Clayton L A, Byrd W M
Harvard School of Public Health, Division of Public Health Practice, Boston, Massachusetts 02115, USA.
J Natl Med Assoc. 2001 Mar;93(3 Suppl):35S-54S.
Based on the latest available data, African Americans are faced with persistent, or worsening, wide and deep, race-based health disparities compared to the white or general population as we enter the new millennium. These disparities are a 382-year continuum. There have been two periods of health reform specifically addressing the correction of race-based health disparities. The first period (1865-1872) was linked to Freedmen's Bureau legislation and the second (1965-1975) was a part of the Black Civil Rights Movement. Both had dramatic and positive effects on black health status and outcome, but were discontinued too soon to correct the "slave health deficit." Although African-American health status and outcome is slowly improving, black health has generally stagnated or deteriorated compared to whites since 1980. There is a compelling need for a third period of health reform accompanied by a cultural competence movement to address and correct persistent, often worsening, race-based health disparities.
根据现有最新数据，进入新千年后，与白人或普通人群相比，非裔美国人面临着基于种族的、持续存在或不断恶化的广泛且严重的健康差距。这些差距有着382年的连续性。有两个时期的医疗改革专门致力于纠正基于种族的健康差距。第一个时期（1865年至1872年）与自由民局立法相关，第二个时期（1965年至1975年）是黑人民权运动的一部分。这两个时期都对黑人的健康状况和结果产生了巨大的积极影响，但都过早中断，未能纠正“奴隶健康赤字”。尽管非裔美国人的健康状况和结果正在缓慢改善，但自1980年以来，与白人相比，黑人健康总体上停滞不前或有所恶化。迫切需要第三个时期的医疗改革，并伴随着一场文化能力运动，以解决和纠正持续存在且往往不断恶化的基于种族的健康差距。
