社会因素与健康
社会因素与健康
提纲 健康的决定因素 健康的公共政策 社会网络、社会支持和社会资本 社会经济状况 社会紧张因素
提 纲 • 健康的决定因素 • 健康的公共政策 • 社会网络、社会支持和社会资本 • 社会经济状况 • 社会紧张因素
Case study 1
Case Study 1
Fig. 6.1. Age-standardized death rates from tuberculosis in England and Wales,18401968 4000 3500 3000 Tubercle bacillus 500 identified g 2000 恶1500 1000 Chemotherapy 500 BCG vaccination 0 1840 1860 1880 1900 1920 1940 1960 Year Source: McKeown. 1976. Reproduced by kind permission of the publisher
请对这个图的意义谈 谈你的认识
Theodore Cooper指出 “我们的同行发现了一个重大而严肃的事 实:现代卫生保健对人们的影响可能低 于经济状况、教育、住房和环境卫生的 影响。我们的固有观念,即充足的、容 易得到的高质量卫生保健包治百病,纯 粹是一种虚构
Theodore Cooper指出： • “我们的同行发现了一个重大而严肃的事 实：现代卫生保健对人们的影响可能低 于经济状况、教育、住房和环境卫生的 影响。 我们的固有观念，即充足的、容 易得到的高质量卫生保健包治百病，纯 粹是一种虚构 ”
Case study 2 The experience of Eastern Europe Countries such as Poland, Hungary, Bulgaria, and Russia experienced steady improvements in life expectancy after World War‖ These increases ceased and life expectancies began to decline as the economies of these countries have faltered .In russia life expectancy has fallen from 65 years in 1987 to 59 years in 1993
Case Study 2 •Countries such as Poland, Hungary, Bulgaria, and Russia experienced steady improvements in life expectancy after World War II. •These increases ceased and life expectancies began to decline as the economies of these countries have faltered. •In Russia life expectancy has fallen from 65 years in 1987 to 59 years in 1993. The experience of Eastern Europe The experience of Eastern Europe
Case study 3 Economic growth and prosperity Japan best illustrates the relationship between narrow income spreads and improved overall health status. Between 1965 and 1990 it leaped ahead of all other industrialized countries despite increased dietary fat and increased smoking rates Life expectancy was 63.6 years for males and 67.8 years for females in 1955 By 1991 it had increased to 76. 1 for males and 82. 1 years for females
Case Study 3 Economic growth and prosperity •Japan best illustrates the relationship between narrow income spreads and improved overall health status. Between 1965 and 1990 it leaped ahead of all other industrialized countries despite increased dietary fat and increased smoking rates. •Life expectancy was 63.6 years for males and 67.8 years for females in 1955. •By 1991 it had increased to 76.1 for males and 82.1 years for females
社会经济、社会支持、个人自尊 和自我监控能力等都是对健康起 决定性作用的因素
社会经济、社会支持、个人自尊 和自我监控能力等都是对健康起 决定性作用的因素
健康决定因素
健康决定因素
HEALTH DETERMINANTS. Frenk(1991) Health is a crossroad where social and biological factors come together POPULATION C Cult Family Planning ture Genetic counselin 8 R HEALTH CARE Ideologi e Level of SYSTEM d Wealth Health L Sciencie romotion Living Technolo Conditions LIFESTYLES PRevention c ndividual R Ocupational o C Publicity Susceptibil G Political BloLoGlcA Structure INstitution k EDucation Fs a t Diagnosi in t+Social W HEALTH Z i Securit STATUS A Economic C Treatmen T Structure n Social Stratificat. c mArket DISEASE AGENTS R H Occupational Health Biolog Rlsk Vironm. health N Chemical k u Serv Pollution Physic ENVIRONMENTS (Environmental Risks
HEA LTH DE T ERMINAN T S. Frenk ( 1991) H ealth is a crossroad, w here social and biological f actors com e t ogether. S O C I A L O R G N I Z A T I O N P O P U L A T I O N St r uct u r e & Function of Bod y Cultur e & Ide ologi e S cie n cie & Te chnologi e Political Instit utio n s Eco n o mic St r uct u r e Lev el of We alth Ocu patio n al St r uct u r e S ocial St r atific at. R e d i s t r i b u t i o n M e c. HE A L T H C ARE SYST E M F a mily Planning E N V I R O N M E N T W o r k i n g C o n. O c c u p a t i o n R i k s Li ving Condition s ---- --- - - P ublicit y Ed u catio n So cial Secu rity Ma r k et Comi Hd a o u s In divid u al S usceptibility HE ALTH ST AT U S DIS E A S E AGEN T S (Biolog, Che mical Ph y sical) Pollutio n (E n viron m ental Ris k s) LIFES T Y LES F a m i l y S t r u c t O ccup ational H e alth SeEnvrvironm. Health Serv Diagno sis & Treatment G enetic cou nselin g Preventio n Health Promotio n B I O L O G I C A L R I S k S