会决定因素的知识起源，并认为《拉隆德报告》对健康社会决定因素的贡献微乎其微。
