從推廣安全社區經驗談社區健康營造

Community Health Building: The Safe Community Promotion Experience

健康促進與安全促進在社區這個層級有其特殊針對的問題與方法，社區營造的重點在安全方面是社區安全促進，其目標是營造一個安全社區；重點在健康方面是社區健康營造，目標則在營造一個健康城市。推動安全社區或健康城市的「社區」沒有區域大小或人口多寡的條件。而是以有無能涵蓋所有的人和環境的多元議題、有無不同領域背景、不同的身分的人一起參與、以及能否永續經營為主要考量。安全社區與健康城市都有國際性的網絡組織，前者評量的指標重在永續發展的機制，後者則只看結果數據。我國的社區可加入國際安全社區網絡為正式會員；但卻只能申請成為健康城市聯盟的「準會員」。 為了社區的永續發展，作者從推動安全社區的經驗建議社區的組織要涵蓋公私部門，經費的來源要多元，志工的角色要更主動積極，衛生所／健康服務中心要擔負起收集與分析資料的任務。

Safety and health promotion at the community level involves special concerns and approaches. A community may develop into a safe community or healthy city depending on the focus of relevant promotion efforts. Neither area nor population size should be factors affecting an initial decision to start safe community or healthy city programs. However, one should consider the diverseness of issues that may have the potential impact on people with different gender and age or on different environments and situations, and whether a planned program is sustainable. While safe communities and healthy cities may be linked to international networks, the qualifications for joining such networks differ. The Healthy City Alliance emphasizes outcome measures and the International Safe Community Network emphasizes the appropriateness of sustainability mechanisms. While Taiwan communities are eligible for designation as international safe communities, they may are eligible for associate membership only in the Healthy City Alliance. The author has the following recommendations with regard to sustainability in community health building in Taiwan: 1) The relevant infrastructure must involve both public and private sectors; 2) The community should try to receive financial support from diverse sources; 3) involve significant numbers of active volunteers; and 4) charge local health centers with data collection and analysis responsibilities.