Vines Anissa I, Godley Paul A
Department of Epidemiology, University of North Carolina at Chapel Hill, School of Public Health, 27599-7400, USA.
N C Med J. 2004 Nov-Dec;65(6):341-9.
Despite the accomplishments of American medical science and the impressive array of healthcare facilities and service delivery models available in this country, the existence of significant health disparities is a matter of urgent national and state health policy priority. Policies to address these issues should address fundamental problems having to do with access to care (such as health insurance coverage and the availability and the geographic and culturally-appropriate accessibility of personal health services), the educational preparation of healthcare professionals for the challenge of caring for the increasing diversity of patients in a truly "patient-centered" healthcare system of the future, efforts to deal with widespread problems of health literacy that reduce the likely impact and effectiveness of healthcare, and a more aggressive effort to assure that future medial science continues to include minorities and women (and they continue to participate) as subjects in clinical trials of innovative therapeutic interventions. The policy agenda to address these issues is both broad and demanding, as would be expected of any set of problems which is so widespread and complex. But, America is no stranger to challenges, and few are more worthy of the effort than this.
尽管美国医学取得了诸多成就，且该国拥有令人印象深刻的一系列医疗设施和服务提供模式，但显著的健康差距问题仍是国家和州卫生政策亟待优先解决的事项。解决这些问题的政策应处理与获得医疗服务相关的基本问题（如医疗保险覆盖范围、个人健康服务的可获得性以及其在地理和文化上的适宜可及性），为医疗专业人员提供教育准备，使其能够在未来真正“以患者为中心”的医疗体系中应对日益多样化的患者护理挑战，努力解决广泛存在的健康素养问题，这些问题会降低医疗保健的可能影响和效果，还要做出更积极的努力，确保未来医学科学继续将少数族裔和女性（并让她们继续参与）纳入创新治疗干预临床试验的受试者范围。解决这些问题的政策议程既广泛又艰巨，对于任何如此广泛和复杂的问题集来说都是如此。但是，美国对挑战并不陌生，很少有挑战比这更值得付出努力。
