Department of Women's Studies and the Consortium on Race, Gender and Ethnicity, University of Maryland, 2101 Woods Hall, College Park, MD 20742, USA.
Am J Public Health. 2010 Jan;100(1):18-23. doi: 10.2105/AJPH.2008.138826.
An impressive body of public health knowledge on health care disparities among Latinos has been produced. However, inconclusive and conflicting results on predictors of health care disparities remain. We examined the theoretical assumptions and methodological limitations of acculturation research in understanding Latino health care disparities, the evidence for socioeconomic position as a predictor of health care disparities, and the effectiveness of cultural competency practice. Persistent use of culture-driven acculturation models decenters social determinants of health as key factors in health disparities and diminishes the effectiveness of cultural competency practice. Social and economic determinants are more important predictors than is culture in understanding health care disparities. Improvements in the material conditions of low-income Latinos can effectively reduce health care disparities.
在医疗保健领域的拉丁裔人群差异方面，已经产生了大量令人印象深刻的公共卫生知识。然而，对于导致医疗保健差异的预测因素，研究结果仍存在不确定性和争议。我们研究了文化适应研究在理解拉丁裔医疗保健差异方面的理论假设和方法学限制，以及社会经济地位作为医疗保健差异预测因素的证据，以及文化能力实践的有效性。持续使用以文化为导向的文化适应模型将健康差异的关键因素——社会决定因素边缘化，并降低了文化能力实践的效果。在理解医疗保健差异方面，社会经济决定因素比文化更重要。改善低收入拉丁裔人群的物质条件可以有效减少医疗保健差异。
