The need for integration in health sciences sets the future direction for public health education

Since the foundation of the People's Republic of China in 1949, there has been remarkable developments in public health in the country. These achievements are primarily attributed to the public health services and patriotic public health campaigns, although the contribution of high-technology medical applications is also recognized. However, along with the recent socio-economic developments and scientific and technological progress, medical disciplines have become more and more specialized, and clinical and preventive medicine have become further separated from each other. Conventional Chinese wisdom says 'when long divided they must unite, when long united they must divide'. At the onset of the new round of reforms of health care in China, it seems important to revisit the discussions on the urgency for integration of health sciences in medicine in China. Several issues and viewpoints on integrating medicine are discussed in this paper. The biopsychosocial model for health calls for broad integration. Primary care development in China requires integration in education and practice, and in treatment and prevention. Control of chronic diseases requires integrated and united action. Integration of traditional Chinese medicine with Western medicine requires creativity. The integration perspective should be instilled in the minds of medical students. Integration also entails integrated practice. After all, integration entails integrated education and practice in public health education. Changing the current public health education system still has a long way to go. True integration requires integration of concepts, policies, resources and measures, as well as changes in the organization of health care including public health, prevention and treatment. This needs to be a systematic process. Finally, success of integration relies on social mobilization, advocacy, promotion and attention of the entire society.     

加强高职高专医学生公共卫生和临床医学整合教育的思考

文章讨论了由突发公共卫生事件引发的对构建现代公共卫生和临床医学整合教育模式的反思及其对策措施.透过SARS危机，暴露出我国现行医学教育体制上存在的医防分离的严重性，提示我们应借鉴21世纪医学生培养目标与要求，改革医学教育模式，促进多学科、跨专业的合作，建立以社区为目标、以问题为中心的公共卫生与临床医学整合教育的全新综合化课程体系;积极推广计算机辅助教育（CAI），加强运用现代化教学手段;建设以社区实践为主要内容的公共卫生和临床医学整合教育基地，加强高职高专医学生实践技能的培养，以构建新型高职高专医学人才培养模式，培养防治结合的新型实用型医学人才.     

我国公共卫生医师培养现状及影响因素研究

目的:通过分析当前公共卫生医师培养现状及其影响因素,探究制度根源并提出相应建议以完善公共卫生医师培养制度。方法:通过文献法及专家咨询法,厘清当前我国公共卫生医师培养现状,并运用解释结构模型对影响公共卫生医师培养的因素进行分区和分层,追溯问题根源。结果:当前我国公共卫生医师培养模式包含院校教育、毕业后教育、继续医学教育三部分,解释结构模型将影响公共卫生医师培养的13个因素划分为7个层级。结论:当前我国公共卫生医师培养由于底层因素政府投入的不足,导致激励机制不健全以及指导性标准制定滞后,三阶段制度待完善;继而影响到各阶段教育任务的落实,以及与之相随的师资结构、教学设计及生源质量问题。     

The Faculty of Public Health in Sofia: activities and experiences in setting New Public Health as a national priority

The article outlines the development and recent national and international activities of the Faculty of Public Health, Medical University - Sofia (FPH, MU - Sofia). It has a leading position in public health education and research in Bulgaria and plays a key role in the introduction of the New Public Health approach to Bulgarian health system and policy. A general aim of the FPH is to build up a well-trained capacity of public health specialists and thus strengthen human recourses in the public health sphere in the country. A major objective of the FPH is to create a new generation of healthcare managers ready for the challenges of the dynamic European market of health services. During its 5-year history, the FPH has been an extremely active player on the regional and international public health stage as well as on a national level. The main priority of the FPH for the future is to guarantee public health education in harmony within the south eastern Europe (SEE) region as well as with European standards. It also strives to provide methodological support to health politicians and decision makers in Bulgaria in order to establish a socially orientated, equitable, effective and high-quality healthcare system.     

医患双主体视角下南京地区公众健康教育的现状调查与问题分析

目的 通过现状调查了解健康中国进程以来江苏南京地区公众健康教育实施的问题和不足,为我国公众健康教育可持续发展提供积极的路径参考。方法 2020年8月至2021年6月,选取南京地区5所三甲医院,采用整群随机抽样方法,针对医患双主体人群,开展公众健康教育相关问题调查,并对调查数据进行统计分析。结果 在内容上,医患双方在涉医的公众伦理、心理、法律教育评价上呈现统计学差异(P＜0.05); 在方式上,医患在公众健康教育媒介选择上具有统计学差异(P＜0.05),医方更希望采用群体教育方式(=19.003,P＜0.001),患方更希望采取个性化教育方式(=136.196,P=0.001); 在责任上,医患对公众健康教育的责任主体评价存在差异(网络媒体=63.863,P＜0.001; 医院及医护人员=46.197,P＜0.001); 在重要性评价上,医方的概念认知水平高于患方(Z=-3.815,Z=-3.530,P＜0.001),不同学历患者在公众健康教育认知上呈现统计学差异(高中b=-0.010,大专b=-0,201,本科b=0,硕士b=0.002,博士b=0.234,P＜0.05)。结论 明确公众健康教育中的政府主导与多方合力,强化医学专业人员公众健康教育的意识和能力,提升医学教育中公众健康内容的针对性和有效性,充分利用新旧媒介的复合传播功能推进技术升级,从而形成医院、大学、政府、社会多方参与的公众健康教育发展模式。     

