Bonner, A.Social Determinants of Health: An Interdisciplinary Approach to Social Inequality and Well-Being, Bristol, UK: Policy Press2018. £29.99 (pbk) £34.79 (ebk) ISBN 978-1-4473-3685-3
Bonner, A.Social Determinants of Health: An Interdisciplinary Approach to Social Inequality and Well-Being, Bristol, UK: Policy Press2018. £29.99 (pbk) £34.79 (ebk) ISBN 978-1-4473-3685-3
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Bonner, A.《健康的社会决定因素：社会不平等和福祉的跨学科方法》，布里斯托尔，英国：政策出版社 2018 年。
DOI：
10.1111/1467-9566.13036
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发表时间：
2019
影响因子：
2.9
通讯作者：
Plessas A
中科院分区：
文献类型：
--
作者：
Plessas A
健康的社会决定因素是什么？为什么弱势群体最容易受到健康状况不佳的影响？尽管世界各地的卫生和医疗技术取得了重大发展，许多国家的健康状况也普遍改善，但持续存在的卫生不平等现象意味着，特别是边缘化和弱势社会群体的健康和福祉改善有限。在英国，尽管预期寿命有所延长，但健康不平等现象继续加剧，并在社会中根深蒂固。这就产生了如何最好地解决当代社会和健康不平等的问题，这也是本书的核心问题。这本书提出了一个跨学科的方法来理解和解决这个问题。它是由来自广泛学科背景的专家撰写的23篇文章的合集，每一篇文章都反映了当代卫生不平等背后的因素，以及可能的社会、经济或基于健康的解决方案。这些文章被组织成六个部分，反映了Dahlgren和Whitehead（1991）关于健康的社会决定因素的“彩虹”模型。其中包括关于生活机会的部分；生活的挑战;社会和社区网络；就业和住房；支持处于社会边缘的人；还有社会政治环境。在大多数情况下，这些分组工作很好，反映了个人生活因素和促进社会和社区凝聚力的地方努力在影响健康不平等方面的核心重要性，以及必须解决的宏观层面的力量，以便有效减少健康不平等。然而，考虑到这一概念的相对模糊性，对“健康的社会决定因素”这一实际概念进行一些评估可能会有所帮助。尽管如此，这本书从微观和地方层面逐渐过渡到更广泛的社会政治景观，引起了人们对这些层面上的政策行动需求的关注，同时也使读者能够根据自己的目标和兴趣深入阅读章节。在书的开头几章中，Bonner和Kerr等作者将早期生活经历确定为健康的主要社会决定因素。这一主题后来在赫瑟林顿和哈姆雷特探讨无家可归的原因和根源的章节中也得到了呼应。这些章节很重要，不仅因为它们认识到遗传因素和早期生活经历之间复杂的相互作用，这可以显著影响整个生命过程中的健康，还因为它们强调需要一种方法来解决这些问题的复杂性。然而，科尔斯的章节之所以引人注目，是因为它确定了一个阶段，而不是早期，在这个阶段有可能干预减少健康不平等。本章探讨了社会企业在帮助没有接受正规教育、就业或培训的年轻人从事有意义的工作（与良好的心理健康和福祉密切相关的工作）方面的潜在变革作用。这证明旨在改善社会环境和现有成年和青年人口的生活机会的政策仍然可以具有巨大的社会和经济价值。这本书整体上非常强调政治——更具体地说是紧缩政治——在扩大和维持英国健康和社会不平等方面的作用。Bambra， Garthwaite和Murphy关于健康的地缘政治方面的章节之所以引人注目，某种程度上是因为它明确地确定了空间健康不平等的结果……
What are the social determinants of health and why are disadvantaged groups most vulnerable to poor health? Despite significant developments in health and medical technology around the world, and a general improvement in health in many countries, persistent health inequalities mean particularly marginalised and vulnerable social groups have experienced limited improvement in their health and wellbeing. In the UK, despite an extension in life expectancy rates, health inequalities have continued to grow and remain engrained in society. This generates the question of how best to tackle contemporary social and health inequalities, a question at the centre of this book. The book proposes an interdisciplinary approach to understanding and addressing this question. It is a collection of 23 essays by experts from a wide range of disciplinary backgrounds, each reflecting on the factors behind contemporary health inequalities, as well as possible social, economic or health-based solutions. The essays are organised into six parts, reflecting Dahlgren and Whitehead’s (1991)‘rainbow’model of the social determinants of health. These include sections on life chances; lifestyle challenges; social and community networks; employment and housing; supporting people at the edge of the community; and the socio-political environment. For the most part, these groupings work very well, reflecting the central importance of individual life factors and locally based efforts promoting social and community cohesion, in influencing health inequalities, alongside those macro level forces that must be addressed in order to bring about effective reductions in health inequality. It may however, given the concept’s relative ambiguity, have been helpful to have opened the book with some evaluation of the actual concept of ‘social determinants of health’. Nonetheless, the book’s gradual transition from the micro-and local-level, to the wider socio-political landscape draws attention to the need for policy action at each of these levels, while also enabling readers to dip in and out of chapters according to their aims and interests. Early life experiences are identified as a major social determinant of health by authors such as Bonner and Kerr, in the book’s opening few chapters. This theme is also echoed later, in Hetherington and Hamlet’s chapter exploring some of the causes of, and roots into homelessness. These chapters are important, not only because they recognise the complex interactions between genetic factors and early life experiences which can significantly influence wellbeing throughout the life course, but also because of their emphasis on the need for an approach equipped for tackling the complexity of these issues. Coles’ chapter, however, stands out because of its identification of a stage other than the early years at which it is possible to intervene in reducing health inequalities. The chapter explores social enterprise’s potentially transformative role in helping young people not in formal education, employment or training become engaged in meaningful employment (something strongly linked with good mental health and wellbeing). It is testament to how policies aimed at improving the social environments and life chances of existing adult and young adult populations can still be of immense societal and economic value. The book as a whole places significant emphasis on the role of politics–and more specifically austerity politics–in widening and sustaining health and social inequalities in the UK. Bambra, Garthwaite and Murphy’s chapter on geopolitical aspects of health stands out somewhat because of its explicit identification of spatial health inequalities as resulting …