Luepker R V
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55454-1015.
Prev Med. 1994 Sep;23(5):602-5. doi: 10.1006/pmed.1994.1097.
Community-wide or population approaches are essential in most health promotion and prevention strategies. However, much less is known about these methods compared with traditional clinical approaches. Why is the community approach essential? Most common health problems amenable to prevention have strong environmental, cultural, lifestyle, and behavioral components. People, communities, whole countries make choices about whether or not to consume alcohol, and drive, smoke cigarettes, exercise, or have their children immunized. All of these involve individual choices but also involve societal or cultural barriers and enticements, access, and availability, monetary and opportunity costs, laws, and other community-wide factors. While some prevention issues respond to traditional clinical or health care approaches, most do not. They require a coordinated community approach to support the preventive efforts of the health care sector and develop an environment and an educated population which makes prevention possible. If we are to approach true primary prevention or elimination of major health impairing conditions, the population approach is a necessary element.
在大多数健康促进和预防策略中，社区层面或针对全体人群的方法至关重要。然而，与传统临床方法相比，人们对这些方法的了解要少得多。为什么社区方法至关重要？大多数适合预防的常见健康问题都有很强的环境、文化、生活方式和行为因素。个人、社区乃至整个国家都会做出是否饮酒、开车、吸烟、锻炼或让孩子接种疫苗的选择。所有这些既涉及个人选择，也涉及社会或文化障碍与诱惑、获取途径、可得性、金钱和机会成本、法律以及其他社区层面的因素。虽然一些预防问题可以通过传统临床或医疗保健方法解决，但大多数问题并非如此。它们需要一种协调一致的社区方法来支持医疗保健部门的预防工作，并营造一个使预防成为可能的环境和培养有知识的人群。如果我们要真正实现初级预防或消除主要的健康损害状况，针对全体人群的方法是一个必要要素。
