“We invited the disease to come to us”: neoliberal public health discourse and local understanding of non-communicable disease causation in Fiji
“We invited the disease to come to us”: neoliberal public health discourse and local understanding of non-communicable disease causation in Fiji
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“我们邀请疾病来到我们身边”：新自由主义公共卫生话语和斐济当地人对非传染性疾病因果关系的理解
DOI：
10.1080/09581596.2017.1329521
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
M. O’Keefe
中科院分区：
文献类型：
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作者：
Tarryn Phillips;C. McMichael;M. O’Keefe
摘要 全球非传染性疾病（NCD）发病率正在上升，特别是在低收入和中等收入国家。重要的公共卫生学者认为，虽然政治和社会经济因素在特定环境下影响健康结果，但新自由主义公共卫生努力倾向于强调个人责任，以避免行为风险和“选择”健康。然而，对于这些关于非传染性疾病个人责任的话语如何被南半球目标人群内化、抵制或适应的分析却很少。本文通过考察斐济当地人对非传染性疾病因果归因的理解来实现这一目标。数据来自对奥瓦劳岛门诊患者、村民和医护人员的定性研究（n = 68）。居民认为个人选择是健康状况不佳的主要原因。虽然他们提到了非传染性疾病的一些社会、历史和精神决定因素，但社区成员已经内化了新自由主义的治理方式，在这种治理方式中，个人对预防疾病负有道德责任。此外，这些关于非传染性疾病的信息与斐济社会提倡个人责任的其他话语相互交叉——例如殖民遗产、传统性别角色和基督教。这种新自由主义在当地的适应再现了历史上根深蒂固的关于斐济原住民是不负责任公民的刻板印象，并模糊了社区对非传染性疾病问题结构性决定因素的认识和反应。
Abstract Rates of non-communicable diseases (NCDs) are increasing globally, particularly amongst low- and middle-income countries. Critical public health scholars have argued that while political and socio-economic factors shape health outcomes within particular environments, neoliberal public health efforts tend to emphasise individual responsibility to avoid behavioural risks and ‘choose’ health. Yet there is little analysis of how these discourses about personal responsibility for NCDs are internalised, resisted or adapted by target populations in the Global South. This paper does so by examining local understandings of causal attribution for NCDs in Fiji. Data are drawn from qualitative research with outpatients, villagers and health care staff on the island of Ovalau (n = 68). Residents deem individual choices to be the principal cause of poor health outcomes. While they mention some social, historical and spiritual determinants of NCDs, community members have internalised a neoliberal governmentality, in which individuals are held morally accountable for preventing disease. Moreover, these messages about NCDs intersect with other discourses that promote personal responsibility in Fijian society – such as colonial legacies, traditional gender roles and Christianity. This local adaptation of neoliberalism reproduces historically entrenched stereotypes about Indigenous Fijians as irresponsible citizens, and obscures community recognition and response regarding the structural determinants of the NCD problem.
TPP 下的知识产权和争端解决：国际公法视角
DOI：
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发表时间：
2016
期刊：
影响因子：
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作者：
安藤至大,大内伸哉,川口大司,佐野晋平,島田陽一;水島朋則
通讯作者：
水島朋則
面条叙事：二十一世纪工业食品的全球崛起
DOI：
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发表时间：
2013
期刊：
影响因子：
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作者：
Shirakawa;H;Tatsuro Fujikura
通讯作者：
Tatsuro Fujikura