Bhopal Raj
Section of Public Health Sciences, University of Edinburgh, Medical School, Teviot Place, Edinburgh, UK.
Eur J Public Health. 2009 Apr;19(2):140-3. doi: 10.1093/eurpub/ckp024.
The pattern of chronic disease varies hugely internationally, and this is now reflected in Europe's multi-ethnic populations. This is creating challenges for epidemiology, public health and clinical care. Human rights legislation and health policies are mandating equity of service i.e. equal needs being met equally well. Indicators of race and ethnicity demonstrate important variations in health and health care, but the data are sparse, especially in Southern and Eastern Europe, and for some ethnic groups across the continent. Ethnic coding of routine health databases is required. The task will best succeed as a national one, with European level coordination and guidance on concepts. Pending this achievement, data linkage techniques can help fill the information gap. One of many ongoing debates that need resolution across Europe is on the preferred indicator of ethnicity, related terminology and mode of measurement. Original research also needs expansion, especially in relation to cohort studies and trials and boosted samples of ethnic minority groups in large scale European health surveys. Such work may require European legislation of the kind that has been effective in the United States (NIH Revitalisation Act 1993). A dialogue between policy makers, funders, researchers and practitioners is needed urgently as a precursor to engaging the public.
慢性病模式在国际上差异巨大，如今在欧洲的多民族人口中也有所体现。这给流行病学、公共卫生和临床护理带来了挑战。人权立法和卫生政策要求服务公平，即同等需求得到同等满足。种族和族裔指标显示了健康和医疗保健方面的重要差异，但数据稀少，尤其是在南欧和东欧，以及欧洲大陆的一些族裔群体中。常规健康数据库需要进行族裔编码。这项任务作为一项国家任务，在欧洲层面就概念进行协调和指导的情况下将最有可能成功。在取得这一成果之前，数据链接技术有助于填补信息空白。欧洲各地众多需要解决的争论之一是关于族裔的首选指标、相关术语和测量方式。原创研究也需要扩展，特别是在队列研究和试验方面，以及在大规模欧洲健康调查中增加少数族裔群体的样本。此类工作可能需要类似于美国（1993年《国立卫生研究院振兴法案》）那样有效的欧洲立法。政策制定者、资助者、研究人员和从业者之间迫切需要进行对话，作为让公众参与的前奏。
