Thomas J C, Thomas K K
Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill 27599-7400, USA.
Soc Sci Med. 1999 Oct;49(8):1075-84. doi: 10.1016/s0277-9536(99)00197-5.
Social forces shaping a region can also affect behaviors that facilitate the transmission of sexually transmitted diseases (STDs), including HIV. We sought to understand the social forces underlying high rates of infection, particularly among blacks, in a rural county of North Carolina in which 40% of the county is black. In the context of ongoing research on STDs we collected information from archival data on the county since the 1940s and interviewed local residents knowledgeable about the county's history. We present local data in the context of national economic and demographic trends. Successive changes in the national economy and farming policies disproportionately affected black farmers. A rural ghetto formed when poor blacks left their farms to seek work in the central town of the county. Segregationist housing policies and race-based differentials in employment opportunities exacerbated the concentration of poverty. Migration to northern industrial cities, predominantly by skilled black men, decreased the social capital of the community and lowered the ratio of men to women. Poverty, income disparity, social capital and the ratio of men to women can all affect the behaviors that facilitate transmission of STDs. Knowledge of social forces and their effects is critical for designing and evaluating interventions to prevent STDs and to decrease extreme racial disparities in rates of disease.
塑造一个地区的社会力量也会影响那些促进包括艾滋病毒在内的性传播疾病传播的行为。我们试图了解北卡罗来纳州一个乡村县高感染率背后的社会力量，该县40%的人口为黑人，尤其是黑人中的高感染率情况。在对性传播疾病进行的持续研究背景下，我们从20世纪40年代以来的该县档案数据中收集信息，并采访了了解该县历史的当地居民。我们将当地数据置于国家经济和人口趋势背景下呈现。国家经济和农业政策的相继变化对黑人农民产生了不成比例的影响。当贫穷的黑人离开农场到该县中心城镇寻找工作时，形成了一个乡村贫民窟。种族隔离的住房政策和基于种族的就业机会差异加剧了贫困的集中。主要是熟练黑人男性向北方工业城市的迁移，减少了社区的社会资本，降低了男女比例。贫困、收入差距、社会资本以及男女比例都会影响那些促进性传播疾病传播的行为。了解社会力量及其影响对于设计和评估预防性传播疾病以及减少疾病发生率方面极端种族差异的干预措施至关重要。
