Logan Jennifer L
Division of Infectious Disease and International Medicine, University of South Florida College of Medicine, 2 Columbia Dr G318, Tampa, FL 33606, USA.
J Natl Med Assoc. 2009 Feb;101(2):161-6. doi: 10.1016/s0027-9684(15)30830-0.
In the United States, health disparities exist among ethnic minority groups, the uninsured, and those with other barriers to health care access. Health disparities exist for many diseases, but are especially pronounced for preventive health services and preventable diseases. Persons affected by disparities experience higher incidences of vaccine-preventable diseases, such as influenza, and are more likely to die from those diseases as well. Although influenza vaccines are relatively safe, inexpensive, and effective in reducing infection and disease complications, many groups in the United States do not yet benefit from this potentially lifesaving intervention. Possible explanations for disparities in influenza vaccination include: (1) barriers to access such as cost, insurance status, and language differences; (2) underestimation of personal risk and misunderstanding of vaccination risks; (3) mistrust toward the health care system. Proposed strategies to minimize these disparities include: (1) changes to health care system structural factors that serve as access barriers, (2) education to increase awareness and improve demand for vaccines, (3) involvement of community-based organizations to assess local needs and design responsive solutions.
在美国，少数族裔群体、未参保者以及那些在获得医疗保健方面存在其他障碍的人群中存在健康差异。许多疾病都存在健康差异，但在预防性健康服务和可预防疾病方面尤为明显。受健康差异影响的人群患流感等疫苗可预防疾病的几率更高，死于这些疾病的可能性也更大。尽管流感疫苗相对安全、廉价且在减少感染和疾病并发症方面有效，但美国的许多群体尚未从这种可能挽救生命的干预措施中受益。流感疫苗接种差异的可能解释包括：（1）获取方面的障碍，如成本、保险状况和语言差异；（2）对个人风险的低估以及对疫苗接种风险的误解；（3）对医疗保健系统的不信任。为尽量减少这些差异而提出的策略包括：（1）改变作为获取障碍的医疗保健系统结构因素，（2）开展教育以提高认识并增加对疫苗的需求，（3）让社区组织参与评估当地需求并设计针对性的解决方案。
