Fox Ken
Boston University School of Medicine, Division of General Pediatrics and Adolescent Center, Boston Medical Center, MA 02118, USA.
Theor Med Bioeth. 2002;23(6):471-97. doi: 10.1023/a:1021320815915.
A wide variety of forms of domination has resulted in a highly heterogeneous health risk category, "the vulnerable." The study of health inequities sheds light on forces that generate, sustain, and alter vulnerabilities to illness, injury, suffering and death. This paper analyzes the case of a high-risk teen from a Boston ghetto that illuminates intersections between "race" and class in the construction of vulnerability in the US. Exploration of his "wounds" helps specify how large-scale social and cultural forces become embodied as individual experience of disparate health risk. The case demonstrates that health inequities would not occur if resources--employment, income, wealth, education, housing, profiling in the legal system, and health care--were more justly managed in keeping with standards outlined in the Universal Declaration of Human Rights. Professional responses to the "wounds of vulnerability" may reveal important aspects of who we are and what our work as scholars, practitioners, and advocates must become.
各种各样的统治形式导致了一个高度异质的健康风险类别，即“弱势群体”。对健康不平等的研究揭示了那些产生、维持并改变疾病、伤害、痛苦和死亡脆弱性的力量。本文分析了一名来自波士顿贫民区的高危青少年的案例，该案例阐明了在美国构建脆弱性过程中“种族”与阶级的交叉点。对他“创伤”的探究有助于明确大规模社会和文化力量如何具体体现为不同健康风险的个体经历。该案例表明，如果按照《世界人权宣言》所概述的标准更公正地管理资源（就业、收入、财富、教育、住房、法律体系中的形象塑造以及医疗保健），健康不平等就不会出现。对“脆弱性创伤”的专业应对可能会揭示我们是谁以及作为学者、从业者和倡导者我们的工作必须成为什么样的重要方面。
