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건강형평정책과 사업: 건강 불평등 완화를 위한 접근

Health Equity Policy and Practice: Strategic Approach for Alleviation of Health Inequality

김명희|윤태호|정백근|신영전|서제희
한국사회정책학회 (Korean Association of Social Policy)|2011.12|한국사회정책 (Korea Social Policy Review)|제18권 제4호|pp. 41-77|DOI 10.17000/kspr.18.4.201112.41

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참고문헌

키워드

approach건강 불평등health inequality접근방법건강형평정책/사업health equity policies/programs

초록

최근 건강 수준이 전반적으로 향상되었음에도 불구하고, 건강 불평등 문제는 점차 심각해지고 있어 건강형평이 중요한 보건정책 과제로 부각되고 있다. 건강 불평등의 완화를 위한 노력의 중요성에도 불구하고 아직 한국 내에서는 건강 불평등 완화를 위한 필요성, 주요 접근 원칙과 접근 방법에 대한 논의는 지극히 초기 단계에 머물러 있다. 건강형평정책은 건강 불평등의 예방과 완화, 해소를 위해 행해지는 모든 정책 또는 사업을 의미하며, 이것은 규범적인 측면에서 뿐만 아니라 현실적, 실용적 측면에도 필요하다. 기존의 보건사업 방식만으로는 건강 불평등을 예방, 완화, 해소하기 어려우므로 1) 건강공공정책과 부문 간 협력, 2) 다수준적 접근, 3) 지역기반전략, 4) 생애적 접근, 5) 참여, 역량 강화, 맥락에 대한 고려, 6) 건강 불평등 해소를 위한 모니터링, 관리와 평가와 같은 접근이 필요하다. 향후 건강형평관련 정책/사업과 연구가 지속적으로 이루어져야 하며, 정책/사업의 기획과 시행에는 국내외 경험과 연구결과들을 바탕으로 만들어진 주요 원칙 및 접근방법을 유용하게 활용하여야 할 것이다.

Abstract

Despite overall health improvement over a few decades, health inequalities seem to be worsening, which calls for alternative health policies to consider health equity as their major agenda. However, yet much has been not discussed over justification of alleviating health inequalities, principles in program/policy planning, and modalities for delivery. Health equity policies are defined as all policies and programs to be implemented for preventing, alleviating and eliminating health inequalities. They are required for practical as well as normative reasons. Conventional health programs solely cannot tackle health inequalities and the followings are required; 1) healthy public policies and inter-sectoral cooperation; 2) multi-level approach; 3) area-based strategies; 4) life-course approach ; 5) consideration for participation, empowerment, and social contexts; 6) monitoring, management, and evaluation of policies and programs through an equity lense. Further research and policy/programs for health equity should be followed in Korea. In addition, key principles and appropriate approach based on the best available evidence should be applied in planning and implementing policies and programs.

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