Health promotion in cities and communities. Present state and perspectives for community settings after enacting the Prevention Law in Germany
Health promotion in cities and communities. Present state and perspectives for community settings after enacting the Prevention Law in Germany
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DOI：
10.1007/s11553-016-0557-y
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发表时间：
2016-11-01
影响因子：
0.9
通讯作者：
Kuhn, Joseph
中科院分区：
文献类型：
--
作者：
Trojan, Alf;Reisig, Veronika;Kuhn, Joseph
背景本文介绍了重新发现的社区作为一个设置的预防和健康促进，最初开始于20世纪70年代，并说明其核心特征，如关键利益相关者，结构，资金和质量保证。2015年通过的《德国预防法》就其与社区环境的相关性进行了审查。此外，本文探讨了预防法对社区一级预防和健康促进的影响，并了解了其实施的现状。2015年通过的《预防法》是健康促进和预防的新里程碑。它强调环境方法在一般情况下，特别是在社区环境中的重要作用。我们的贡献描述了社区健康促进的现状，并反映了预防法对未来发展的相关性。1970年代，重新发现社区是预防和促进健康的场所，这是新倡议的一个重要起点，1986年的《渥太华宪章》进一步加强了这一点。因此，关键的利益攸关方、结构和治理办法已经存在，但缺乏可持续的基础。资金和质量保证已成为最近事态发展的一个特别重点，但它们仍然是零碎的。新的《预防法》有助于改善健康促进工作的供资和协调，特别是在地方一级。最后，我们讨论的机会和挑战的预防法促进社区健康。目前还无法判断执行《预防法》的工具是否有效。在迅速取得进展方面仍然存在相当大的障碍;但是，在继续加强社区设置办法和地方公共卫生服务的作用方面，也可以发现有希望的方面。
Background. This paper describes the rediscovery of the community as a setting for prevention and health promotion that originally started in the 1970s and illustrates its central characteristics such as key stakeholders, structures, funding, and quality assurance. The German Prevention Law, which was passed in 2015, is reviewed with respect to its relevance for the communal setting. In addition, the paper explores the implications of the prevention law for prevention and health promotion on the community level and captures the current state of its implementation. The Prevention Act passed in 2015 represents a new milestone for health promotion and prevention. It emphasizes the important role of the settings approach in general and in community settings in particular.Goals. Our contribution describes the current state of what has been achieved in community health promotion and reflects on the relevance of the Prevention Act for future developments.Results. In the 1970s, the rediscovery of the community as a setting for prevention and health promotion was an important starting point for new initiatives which were further strengthened by the Ottawa Charta in 1986. Thus, key stakeholders, structures and governance approaches already exist; however, they lack a sustainable basis. Funding and quality assurance have become a special focus in recent developments but they remain fragmentary. The new Prevention Act could help to improve funding and coordination of health promotion especially at the local level.Discussion. We conclude with a discussion of the chances and challenges of the Prevention Act for community health promotion. Judgements on the effectiveness of tools for the implementation of the Prevention Act are not yet possible. There are still considerable barriers for rapid progress; however, one can also identify promising aspects regarding a continued strengthening of the community setting approach and the role of local public health services.