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引用本文:Miranda J J,Kinra S,Casas J P,等.中低收入国家的慢性病:背景、决定因素与卫生政策[J].中国卫生政策研究,2013,6(10):12-20
中低收入国家的慢性病:背景、决定因素与卫生政策
投稿时间:2013-09-02  修订日期:2013-09-20  PDF全文浏览  HTML全文浏览
Miranda J J1, Kinra S1, Casas J P1, Davey Smith G2, Ebrahim S1
1. 伦敦卫生与热带病医学院 英国伦敦
2. 布里斯托大学 英国布里斯托
摘要:近年来,中低收入国家慢性病不断上升的趋势及其产生的影响受到广泛关注,但有关这种上升趋势的解释和说明大多基于高收入国家的慢性病发展史,但其所经历的发展历程与中低收入国家并不完全相同。本文对这些差异进行评价,以更好地理解中低收入国家慢性病的流行趋势,并对慢性病决定因素的相关理论加以讨论,为慢性病的防控提供循证支持。此外,本文将慢性病防控政策看作是降低人口患病风险和个体易感性的重要干预手段,并讨论了中低收入国家需要开展的相关政策研究。在此基础上进一步强调了加强初级卫生保健改革的必要性,并将其作为降低慢性病流行趋势的一项重要政策。
关键词:发展中国家  健康转变  非传染性疾病  公共卫生  危险因素
Non-communicable diseases in low-and middle-income countries:Context, determinants and health policy
Miranda J J1, Kinra S1, Casas J P1, Davey Smith G2, Ebrahim S1
1. London School of Hygiene and Tropical Medicine, London, UK
2. University of Bristol, Bristol, UK
Abstract:The rise of non-communicable diseases and their impact in low-and middle-income countries has gained increased attention in recent years. However, the explanation for this rise is mostly an extrapolation from the history of high-income countries whose experience differed from the development processes affecting today's low-and middle-income countries. this review appraises this difference in context to gain a better understanding of the epidemic of non-communicable diseases in low-and middle-income countries. Theories of developmental and degenerative determinants of non-communicable diseases are discussed to provide strong evidence for a causally informed approach to prevention. Health policies for non-communicable diseases are considered in terms of interventions to reduce population risk and individual susceptibility and the Research needs for low-income and middle-income countries are discussed. Finally, the need for health system reform to strengthen primary care is highlighted as a major policy to reduce the toll of this rising epidemic.
Key words:Developing countries  Health transition  Non-communicable diseases  Public health  Risk factors
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