A conceptual framework for public health: NICE's emerging approach.
A conceptual framework for public health: NICE's emerging approach.
复制标题
DOI：
10.1016/j.puhe.2008.10.031
复制
发表时间：
2009-01-01
期刊：
影响因子：
5.2
通讯作者：
Bonnefoy, J
中科院分区：
文献类型：
--
作者：
Kelly, M P;Stewart, E;Bonnefoy, J
本文概述了国家卫生和临床卓越研究所（NICE）新兴的公共卫生概念框架。这是根据NICE前三年（2005-2008年）编制公共卫生指南的经验得出的。该框架已被用于对NICE的公共卫生程序和方法手册进行修订，供2009年后使用，并将为NICE将于2009年4月编制的公共卫生指南提供信息。该框架基于这样一个概念，即个人和群体的疾病模式都有因果机制。它们在分析上是分开的。个别疾病的诊断涉及生物、社会和相关现象之间的相互作用。人口模式的演变涉及相同的相互作用，但也涉及一系列其他现象之间的额外相互作用。这些被描述。因此，因果途径涉及健康的社会、经济和政治决定因素以及心理和生物因素。四个矢量的因果关系：人口，环境，组织和社会。概述了载体与人类行为之间的相互作用。更广泛的决定因素和个人健康结果之间的桥梁是生命过程和生活世界的整合。
This paper outlines the National Institute for Health and Clinical Excellence's (NICE) emerging conceptual framework for public health. This is based on the experience of the first 3 years of producing public health guidance at NICE (2005-2008). The framework has been used to shape the revisions to NICE's public health process and methods manuals for use post 2009, and will inform the public health guidance which NICE will produce from April 2009. The framework is based on the precept that both individual and population patterns of disease have causal mechanisms. These are analytically separate. Explanations of individual diseases involve the interaction between biological, social and related phenomena. Explanations of population patterns involve the same interactions, but also additional interactions between a range of other phenomena working in tandem. These are described. The causal pathways therefore involve the social, economic and political determinants of health, as well as psychological and biological factors. Four vectors of causation are identified: population, environmental, organizational and social. The interaction between the vectors and human behaviour are outlined. The bridge between the wider determinants and individual health outcomes is integration of the life course and the lifeworld.