19世纪英国“因病致贫”论与公共卫生管理

The Theory of “Poverty Caused by Illness” and Public Health Management in Britain in the 19th century

19世纪中期,随着英国城镇化进程加速,公共卫生环境日益恶化;以查德威克为代表的有识之士通过调查,认为卫生环境恶化导致疫病流行,不仅危害个体健康,进而可能引发贫困普及,出现道德崩坏、伦理失序和国力衰退等糟糕后果;建议国家必须全面彻底地介入公共卫生管理,改良环境卫生,保障民众身心健康与社会稳定繁荣,并将此作为中央政府赈济贫困的必备策略,以便匡扶社会公平与正义;这种“因病致贫”论将卫生、济贫与经济发展、社会正义联系起来,深刻影响了英国公共卫生管理制度的构建,并为后续福利国家的建设与发展奠定了基础。

In the mid-19century, with the acceleration of urbanization in Britain, the public health environment was deteriorating day by day. Through investigation, men of insight represented by Chadwick believed that the deterioration of the health environment would lead to epidemic diseases, which would not only endanger the health of individuals, but also may lead to the spread of poverty, moral collapse,ethical disorder and national strength decline. Therefore, it was suggested that the state must fully and thoroughly intervene in public health management, improve environmental health, ensure the physical and mental health of the people as well as social stability and prosperity, and take this as a necessary strategy for the central government to relieve poverty, so as to uphold social equity and justice. This theory of “poverty caused by illness” linked health, poverty relief with economic development and social justice, which profoundly affected the construction of the British public health management system, and laid a foundation for the subsequent construction and development of the welfare state.