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善意铺就的道路:公共卫生和人类服务提供者是否导致了健康方面的种族/族裔差异?

Paved with good intentions: do public health and human service providers contribute to racial/ethnic disparities in health?

作者信息

van Ryn Michelle, Fu Steven S

机构信息

Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Medical Center, MN 55417, USA.

出版信息

Am J Public Health. 2003 Feb;93(2):248-55. doi: 10.2105/ajph.93.2.248.

Abstract

There is extensive evidence of racial/ethnic disparities in receipt of health care. The potential contribution of provider behavior to such disparities has remained largely unexplored. Do health and human service providers behave in ways that contribute to systematic inequities in care and outcomes? If so, why does this occur? The authors build on existing evidence to provide an integrated, coherent, and sound approach to research on providers' contributions to racial/ethnic disparities. They review the evidence regarding provider contributions to disparities in outcomes and describe a causal model representing an integrated set of hypothesized mechanisms through which health care providers' behaviors may contribute to these disparities.

摘要

有大量证据表明在接受医疗保健方面存在种族/民族差异。医疗服务提供者的行为对这种差异的潜在影响在很大程度上仍未得到探索。健康和人类服务提供者的行为方式是否会导致医疗保健和治疗结果方面的系统性不平等?如果是这样,为什么会发生这种情况?作者基于现有证据,提供了一种综合、连贯且合理的方法来研究医疗服务提供者对种族/民族差异的影响。他们回顾了有关医疗服务提供者对治疗结果差异影响的证据,并描述了一个因果模型,该模型代表了一套综合的假设机制,通过这些机制,医疗保健提供者的行为可能导致这些差异。

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