Evolutionary theory in public health and the public health of evolutionary theory

摘要

Evolutionary theory is the most powerful explanatory system in the life sciences and is the only framework that can unify knowledge in otherwise disparate fields of research. Considerable advances have been made in the application of evolutionary biology to health issues in recent decades. Health researchers and practitioners could benefit considerably from an understanding of the basic principles of evolution and how humans have been shaped by natural and sexual selection, even if they are not explicitly testing evolutionary hypotheses. Life History Theory is a powerful framework that can be used for examining modern human environments and developing environments that maximize opportunities for positive health outcomes. Many of the recommendations derived from this framework converge with the visions of current public health advocates. Despite the benefits of an evolutionary framework, the challenges that face those attempting to integrate evolutionary theory into public health are perhaps greater than those in the social sciences. Although considerable advancements in the understanding of health issues have already been made, health researchers with an evolutionary perspective are very few in number and face constraining disciplinary attributes. Advances in medical technology will continue to extend the boundaries of saving lives in danger, however traditional public health efforts may be reaching their limits of effectiveness in encouraging health-promoting behaviors. This may partially account for the current interest in broad social and policy change to enhance health and reduce health disparities amongst sub-populations. Such substantial physical and social restructuring will face many challenges and gradual progress may be enhanced by a strong foundation of evolutionary human science. The slow but eventual integration of evolutionary principles will gradually enhance the effectiveness of health interventions and provide an ultimate explanation for patterns in health outcomes that are otherwise puzzling. The speed at which the field of public health adopts a Darwinian framework has yet to be determined, and several futures are possible. This pace will depend on several factors, including the visible utility of evolutionary theory for addressing the health promotion goals of the field.