Smith D B
Department of Health Administration, Temple University, Philadelphia, PA 19122.
Milbank Q. 1990;68(4):561-96.
Although the passage of major civil-rights legislation in the 1960s compelled American hospitals to take concerted steps to achieve racial integration, nursing homes did not come under the same organizational and financial pressures to do so. As a result, nursing homes remained significantly segregated; to this day, there is a greater discrepancy between black and white people's access to long-term-care facilities than to acute-care hospitals. The perspective of population ecology may be used to help account for these disparate historical outcomes; economics, demographics, and more subtle patterns of discrimination continue to reinforce forms of segregation in health-care facilities.
尽管20世纪60年代主要民权立法的通过迫使美国医院采取协调一致的措施来实现种族融合，但养老院并未面临同样的组织和财政压力去这样做。结果，养老院仍然严重隔离；直到今天，黑人和白人在获得长期护理设施方面的差距比在急症护理医院方面更大。人口生态学的观点或许可以用来解释这些不同的历史结果；经济、人口统计学以及更微妙的歧视模式继续强化着医疗保健设施中的隔离形式。
