健康公平——概念、影响因素与政策

Equity in health:characteristics, determinants and policy

长期以来健康不平等和不公平一直是卫生改革与发展所关注的重点 ,并已经成为了国际卫生政策的主要方向。在国家之间健康不平等和不公平也存在不同的理解。发达国家主要集中在产生疾病和导致死亡率差异的社会经济阶层的形成机制 ,将健康不平等作为疾病病原学的一个函数 ,关键措施是加强初级卫生保健 ;在中低收入国家 ,人们却趋向于通过提供基本的医疗保健服务来解决这一问题。

Inequalities and inequities in health have long been central to the concerns of health care system reform and development, and have been pushed up to the global health policy agenda. Health inequalities and inequities within countries are not understood in the same way throughout the world. The research on inequalities in health has focused on the mechanisms that generate socioeconomic gradients in ill health and mortality in the developed countries.From this perspective, inequalities in health are mainly a function of the aetiology of disease, and the key policy solutions are primary health care and prevention. In low and middle income countries,people working on inequalities in health tend to see the problem as one of devising policies to ensure more equitable provision of basic health care.