论临床医学与公共卫生的协调发展

随着社会经济的发展和科学技术的进步，临床医学与公共卫生间出现了裂痕。临床医学的重点是研究疾病机理，而公共卫生的重点是研究环境和社会因素对疾病和健康的影响。临床医学与公共卫生的分离，使得医疗卫生服务体系难以适应社会的发展。发展全科医学和社区卫生服务是弥补多年来疾病治疗（临床医学）与疾病预防（公共卫生）之间裂痕的最佳选择和最好办法。同时，应加强对医学院、公共卫生学院的领导、学生及教师、临床医生、卫生行政管理人员、卫生政策制定者等的公共卫生教育。     

推进实施性研究在中国公共卫生领域的应用

随着医学实践的迅速发展,循证医学将最佳证据、临床经验和患者价值有机地结合,循证公共卫生在公共卫生领域的作用也日益突显。然而,仅有约50%的循证医学证据能够真正转化成常规的卫生保健服务,且转化过程耗时长。为了弥合从最佳证据到临床或公共卫生应用之间的鸿沟,实施性研究作为一门新兴学科应运而生。本文介绍了实施性研究的产生背景、发展、理论和方法,并讨论其在中国公共卫生领域的应用及面临的挑战。     

突发公共卫生事件风险沟通研究进展

风险沟通是处置突发公共卫生事件的重要环节.本文通过搜集国内外相关文献,对风险沟通的发展历史、沟通流程、理论模型等进行概述,重点关注风险沟通在突发公共卫生事件中的应用.理论研究和实践经验均表明,风险沟通应遵循特定的流程,根据事前、事中、事后的特点采取相应的沟通策略.2003年SARS疫情以后,我国的风险沟通机制不断完善,...     

健康医疗大数据驱动下的疾病防控新模式

随着互联网技术的快速发展和医疗信息化的不断推进，健康医疗大数据已逐渐成为创新健康管理、满足人民群众日益增长的健康需求的重要资源，成为国家全面实施大数据战略的重要组成部分。宁波市鄞州区通过构建健康大数据平台及大数据技术的应用，积极探索健康医疗大数据在传染病、预防接种、慢性病等疾病防控领域的防控模式创新，期望通过"互联网+健康医疗"提高区域疾病防控和健康管理水平，培育发展新业态，成为健康中国的有力支撑。本文对鄞州区的这一防控新模式的实践探索进行介绍，并对模式的初步成效进行讨论。     

个人和公共卫生支出对城乡居民收入差距的影响

健康和教育一样,是人力资本的重要组成部分,因此健康状况也影响人们的收入。健康状况受许多因素的影响,但主要是对健康的投资,包括公共部分和个人部分。本文分析了中国1980年以后个人和公共卫生支出对城乡居民收入差异的影响。结果显示,城乡个人医疗保健支出比例增大,城乡居民收入差距也会扩大,而公共卫生支出增加和农村社保投资比重加大都有助于缩小城乡收入差距。     

以全健康理论提升我国应对突发公共卫生事件的能力

随着全球化进程和交通技术发展,突发公共卫生事件的影响范围可以在短时间内从发生地突破国家界限,并对其他国家形成健康威胁。突发公共卫生事件不仅累及人类-动植物-环境健康,对于社会发展也有长远影响,因此其应对方法已经超越了一般卫生问题,需要以整体和综合的策略进行应对。本文以全健康视角剖析了我国目前突发公共卫生事件应对体系存在的问题和短板,应用全健康相关理念,从整体、联动、发展、可持续的角度提出了相关建议,为我国进一步优化突发公共卫生事件应对体系提供参考依据。     

One country, two systems: public health in China

This paper, presented in Lisbon in May 2007, uses the framework of the three domains of public health practice--namely, health protection, health improvement and health services--as a reference to outline some of the main current public health challenges in Hong Kong and Mainland China [Griffiths S, Jewell T, Donnelly P. Public health in practice: the three domains of public health. Public Health 2005;119:907-13.(1)].     

