Prost A
Organisation mondiale de la santé, Genève, Suisse.
Sante. 1995 Nov-Dec;5(6):331-3.
With the onset of science-based medicine in the mid-19th century, environmental factors were almost totally discarded as health determinants. This was a complete rupture with the medical thinking which had prevailed since the time of Hippocrates. Yet, for the vast majority of mankind, harmony with environmental reality remains the most important determinant of good or ill health. This scission explains to a great extent the differences between traditional and Western medicine, which are based on entirely different concepts and on distinct paradigms. Environment as a health determinant--in its broadest definition to include both physical and social environments--is again being considered of importance as a result of better understanding of causality factors, and because of the influence of disciplines such as ecology and epidemiology. Here we show that human societies can develop different methods of adjusting to their environments, some of which would increase the risks of disease and others which can be considered as resistance factors of a social nature. Societies and individuals alike are not equal in relation to health risks.
随着19世纪中叶基于科学的医学的兴起，环境因素几乎完全被摒弃在健康决定因素之外。这与自希波克拉底时代以来盛行的医学思想完全决裂。然而，对于绝大多数人类来说，与环境现实的和谐仍然是健康好坏的最重要决定因素。这种分裂在很大程度上解释了传统医学和西医之间的差异，它们基于完全不同的概念和截然不同的范式。由于对因果因素有了更好的理解，以及受生态学和流行病学等学科的影响，环境作为一种健康决定因素——从最广泛的定义来看，包括物理环境和社会环境——再次被认为具有重要意义。在这里我们表明，人类社会可以发展出不同的适应环境的方法，其中一些方法会增加疾病风险，而其他一些方法则可被视为具有社会性质的抵抗因素。社会和个人在健康风险方面并不平等。
