Pamies R J, Woodard L J
Department of Family Medicine, University of South Florida College of Medicine, Tampa.
Prim Care. 1992 Sep;19(3):443-50.
This article presents a summary of the health status of the disadvantaged populations in the United States, with specific regard to the incidence, treatment, and mortality of cancer. It begins with an historical overview of health care for the poor in this country, and continues with an explanation of the risk factors prevalent, if not inherent, in the life-style associated with low socioeconomic status, such as poor diet, cigarette smoking, and ignorance of preventive health measures and screening techniques. It includes a discussion of the different types that are overrepresented in this population and of the barriers to preventive care and treatment that still exist. The most important of these is decreased access to continuous medical care because of a lack of health insurance and an overdependence on emergency room treatment for all health care. The final section reviews solutions that have been preferred by physicians, nurses, lawmakers, public health workers, and community advocates for the poor. The most important parts of the solution are patient education for preventive health care, disease warning signs, and screening techniques and an overhaul of the present system of providing health care to ensure equal access and treatment for all members of the society.
本文概述了美国弱势群体的健康状况，特别关注癌症的发病率、治疗情况和死亡率。文章首先对美国穷人的医疗保健进行了历史回顾，接着解释了与低社会经济地位相关的生活方式中普遍存在（即便不是固有的）的风险因素，如不良饮食、吸烟以及对预防性健康措施和筛查技术的无知。文中讨论了该人群中高发的不同癌症类型，以及仍然存在的预防保健和治疗障碍。其中最重要的障碍是由于缺乏医疗保险以及在所有医疗保健方面过度依赖急诊室治疗，导致难以获得持续的医疗护理。最后一部分回顾了医生、护士、立法者、公共卫生工作者和社区贫困问题倡导者所倾向的解决方案。解决方案最重要的部分是对患者进行预防性医疗保健、疾病警示信号和筛查技术的教育，以及对现行医疗保健体系进行全面改革，以确保社会所有成员都能平等获得医疗服务和治疗。