Mind the gap: developing the PH workforce in the North East and Yorkshire and Humber regions: a scoping stakeholder study

OBJECTIVES: The aim of this study was to identify key issues around public health workforce development in the North of England, considering the gap between need and current capacity and the training requirements to deliver the public health and health improvement agenda. METHODS: Interviews were carried out with over 50 professionals in a variety of stakeholder organizations, seeking their views on priorities for workforce development and perceived opportunities and threats to the development of a good public health workforce. RESULTS: There was general recognition of a gap between current public health resources and what is needed to meet the public health agenda. Priorities included both increasing capacity at the specialist end of public health and raising general public health awareness at all levels of public organizations. Major barriers identified to meeting these needs included organizational difficulties, professional barriers and shortages of appropriate training and resources. Opportunities were seen to be presented by the increased amount of joint working and by national and local raising of awareness of public health issues. CONCLUSIONS: Across the health sector, local authorities, training organizations and voluntary sectors, similar issues and expectations were mentioned at both specialist and practitioner levels. However, it has not been possible in North East England to translate this finding into practical programmes in the absence of nationally identified resources to address the issue.     

西部农村区域公共卫生绩效现状评价与改进对策研究

通过对我国西部某省3个县的现场调查,从投入、产出、结果3个维度比较分析了样本地区的公共卫生绩效,计算得到了样本地区公共卫生绩效综合评价指数:公共卫生投入水平普遍偏低;不同公共卫生项目的产出绩效参差不齐;结果绩效整体水平较高.提出了健全农村公共卫生筹资机制、建立以绩效为基础的投入机制、均衡提供基本公共卫生服务项目、加强社会各界的支持等发展农村公共卫生的策略建议.     

Inferring transit-based health seeking patterns from smart card data – A case study in Beijing,China

Massive electronic trip records have recently been utilized to infer people's trips for healthcare. Many inferential methods were developed to derive healthcare trips by taxi using GPS trajectory records, but little attention is paid to public transit, as a common travel mode for healthcare. This paper proposes a method to fill this gap by mining a big data of smart transit cards with spatio-temporal constraints. We demonstrate and validate this method in Beijing, China. The inferred trips achieve a high degree of consistency, in space and time, with empirically observed trips from a survey. The inferred trips are further used to identify spatial disparities in transit-based access to healthcare, which might have been overlooked by health policy makers.     

From economic development to public health improvement: China faces equity challenges

In the past three decades China has been going through a period of rapid economic growth, which has had profound repercussions for the nation’s public health system. Prior to the current health reforms much of the population was left uninsured and facing high financial risk from inadequate healthcare, with especially deep divisions between the urban and rural populations, which continues to pose a huge challenge to health equity and social justice. This paper explores the relationship between economic development and public health and discusses a series of health disparity issues that are emerging in China. These include: (1) health risk and access to care issues among unregistered urban populations (i.e. migrants); (2) low recognition of mental health, and the stigma associated with people with mental illness or communicable disease; and (3) challenges to the traditional system of family care for the elderly, as younger generations migrate to the cities and the remaining rural population ages. Implications for government policy and action to address these issues and improve public health as well as equity are discussed.     

我国公共卫生教育教学方法改革浅析

[目的]探讨目前我国公共卫生教育中教学方法的现状及弊端，归纳和分析我国公共卫生教学方法改革的趋势，为提出我国公共卫生教学方法改革基本思路奠定基础。[方法]采用查阅文献和资料、网上查询等方式对目前我公共卫生教育所采用的教学方式及改革趋势进行调查、整理与归纳。[结果]我国目前公共卫生教育大多采用传统教学方式，改革面临困境和问题，部分院校进行了初步的改革尝试。[结论]我国公共卫生教育的教学方法落后于现代公共卫生教育的需要，成为阻碍制约教学改革的瓶颈，部分院校所引进的国外公共卫生教育的教学方法与改革值得学习与借鉴。     

试论开展突发公共卫生事件症状监测的必要性和困难

症状监测是致力于早期发现突发公共卫生事件的主动监测系统，目前正日益受到世界各国的重视。本文通过分析症状监测的定义、应用、优点和局限性，结合我国现状，探讨在我国开展症状监测的必要性和困难。     

疾病预防控制机构公共卫生人才培养的现状及思考

在全民健康上升为国家优先发展战略地位背景下，加快公共卫生人才能力建设显得尤为重要。本文立足中国工程院咨询项目“我国医药卫生人才培养战略研究”，从公共卫生3个阶段教育基础上，分析了疾病预防控制机构公共卫生人才培养的现状、存在的问题，提出了公共卫生人才培养首先要解决公共卫生人员队伍建设问题，要构建院校教育-毕业后教育-继续教育贯通的人才培养体系，针对不同人群，设计不同的培养模式，全方位提高公共卫生人员能力。