新型冠状病毒肺炎疫情下健康不平等的社区治理应对思考——基于英国的分析

Addressing Neighbourhood Health Inequalities under the COVID-19 Pandemic:A Case Study from the United Kingdom

减少健康不平等是"健康中国"战略的核心目标之一。新型冠状病毒肺炎(以下简称"新冠肺炎")疫情的暴发不仅危害身体和心理健康,而且可能扩大健康不平等。虽然我国的新冠肺炎疫情防控工作已取得了众多阶段性成果,并逐渐成为他国借鉴的典范,但我国的健康规划特别是社区层面的治理工作起步较晚且对健康不平等的关注还略显不足。在梳理疫情下英国社区健康不平等的具体表现、形成机制的基础上,以伦敦为例进行具体分析,进一步总结疫情期间英国促进社区健康平等的政策措施、NHS(英国国家医疗服务体系)与多主体促进社区健康平等的协作机制,以及与社区规划相关的规划指引更新内容。通过分析,提出健康社区规划的建议:在健康社区规划中应该保证法制先行;完善短期政策并发展为长期政策;提高与政府紧密合作的多元主体的参与程度;增加覆盖弱势人群的范围并进行精细化管理。以期为国内的健康不平等研究提供参考,特别是为重大公共卫生事件下的健康不平等以及社区治理应对方案提供借鉴案例。

Reducing health inequalities is one of the core goals of the’Healthy China’strategy.The outbreak of COVID-19 not only harms physical health,but also widens health inequalities.Although China has made great achievements in COVID-19 prevention and control,and become a model for other countries,China’s health planning work,especially governance at the neighbourhood level started late and its attention on health inequalities,is still insufficient.This paper introduces the characteristics and formation mechanism of neighbourhood health inequalities,and takes London as an example for analysis in the UK during the COVID-19 pandemic.It further summarizes policy measures to promote neighbourhood health equality,the collaboration mechanism between NHS(National Health Service)and multi-agency to promote neighbourhood health equalities,and update planning guidelines related to neighbourhood planning.Based on the above analysis,this paper finally summarizes four suggestions for the healthy neighbourhood planning in China:(1)The legal system should be ensured first in the healthy neighbourhood planning;(2)Improving short-term policies and developing them into long-term policies;(3)Encouraging the participation of multi-agencies in-close partnership with the government;(4)Increasing the coverage of the vulnerable population and implementing refined management.The purpose of this paper is to provide a reference for research in China on health inequalities,especially for the health inequalities response plan and neighbourhood governance in the context of a major public health event.