Global Health and Development: Conceptualizing Health between Economic Growth and Environmental Sustainability
Global Health and Development: Conceptualizing Health between Economic Growth and Environmental Sustainability
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DOI：
10.1093/jhmas/jrr076
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发表时间：
2013-07-01
影响因子：
0.5
通讯作者：
Borowy, Iris
中科院分区：
文献类型：
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作者：
Borowy, Iris
第二次世界大战后，卫生被牢固地纳入关于国家发展的讨论。过渡理论将健康改善描绘为以高收入国家近期工业化历史为模式的经济增长为基础的总体发展模式的一部分。1970年代，人们日益认识到工业化造成的环境退化，对传统的发展模式提出了挑战。人们逐渐清楚地认识到，健康状况的改善取决于包括工业化在内的减贫战略。工业化反过来又有可能加剧环境退化，对公众健康产生负面影响。因此，低收入国家的公共卫生有可能因经济发展不足以及全球经济发展的结果而受到影响。同样，发展中国家的需求也面临着被困在两种要求之间的风险：一种是要求全球财富再分配，这在政治上是不可能的;另一种是要求无限制的物质发展，在一个土地、水、空气、能源和资源有限的世界里，物质发展越来越看起来也是不可能的。试图在发展理论中抓住问题和解决策略。从广义上讲，出现了两种模式：一种是"地方主义模式"，分析国家卫生数据，倡导以减贫为重点的增长政策;另一种是"全球主义"模式，以全球卫生数据为基础，要求增长最优化，而不是最大化。这两种模式都侧重于不同类型的健康负担，并得到了不同机构的支持。简而言之，关于健康的讨论集中体现了关于相互竞争的发展愿景的更大争议。关键词：全球卫生，世界卫生组织，布伦特兰委员会，世界银行，转型理论，发展。
After World War II, health was firmly integrated into the discourse about national development. Transition theories portrayed health improvements as part of an overall development pattern based on economic growth as modeled by the recent history of industrialization in high-income countries. In the 1970s, an increasing awareness of the environmental degradation caused by industrialization challenged the conventional model of development. Gradually, it became clear that health improvements depended on poverty-reduction strategies including industrialization. Industrialization, in turn, risked aggravating environmental degradation with its negative effects on public health. Thus, public health in low-income countries threatened to suffer from lack of economic development as well as from the results of global economic development. Similarly, demands of developing countries risked being trapped between calls for global wealth redistribution, a political impossibility, and calls for unrestricted material development, which, in a world of finite land, water, air, energy, and resources, increasingly looked like a physical impossibility, too.Various international bodies, including the WHO, the Brundtland Commission, and the World Bank, tried to capture the problem and solution strategies in development theories. Broadly conceived, two models have emerged: a "localist model," which analyzes national health data and advocates growth policies with a strong focus on poverty reduction, and a "globalist" model, based on global health data, which calls for growth optimization, rather than maximization. Both models have focused on different types of health burdens and have received support from different institutions. In a nutshell, the health discourse epitomized a larger controversy regarding competing visions of development. KEYWORDS: global health, World Health Organization, Brundtland Commission, World Bank, transition theories, development.