Revitalising the evidence base for public health: an assets model
Revitalising the evidence base for public health: an assets model
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重振公共卫生证据基础：资产模型
DOI：
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发表时间：
2007
期刊：
影响因子：
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通讯作者：
E. Ziglio
中科院分区：
文献类型：
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作者：
A. Morgan;E. Ziglio
从历史上看，促进人口健康的方法一直是基于赤字模式。也就是说，它们往往侧重于查明需要专业资源和高度依赖医院和福利服务的人口的问题和需求。这些赤字模型对于确定需求和优先事项的水平非常重要和必要。但是，由于它们存在一些缺陷，需要其他一些观点的补充。赤字模型往往以负面的方式定义社区和个人，而忽视积极的、在特定人群中有效的东西。与此相反，“资产”模式往往强调查明问题和启动解决办法的积极能力。它们侧重于促进有益健康的资源，促进个人和社区的自尊和应对能力，最终减少对专业服务的依赖。决策者在就促进健康和解决卫生不公平问题的最有效办法作出决定时所掌握的许多证据都是以赤字模式为基础的，这可能会不成比例地导致政策和做法剥夺本应从中受益的人口和社区的权力。对健康和发展采取资产办法，包括创造健康的“有益健康”的概念，并在这样做时鼓励地方社区充分参与健康发展进程。这里提出的资产模型旨在振兴政策制定者，研究人员和从业人员如何思考和采取行动，以促进更足智多谋的方法来解决卫生不公平问题。该模型概述了一种基于资产的公共卫生系统方法，可以为如何最大限度地增加促进健康所需的关键资产存量提供科学证据和最佳实践。重新调整循证公共卫生的资产和赤字模型之间的平衡，可以帮助我们解开一些现有的障碍，对卫生不公平采取有效行动。这种重新平衡将有助于更好地了解影响健康的因素以及可以采取的措施。它将促进采取积极和包容性的行动方针。（《促进和教育》，2007年，补编（2）：第17-22页）。
Historically, approaches to the promotion of population health have been based on a deficit model. That is, they tend to focus on identifying the problems and needs of populations that require professional resources and high levels of dependence on hospital and welfare services. These deficit models are important and necessary to identify levels of needs and priorities. But they need to be complemented by some other perspectives as they have some drawbacks. Deficit models tend to define communities and individuals in negative terms, disregarding what is positive and works well in particular populations. In contrast `assets' models tend to accentuate positive capability to identify problems and activate solutions. They focus on promoting salutogenic resources that promote the self esteem and coping abilities of individuals and communities, eventually leading to less dependency on professional services. Much of the evidence available to policy makers to inform decisions about the most effective approaches to promoting health and to tackling health inequities is based on a deficit model and this may disproportionately lead to policies and practices which disempower the populations and communities who are supposed to benefit from them. An assets approach to health and development embraces a `salutogenic' notion of health creation and in doing so encourages the full participation of local communities in the health development process. The asset model presented here aims to revitalise how policy makers, researchers and practitioners think and act to promote a more resourceful approach to tackling health inequities. The model outlines a systematic approach to asset based public health which can provide scientific evidence and best practice on how to maximise the stock of key assets necessary for promoting health. Redressing the balance between the assets and deficit models for evidence based public health could help us to unlock some of the existing barriers to effective action on health inequities. This re-balancing would help in better understanding the factors that influence health and what can be done about them. It would promote a positive and inclusive approach to action. (Promotion & Education, 2007, Supplement (2): pp 17-22).