What is health? 什么是健康?
“Health is a state of complete physical, mental and social wellbeing, not merely the absence of disease or infirmity.” “健康是一种身体、心理和社会完全健康的状态,而不仅仅是没有疾病或虚弱。”
“A resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities.” “日常生活的资源,而不是生活的目标。健康是一个积极的概念,强调社会和个人资源,以及身体能力。
What is public health? 什么是公共卫生?
Whereas in medicine, the patient is an individual person, in public health, the ‘patient’ is the whole community or population. The goal of public health is to reduce disease and early death in populations. 在医学中,患者是个体,而在公共卫生中,“患者”是整个社区或人群。公共卫生的目标是减少人群的疾病和过早死亡。
– Dan Beauchamp and Bonnie Steinbock (1999) – 丹·博尚 (Dan Beauchamp) 和邦妮·斯坦博克 (Bonnie Steinbock) (1999)
Definition of public health is: 公共卫生的定义是:
contested 争议
differs according to different fields 根据不同领域而有所不同
changes by time 按时间更改
Three domains of public health (UK Faculty of Public Health, national professional body) 公共卫生的三个领域(英国公共卫生学院,国家专业机构)
Health improvement 健康改善
Health protection 保健
Health services 健康服务 rarr\rightarrow social determinants of health rarr\rightarrow 健康的社会决定因素
Three functions of public health rarr\rightarrow to enhance global health 公共卫生 rarr\rightarrow 的三大功能促进全球健康
Disease prevention and health promotion 疾病预防和健康促进
Risk/harm reduction 降低风险/危害
Early intervention 早期干预
Public Health vs. Medical Care 公共卫生与医疗保健
Public Health 公共卫生
Medical Care 医疗
Patient 病人
Community 社区
Individuals 个人
核心功能
Core
functions
Core
functions| Core |
| :--- |
| functions |
疾病预防 健康促进 延寿
Disease prevention
Health promotion
Life prolonging
Disease prevention
Health promotion
Life prolonging| Disease prevention |
| :--- |
| Health promotion |
| Life prolonging |
Treating ill persons 治疗病人
治疗之路
Road to
treatments
Road to
treatments| Road to |
| :--- |
| treatments |
O 更复杂 涉及政治决策
O More complicated
Involve political
decision
O More complicated
Involve political
decision| O More complicated |
| :--- |
| Involve political |
| decision |
由患者选择接受或不接受治疗
Up to the patient's
choice to accept the
treatment or not
Up to the patient's
choice to accept the
treatment or not| Up to the patient's |
| :--- |
| choice to accept the |
| treatment or not |
Recognition 识别
More abstract 更抽象
More obvious 更明显
为改善人口健康做出贡献
Contribution
to population
health
improvement
Contribution
to population
health
improvement| Contribution |
| :--- |
| to population |
| health |
| improvement |
Increase US life
expectancy by 25//30
years in 20^("th ") century| Increase US life |
| :--- |
| expectancy by $25 / 30$ |
| years in $20^{\text {th }}$ century |
提高美国的预期寿命
由 5//305 / 20 世纪的 30 年
Increase US life expectancy
by 5//305 / 30 years in 20 th century
Increase US life expectancy
by 5//30 years in 20 th century| Increase US life expectancy |
| :--- |
| by $5 / 30$ years in 20 th century |
Public Health Medical Care
Patient Community Individuals
"Core
functions" "Disease prevention
Health promotion
Life prolonging" Treating ill persons
"Road to
treatments" "O More complicated
Involve political
decision" "Up to the patient's
choice to accept the
treatment or not"
Recognition More abstract More obvious
"Contribution
to population
health
improvement" "Increase US life
expectancy by 25//30
years in 20^("th ") century" "Increase US life expectancy
by 5//30 years in 20 th century"| | Public Health | Medical Care |
| :--- | :--- | :--- |
| Patient | Community | Individuals |
| Core <br> functions | Disease prevention <br> Health promotion <br> Life prolonging | Treating ill persons |
| Road to <br> treatments | O More complicated <br> Involve political <br> decision | Up to the patient's <br> choice to accept the <br> treatment or not |
| Recognition | More abstract | More obvious |
| Contribution <br> to population <br> health <br> improvement | Increase US life <br> expectancy by $25 / 30$ <br> years in $20^{\text {th }}$ century | Increase US life expectancy <br> by $5 / 30$ years in 20 th century |
INTRODUCTION TO PUBLIC HEALTH 公共卫生概论
What is health? “Health is a state of complete physical, mental and social wellbeing, not merely the absence of disease or infirmity.” - WHO (1946) “A resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities.” - WHO (1986) What is public health? Whereas in medicine, the patient is an individual person, in public health, the ‘patient’ is the whole community or population. The goal of public health is to reduce disease and early death in populations. – Dan Beauchamp and Bonnie Steinbock (1999) Definition of public health is: o contested o differs according to different fields o changes by time 什么是健康?“健康是一种完整的身体、心理和社会福祉状态,而不仅仅是没有疾病或虚弱。”- 世界卫生组织 (1946) “日常生活的资源,而不是生活的目标。健康是一个积极的概念,强调社会和个人资源以及身体能力。- 世界卫生组织 (1986) 什么是公共卫生?在医学中,患者是个体,而在公共卫生中,“患者”是整个社区或人群。公共卫生的目标是减少人群的疾病和过早死亡。– Dan Beauchamp 和 Bonnie Steinbock (1999) 公共卫生的定义是: o 有争议的 o 根据不同的领域而不同 o 随时间变化 qquad\qquad
Three domains of public health (UK Faculty of Public Health, national professional body) 公共卫生的三个领域(英国公共卫生学院,国家专业机构)
Health improvement 健康改善
Health protection 保健
Health services à social determinants of health Three functions of public health à to enhance global health 1. Disease prevention and health promotion 卫生服务 à 健康的社会决定因素 公共卫生的三大职能 à 加强全球健康 1.疾病预防和健康促进
Risk/harm reduction 降低风险/危害
Early intervention 早期干预
Discipline of public health 公共卫生学科
1. Epidemiology 1. 流行病学
Science of public health 公共卫生科学
Study of the occurrence, distribution and determinants influencing healthrelated states or events in specified populations 研究影响特定人群中健康相关状态或事件的发生、分布和决定因素
Application of studying the influential determinants to control health problems 应用研究影响决定因素来控制健康问题
E.g.: environmental health, global health etc. 例如:环境健康、全球健康等。
Biostatistics 生物统计学
Application of statistics to health-related problems 将统计数据应用于健康相关问题
Used together with epidemiology 与流行病学一起使用
E.g.: Social & Behavioural Sciences, Biochemistry & Molecular Biology etc. 例如:社会与行为科学,生物化学与分子生物学等。
Health administration, policy, and engagement 卫生管理、政策和参与
Combines politics, business and science in managing human and financial resources needed to deliver effective public health services 将政治、商业和科学相结合,管理提供有效公共卫生服务所需的人力和财政资源
Improve public’s health through legislative action 通过立法行动改善公众健康
E.g.: Nutrition, Health economics etc. 例如:Nutrition, Health economics etc.
Importance of Public Health 公共卫生的重要性
Utilitarianism(功利主義) 功利主義
Maximise health in society 最大限度地提高社会健康
Communitarianism(社群主義)
Collective Responsibility 集体责任
Health of the whole population is beyond one individual’s responsibility for his/her own health 整个人口的健康超出了个人对自身健康的责任范围
3. Libertarianism(自由主義) 3. 自由主義
Protecting individual’s freedom to enjoy a healthy life 保护个人享受健康生活的自由