Wallace S P
Department of Community Health Sciences, School of Public Health, University of California, Los Angeles 90024.
Int J Health Serv. 1990;20(4):665-80. doi: 10.2190/CM59-YP1Q-2CP8-3A95.
The author analyzes the influences of race and class on the life chances of blacks by focusing on the health care of black elderly. Theories based on cultural, class, and racial forces are explained in the context of how each would be used to analyze the health care of older blacks. The lower health and socioeconomic statuses of older blacks compared with older whites are documented. The author argues that cultural factors are unable to explain those differences adequately, and that class factors such as the profit orientation of the medical care system, and race factors such as residential segregation and racial discrimination in the medical care system, both contribute to the disparities in medical care. Since proposals for a U.S. national health insurance or national health service fail to include race-conscious measures, the proposals will fail to eliminate existing racial disparities in the health and health care of the elderly.
作者通过关注老年黑人的医疗保健，分析了种族和阶级对黑人生活机会的影响。基于文化、阶级和种族力量的理论在如何用于分析老年黑人医疗保健的背景下得到了解释。记录了老年黑人与老年白人相比较低的健康和社会经济地位。作者认为文化因素无法充分解释这些差异，医疗保健系统的利润导向等阶级因素以及医疗保健系统中的居住隔离和种族歧视等种族因素，都导致了医疗保健方面的差距。由于美国国家医疗保险或国家医疗服务的提议未能包括具有种族意识的措施，这些提议将无法消除老年人健康和医疗保健方面现有的种族差距。
