Iannantuono A, Eyles J
Department of Geography, McMaster University, Hamilton, Ontario, Canada.
Soc Sci Med. 1997 Jun;44(11):1611-21. doi: 10.1016/s0277-9536(96)00255-9.
This paper presents a textual analysis of a key Canadian health policy document--Achieving Health for All (AHFA). It begins by establishing the importance of policy language and an interpretive approach to reveal dominant meanings and assumptions. This approach points out the significance of language and its contexts (text and intertext) and of developing a formal analytic strategy, based on semiotics. The paper concludes with a detailed, illustrated analysis of AHFA, suggesting that the document's discourse, through appealing to all, with emphases on the nation, community and all Canadians, establishes a frame of individual responsibility and rights, health promotion and broad health determinants--a frame that resonates with the cost-constrained nature of health care delivery-as found in provincial reform documents in the 1980s and 1990s.
本文对加拿大一份关键的卫生政策文件——《实现全民健康》（AHFA）进行了文本分析。文章开篇阐述了政策语言的重要性以及一种用于揭示主导意义和假设的解释性方法。这种方法指出了语言及其语境（文本和互文）的重要性，以及基于符号学制定正式分析策略的重要性。文章最后对AHFA进行了详细且配有说明的分析，表明该文件的论述通过呼吁全体民众，强调国家、社区和所有加拿大人，构建了个人责任与权利、健康促进以及广泛的健康决定因素的框架——这一框架与20世纪80年代和90年代省级改革文件中所体现的医疗保健服务成本受限的性质相呼应。
