Strelnick A Hal, Lee-Rey Elizabeth, Nivet Marc, Soto-Greene Maria L
Institute for Community and Collaborative Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Mt Sinai J Med. 2008 Dec 1;75(6):499-503. doi: 10.1002/msj.20080.
Spurred by its rapidly changing demographics, the United States is striving to reduce and eliminate racial and ethnic health disparities. To do so, it must overcome the legacy of individual, institutional, and structural racism and resolve conflicts in related political and social ideologies. This has moved the struggle over diversity in the health professions outside the laboratories and ivy-covered walls of academic medicine into the halls of Congress and chambers of the US Supreme Court. Although equal employment opportunity and affirmative action programs began as legal remedies for distinct histories of legally sanctioned racial and gender discrimination, they also became effective means for increasing the representation of underrepresented minorities in higher education and the health professions. Beginning in the 1970s and continuing today, legal challenges to measures for realizing equal opportunity and leveling the playing field have reached the US Supreme Court and state-wide ballot initiatives. These historical challenges and successes are the subject of this article. Although the history is not exhaustive, it aims to provide an important context for the struggles of advocates to improve the representation of underrepresented minorities in medicine and reduce racial and ethnic health disparities.
在美国人口结构迅速变化的推动下，美国正在努力减少并消除种族和族裔间的健康差距。要做到这一点，美国必须克服个人、机构和结构性种族主义的遗留问题，并解决相关政治和社会意识形态中的冲突。这使得围绕医疗卫生专业领域多样性的斗争，从学术医学的实验室和常春藤环绕的校园，转移到了美国国会大厅和最高法院的会议室。尽管平等就业机会和肯定性行动项目最初是针对法律认可的种族和性别歧视的不同历史而采取的法律补救措施，但它们也成为了增加高等教育和医疗卫生专业领域中代表性不足的少数群体比例的有效手段。从20世纪70年代开始一直持续到今天，针对实现平等机会和公平竞争环境的措施所发起的法律挑战已经提交到美国最高法院，并在全州范围内进行公民投票倡议。这些历史上的挑战与成功就是本文的主题。尽管这段历史并不详尽，但它旨在为倡导者们为提高医学领域中代表性不足的少数群体的比例、减少种族和族裔间健康差距而进行的斗争提供一个重要背景。
