Satcher David, Rust George
Morehouse School of Medicine, 720 Westview Dr, SW, Atlanta, Georgia 30310, USA.
Ethn Dis. 2006 Spring;16(2 Suppl 3):S3-8-13.
Health disparities are both real and deadly, but disparities are not inevitable. The causes of health disparities are complex, and their elimination will require multi-dimensional interventions. We have developed a three-dimensional model for the elimination of health disparities. The foundation of public health is surveillance, which is the first dimension. We must continually measure racial-ethnic disparities in each specific disease, in its risk factors, and in outcome-relevant quality of care. The second dimension is research into the causes of disparities and potential intervention points to eliminate disparities. These causes and potential intervention points can be in the individual's biology or their behavior, or in their physical and social environment, or in the healthcare arena (quality and access). The third dimension is intervention, which requires moving from what we know to what we do. Translation must not only take knowledge from the bedside, but to the curbside and the countryside, into each community and into each home. We can achieve health equity in America, but first, we all must care enough, know enough, do enough, and persist long enough.
健康差距真实存在且致命,但并非不可避免。健康差距的成因复杂,消除这些差距需要多方面的干预措施。我们已开发出一个消除健康差距的三维模型。公共卫生的基础是监测,这是第一个维度。我们必须持续衡量每种特定疾病在种族-族裔方面的差距,包括其风险因素以及与结果相关的医疗质量。第二个维度是对差距成因及消除差距的潜在干预点进行研究。这些成因和潜在干预点可能存在于个体的生物学特征、行为、物理和社会环境或医疗保健领域(质量和可及性)。第三个维度是干预,这需要从我们所知道的转化为我们所做的。转化不仅要将知识从床边带到路边和农村,还要带入每个社区和每个家庭。我们能够在美国实现健康公平,但首先,我们所有人都必须足够关心、足够了解、做得足够多并且坚持足够久。