Kumanyika Shiriki K, Morssink Christiaan B
School of Medicine, University of Pennsylvania, Philadelphia, USA.
Health Educ Behav. 2006 Aug;33(4):440-58. doi: 10.1177/1090198106287730.
The concept of health disparities is a familiar one, but we must continually challenge our thinking on how disparities issues are framed. The 1985 Report of the Secretary's Task Force on Black and Minority Health established a disease-oriented focus on "excess deaths" as the primary targets of disparities initiatives. However, progress in reducing disparities has been limited. The disease focus, which emphasizes the individual-level and health care services, may be too narrow. A "population health" perspective can foster a more comprehensive and integrated approach. Both disease-oriented and population health perspectives have advantages and disadvantages, for both policy and practical purposes. The challenge is to effectively leverage both approaches to improve the health of ethnic minority and other disadvantaged populations. We need bridge builders who can articulate and hear diverse perspectives, work with systems, and maintain a long-term vision for affecting the social dynamics of society.
健康差距的概念为人熟知，但我们必须不断审视我们对差距问题呈现方式的思考。1985年秘书办公室黑人与少数族裔健康问题特别工作组的报告确立了以疾病为导向，将“超额死亡”作为差距倡议的主要目标。然而，在减少差距方面取得的进展有限。以疾病为导向、强调个体层面和医疗服务的视角可能过于狭隘。“人群健康”视角能够促成一种更全面、综合的方法。从政策和实际应用的角度来看，以疾病为导向的视角和人群健康视角都各有利弊。挑战在于如何有效利用这两种方法来改善少数族裔和其他弱势群体的健康状况。我们需要能够阐明并倾听不同观点、与各系统合作，并为影响社会的社会动态保持长远眼光的桥梁搭建者。
