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浙江大学学报（医学版）
浙江大学学报（医学版）  2021, Vol. 50 Issue (4): 411-419    DOI: 10.3724/zdxbyxb-2021-0155
医学与社会     
生命历程健康发展模型及其启示
柯玉叶1,2(),柴晓运3,*()
1.湖北医药学院卫生管理与卫生事业发展研究中心，湖北 十堰 442000
2.湖北医药学院护理学院，湖北 十堰 442000
3.湖北医药学院应用心理学系，湖北 十堰 442000
The life course health development model: a new approach to understanding human health
KE Yuye1,2(),CHAI Xiaoyun3,*()
1. Center of Health Administration and Development Studies, Hubei University of Medicine, Shiyan 442000, Hubei Province, China;
2. School of Nursing, Hubei University of Medicine, Shiyan 442000, Hubei Province, China;
3. Department of Applied Psychology, Hubei University of Medicine, Shiyan 442000, Hubei Province, China
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摘要：

生命历程健康发展模型作为健康科学领域前沿的理论模型，超越了先前的生物医学和生物心理社会模型，其从“过程”、“关系”、“系统”等多个角度，将健康视为一种在生命历程中不断动态变化的能力，并突出了优化个体健康发展轨迹和健康促进的重要性。该模型认为，应该从发展的角度去理解健康，健康发展具有展开性、复杂性、时机性、可塑性、充分性以及和谐性等特征。因此，健康研究及实践应转变思路，由过去仅仅关注精准诊断和治疗、疾病溯源等转变为充分利用人类发展的相对可塑性，通过在生命历程的各个阶段，增强健康发展能力和丰富健康资源，促进生理、心理、行为和文化等健康发展系统和谐平衡。基于上述理论，建议我国现阶段卫生事业：①加强生命全周期的健康教育，构建符合我国实际的健康促进模式；②重视生命早期的健康促进和疾病预防；③加大对健康促进和健康教育的投入，而不仅仅是疾病治疗的投入。
关键词： 生命历程健康发展模型;  健康;  健康促进;  疾病预防;  公共卫生    
Abstract:

The life course health development (LCHD) model is a cutting-edge theoretical model for the health science, which moves beyond the previous biomedical and biopsychosocial model. From the perspectives of “process, relationship and system”, it recognizes health as a dynamic ability to change over the course of life, and highlights the importance of optimizing individual health trajectories and health promotion. According to LCHD model, we should understand health from the perspective of development, which is characterized by unfolding, complexity, timing, plasticity, thriving and harmony. Health research and practice, therefore, should change ideas from the focus on accurate diagnosis, treatment and etiology previously to full using the relative plasticity of human development to enhance health development ability, enrich health resources and promote the healthy development of physiology, psychology, behavior and culture system; and to achieve a harmonious balance in the different stages of the life course. Based on the LCHD model, it is suggested for our country’s health service system (1) to strengthen the health education across the life-span and construct the health promotion model based on the social system; (2) to pay more attention to health promotion and disease prevention in early life; (3) to increase government spending on health promotion and prevention, not just on disease treatment.
Key words: Life course health development model    Health    Health promotion    Disease prevention    Public health
收稿日期: 2020-12-20 出版日期: 2021-11-01
CLC:  R19-0  
基金资助: 湖北省普通高等学校人文社会科学重点研究基地基金（湖北医药学院，2017YB006）；湖北医药学院人才启动基金（2019QDJRW03）
通讯作者: 柴晓运     E-mail: jadeleaf_ke@163.com;xy_chai@hbmu.edu.cn
作者简介: 柯玉叶，讲师，主要从事健康教育、护理教育研究；E-mail：jadeleaf_ke@163.com；https：//orcid.org/0000-0003-2871-6716
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引用本文:

柯玉叶,柴晓运. 生命历程健康发展模型及其启示[J]. 浙江大学学报（医学版）, 2021, 50(4): 411-419.

KE Yuye,CHAI Xiaoyun. The life course health development model: a new approach to understanding human health. J Zhejiang Univ (Med Sci), 2021, 50(4): 411-419.

链接本文:

http://www.zjujournals.com/med/CN/10.3724/zdxbyxb-2021-0155    或    http://www.zjujournals.com/med/CN/Y2021/V50/I4/411

图 1  健康发展概念模型的演化健康及其相关概念的演变路径（黑色实线箭头）历经了生物医学模型到生物心理社会模型，再到更整合的生命历程健康发展模型的过程，在哲学认识论上反映了从最初的简单还原论，到复杂的系统论、关系论的变化. 这些变化的根本在于多学科视角对健康研究的影响（灰色实线箭头），如流行病学、生命历程社会学、表观遗传学、人类毕生发展心理学和神经发育学等.
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