摘要
突如其来的新冠肺炎疫情让我们继2003年非典之后再次与传染性疾病正面遭遇,也让我们反思当下的公共卫生体系,尤其是公共卫生服务相对薄弱却面临更大的境外输入风险的民族地区,需要如何提升才能应对此次疫情和日后可能出现的其他公共卫生突发事件的冲击。少数民族地区的经济发展状况、地处边境或边疆地区等独特的自然地理环境和社会景观、恶劣的气候和不方便的交通运输,给大流行防控带来了较大的压力,也在一定程度上影响了公共卫生服务的可及性。少数民族地区的公共卫生体系与其他地区相比仍然相对薄弱,城乡不平衡仍然存在。回顾1949年中华人民共和国成立以来公共卫生体系的发展历程,我们会发现,我们积累了预防为主的政策等宝贵经验,也走过了过度市场化的弯路。因此,总结经验,吸取教训,结合少数民族地区的实际,明确政府、社会和公民在公共卫生服务体系中各自的定位、作用和责任,坚持预防为主的原则,加强国际合作,都是完善少数民族地区公共卫生体系的重要内容。
The improvement of public health services in ethnic minority areas is not only important for safeguarding the health of the people,but also of special significance in promoting unity as well as common development and prosperity of the ethnic peoples.Infectious diseases used to be the main threat to human life and hence the primary problem of public health.China is no exception.The health revolution in the 20th century and the consequent population transformation,however,have brought about irreversible changes in the spectrum of diseases:noncommunicable diseases have replaced infectious diseases as the main cause of disability and death,and the era of largescale infectious diseases seems to be behind us.Still,it should be noted that this change of disease patterns is not a successive but an overlapping trend.The threat of infectious diseases has never truly receded in the era of chronic diseases or degenerative diseases.This paper gives a review of both the transformation of the disease spectrum and the development of the public health system in ethnic minority areas since 1949 and it also summarizes the experience and lessons learned from these processes.Meanwhile,combined with the practice of prevention and control of the COVID19 epidemic,it discusses some possible ways to improve the public health systems in ethnic minority areas.The result of the study shows that:Public health services in ethnic minority areas have experienced many twists and turns since 1949,but they have survived all of the challenges and finally have developed into a wellfunctioning and relatively comprehensive system.Although the achievements are obvious,new problems have emerged.The shift of disease spectrum makes the current public health system in ethnic minority areas face the dual threat of chronic diseases as well as infectious ones.Meanwhile,the state of the economy in ethnic minority areas,their unique natural geographic environment,and their social landscape have brought greater pressure on pandemic prevention and control,and have also affected the accessibility of public health services to a certain extent.As a result,the public health systems in ethnic minority areas are still relatively weak compared with other regions,and the imbalance between urban and rural areas still exists.Looking back at history and analyzing the development of the public health system since the founding of the People's Republic of China in 1949,we can conclude we have gained valuable experience,but we also have been distracted too much by marketization.Therefore,learning from experience,clarifying the role and responsibility in the public health system of respectively government,society,and citizens,considering the practical reality of ethnic minority areas,adhering to the principle of putting disease prevention first,strengthening international cooperation,etc.are all important elements of improving the public health systems in ethnic minority areas.
作者
方静文
Fang Jingwen(Institute of Ethnology and Anthropology,Chinese Academy of Social Sciences,Beijing,100081,China)
出处
《民族学刊》
CSSCI
北大核心
2021年第4期33-40,114,共9页
Journal of Ethnology
基金
国家社会科学基金(青年项目)“产痛和癌痛的社会性与文化意义研究”(19CSH055)阶段性成果。
关键词
民族地区
公共卫生
疾病谱
预防为主
ethnic minority areas
public health
disease spectrum
putting disease prevention first