Social inequalities and emerging infectious diseases.
Social inequalities and emerging infectious diseases.
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DOI：
10.3201/eid0204.960402
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发表时间：
1996-10
影响因子：
11.8
通讯作者：
Farmer, P
中科院分区：
文献类型：
--
作者：
Farmer, P
虽然许多研究新发传染病的人赞同疾病的社会生产理论，但很少有人研究社会不平等对疾病出现的贡献。然而，这种不平等不仅有力地塑造了传染病的分布，也塑造了受感染者的病程。埃博拉、艾滋病和结核病的爆发表明，疾病出现的模式必须是动态的、系统的和关键的。这些模型力求将变化和复杂性结合起来，既具有全球性，又能适应地方差异。它们对轻率的因果关系主张，尤其是那些缺乏社会不平等致病作用的主张，持批评态度。对新发感染的批判性观点是，在日益相互联系的人群中，大规模的社会力量如何影响处于不平等地位的个人；新发传染病的关键认识论询问疾病出现的哪些特征被主流分析框架所掩盖。这种对疾病出现的重新审视所产生的研究问题需要基础科学家、临床医生、采用这种观点的社会科学家和流行病学家之间的密切合作。
Although many who study emerging infections subscribe to social-production-of-disease theories, few have examined the contribution of social inequalities to disease emergence. Yet such inequalities have powerfully sculpted not only the distribution of infectious diseases, but also the course of disease in those affected. Outbreaks of Ebola, AIDS, and tuberculosis suggest that models of disease emergence need to be dynamic, systemic, and critical. Such models--which strive to incorporate change and complexity, and are global yet alive to local variation--are critical of facile claims of causality, particularly those that scant the pathogenic roles of social inequalities. Critical perspectives on emerging infections ask how large-scale social forces influence unequally positioned individuals in increasingly interconnected populations; a critical epistemology of emerging infectious diseases asks what features of disease emergence are obscured by dominant analytic frameworks. Research questions stemming from such a reexamination of disease emergence would demand close collaboration between basic scientists, clinicians, and the social scientists and epidemiologists who adopt such perspectives.