上海市伤害现状及其社区防制策略

随着疾病谱的改变，伤害严重威胁着上海市民的健康和生命质量，不仅使个人身心痛苦，也造成巨大的家庭负担、医疗支出和社会代价，已经成为21世纪上海一个重要的公共卫生问题。由于各国或各地区的经济发展水平和文化背景的差异，存在着不同的伤害防制策略的选择。伤害的有效干预和控制过程是一项涉及多学科协作、多部门参与的社会系统工程。上海作为国际化大都市，积极提倡和推行安全社区，与国际接轨，是防制伤害的一个有效选择。本文结合对上海市伤害谱的描述，对社区伤害防制的原则、策略的选择进行了探讨。

The Current Status and Strategies for Shanghainese Injury Prevention and Control in Communities

The disease spectrum has changed apparently in past several decades in Shanghai. The incidence and mortality of infectious diseases keeping reducing, from the 1st death cause in the 1950's to around the 7 th death cause in 2001.Chronic non-communicable diseases have become the preceding death causes of the Shanghai people.Injuries have become a major public health and socio-economic problem in Shanghai.It is the fourth leading cause of death now. Injuries,fatalities and economic losses due to accidents increased with the rising level of motorization. Injury exerts a huge burden on Shanghai's economy and health care services. There are distinct injury policy interventions and strategies that might be transferred on different setting because the vulnerable population groups at risk and national sociopolitical contexts are different.In order to maximize the likelihood of success in Shanghai,intervention strategies that could significantly reduce the burden of injuries in other countries cannot be transferred directly to Shanghai.For example,the adoption of even such an intervention with proven effectiveness as helmet use will not be effective without cognizance of cultural sensitivities,as well as other delicate issues like feasibility sustainability,and acceptability.Obviously,the need to search for local evidence to confirm the acceptance and effectiveness of transposed interventions connot be overemphasized. With careful analysis and synthesis of Shanghai-specific problems,Safe Community should be created to control injury in metropolitan Shanghai.This paper suggests models for both organisation's structure and practical working methods for injury interventions and strategies in community settings. Reducing injury is truly a challenge to Shanghai and succeeding will require the involvement of multiple stakeholders at global,national,municipal and community levels.Additionally,this paper discussed evaluation measures and indicators of policy interventions in Shanghai community.