Hernández-Peña P, Gutiérrez-Zúñiga C, Zurutuza-Fernández R, Jiménez-González O
Departamento de Economía de la Salud, Escuela de Salud Pública de México (ESPM), Instituto Nacional de Salud Pública (INSP), Cuernavaca.
Salud Publica Mex. 1993 Mar-Apr;35(2):119-31.
This work offers an overview of the state of the art and future state of environmental health in our country from a viewpoint of the impact of the commercial opening established in the Free Trade Agreement among Mexico, the USA, and Canada. In the first section of this work, we analyze the expected economic changes resulting from the implementation of the FTA and foretells the way in which those changes will influence the present environmental and epidemiologic profiles of this country in the medium and long term. The main changes predicted by the analysis are, in the epidemiologic context, the acceleration of the transference of occupational, consumption, environmental and population risks, characteristic of industrialized countries, to the country's polarized epidemiologic profile; and, in the environmental context, a transition consisting of a broadening and composition of the spectrum of pollutants, including and important lagging of bacteriologic control. The second section offers an analysis of the predicted response capacity facing the new environmental risk dynamics in the country, encompassing regulation, normativeness and enforcement of environmental and consumer protection, as well as obstacles found in health services to the implementation of surveillance, detection and treatment of health damages caused by environmental factors. The analysis of the organized social response to these problems discloses a relative flexibility of the normativeness and enforcement functions in comparison with our northern neighbors, a paramount factor for the possible transference of environmental risks, as well as the informational and research deficiency about environmental issues, basic elements for sustaining environmental health in the country, aiming at speeding up the development and transference of technologies for prevention, detection and management of environmental risks in the country, drawing upon the systematization of our experience and that of our neighbors. This speeding process ought to match, in the medium term, the velocity of risk transference produced by the commercial opening. In this way, the commercial integration of North America will become a favorable context for the development of the environmental health infrastructure of the country.
这项工作从墨西哥、美国和加拿大之间自由贸易协定中商业开放的影响这一视角，概述了我国环境卫生的现状与未来状况。在这项工作的第一部分，我们分析了自由贸易协定实施后预期的经济变化，并预测这些变化将在中长期对该国当前的环境和流行病学状况产生影响的方式。分析预测的主要变化在流行病学方面，是将工业化国家特有的职业、消费、环境和人口风险转移加速，使该国两极分化的流行病学状况呈现这些特征；在环境方面，是一种转变，包括污染物谱的拓宽和构成变化，包括细菌学控制方面的重大滞后。第二部分分析了该国面对新的环境风险动态预计的应对能力，涵盖环境和消费者保护的监管、规范性和执法，以及卫生服务在实施对环境因素造成的健康损害的监测、检测和治疗方面存在的障碍。对有组织的社会对这些问题的应对分析表明，与我们的北方邻国相比，规范性和执法职能具有相对灵活性，这是环境风险可能转移的一个关键因素，以及关于环境问题的信息和研究不足，而这些是该国维持环境卫生的基本要素，目的是加快该国预防、检测和管理环境风险技术的开发和转移，借鉴我们自己和邻国经验的系统化。这个加速过程在中期应该与商业开放产生的风险转移速度相匹配。这样，北美商业一体化将成为该国环境卫生基础设施发展的有利环境。
