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继拉隆德之后界定公共卫生领域的公众:20世纪70年代至90年代英国的视角

Defining the public in public health after Lalonde: the view from the United Kingdom, 1970s‒1990s.

作者信息

Mold Alex

机构信息

School of Hygiene & Tropical Medicine, London, England.

出版信息

Can J Public Health. 2025 Aug;116(Suppl 1):39-49. doi: 10.17269/s41997-025-01071-z. Epub 2025 Sep 17.

Abstract

This article considers the impact of the Lalonde report on ideas about the public and public health in the United Kingdom from the 1970s to the 1990s. It begins by assessing how "the public" within the context of public health has been thought of. Three key modes are identified: the public as the whole population, as groups, and as individuals. An examination of the Lalonde report, and its British equivalent, Prevention and Health, Everybody's Business, points to the presence of these three ways of thinking about the public. Nonetheless, the role of the individual in disease prevention appeared to dominate both the Lalonde report and Prevention and Health. The influence of this approach is traced through an analysis of British health education campaigns around alcohol from the 1970s to the early 1990s. The target of such efforts changed over time, away from alcoholics and heavy drinkers and towards creating "sensible drinkers". Although alcohol health education campaigns were directed at getting individuals to change their drinking behaviour, they also took into account a population-level view of alcohol consumption. The current article concludes by suggesting that a reappraisal of Lalonde and Prevention and Health points to the existence of collective, as well as individual-based, ways of thinking about publics and doing public health.

摘要

本文探讨了拉隆德报告对20世纪70年代至90年代英国关于公众与公共卫生观念的影响。文章开篇评估了在公共卫生背景下,“公众”是如何被看待的。确定了三种关键模式:公众作为全体人口、作为群体以及作为个体。对拉隆德报告及其英国同类报告《预防与健康:人人有责》的审视表明,存在这三种看待公众的方式。尽管如此,个体在疾病预防中的作用在拉隆德报告和《预防与健康》中似乎都占据主导地位。通过对20世纪70年代至90年代初英国围绕酒精的健康教育运动的分析,追溯了这种方法的影响。这些努力的目标随时间而变化,从酗酒者和重度饮酒者转向培养“理性饮酒者”。尽管酒精健康教育运动旨在促使个体改变饮酒行为,但它们也考虑到了饮酒消费的人口层面观点。本文最后指出,对拉隆德报告和《预防与健康》的重新评估表明,存在基于集体以及基于个体的看待公众和开展公共卫生工作的方式。

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