《国际循环》:Goff教授您好,请问您认为世界卫生组织(WHO)的STEPS计划就是最重要的第一步,还是您认为在人们参与WHO的STEPS计划之前还应该完成其他的第一步?
<International circulation>: This kind of surveillance actions are important to direct future policy and actions of NGOs to figure out how we need to change what we are doing or know what we are doing before we can change it. Many countries like China do not really have surveillance. Do you think the first step is policy and environmental concerns followed by programs geared towards individuals? For a country like China, which likes to design their own programs and policy rather than follow what an international body dictates, would the first step be policy?
《国际循环》:这种监督机制对指导非政府组织(NGOs)制定将来政策和行动计划非常重要,这些政策和计划能明确我们需要怎样改变我们正在做的事情以及在我们能改变这些情况之前我们还能做什么。像中国样的很多国家实际上并没有监督机制。请问您认为第一步是不是政策和外界关注以及随后的面向个体的计划?对于像中国这样习惯于自己制定适合国情的计划和政策而不是跟随国际实体规定的国家,第一步应该是政策的制定吗?
Prof. Goff: The first thing I would want to know is what is the accessability and availability of healthy nutrition and healthy foods across the area I was responsible for. Are there things we call “food deserts”, where there are communities, largely urban communities, where people have very little access to healthy food? These communities primarily are served by convenient stores that have significant amounts of alcohol and foods with high-calorie, low-nutrient density. These populations that live in these types of urban communities have very poor access of healthy food and, in the case of the United States, in spite of the fact that they are living in a country with a surplus of healthy food. It is just an accessibility issue. The first thing to know is what is the environment landscape like for access to healthy food because people cannot consume it if they cannot get to it. Another thing that is important to know is about smoking policies, both regulations on individual smoking and regulations about indoor air to prevent smokers from exposing others to secondhand smoke, which is an important health concern. A third thing would be to know what the physical activity environment is like. Are there opportunities for people to be physically active in a way that is safe so they can be physically active without worrying about crime, violence, traffic accidents, etc. People will not be physically active if they feel it is not safe to go outside and walk or ride a bicycle. These are things that are important to know before you try to stimulate individuals to change. There has to be the social and environmental conditions conducive to making good choices.
Goff教授:在这方面我想要知道的第一件事情是我所负责的地区是否有健康的营养物质和健康食物以及这些营养物质和食物是否可用。有一种情况我们称为“食品荒漠”,在一些地方的社区,大部分是城市社区,人们获得健康食物的机会反而很少?这些大型社区中主要是便利店行业,而这些便利店中主要供应酒精饮品和高卡路里、低营养的食物。生活在这种类型城市社区的人群接触到健康食物的途径很少,在美国,尽管人们居住在乡村有大量的健康食物可供挑选,还是会有以上情况存在。这只是是否能得到健康食物的问题。需要知道的第一件事情是人们生活的环境面貌是什么样的,比如如何获取健康食物,因为假设人们不能获得这些健康食物,就不能消费它们。需要明确的另一件重要事情是吸烟政策,就是关于个人吸烟的规章制度和禁止在室内吸烟以免吸烟者使他人暴露于被动吸烟环境中的规定,这也是一个非常重要的健康关注。需要明确的第三件事情是人们生活中的运动环境是什么样的。人们是否有机会进行安全的体育活动,因此人们在进行体育活动时不需要担心犯罪、暴力、交通事故等发生的可能。如果大家觉得外出散步或骑自行车不安全,就不会进行体育运动。在你试图鼓励人们做出改变之前,了解这些事情是非常重要的。对社会和环境因素的考虑将有助于做出正确的选择。