作为一个“棘手”的公共卫生问题来解决种族主义问题:在反种族主义实践中培养盟友。

Tackling racism as a "wicked" public health problem: Enabling allies in anti-racism praxis.

机构信息

Faculty of Health and Environment Sciences, Auckland University of Technology, Private Bag 92006, Auckland, New Zealand.

Centre for Medicine, Health and Society, Vanderbilt University, PMB #351665, 2301 Vanderbilt Pace, Nashville, TN 37235-1665, USA.

出版信息

Soc Sci Med. 2018 Feb;199:181-188. doi: 10.1016/j.socscimed.2017.03.028. Epub 2017 Mar 16.

Abstract

Racism is a "wicked" public health problem that fuels systemic health inequities between population groups in New Zealand, the United States and elsewhere. While literature has examined racism and its effects on health, the work describing how to intervene to address racism in public health is less developed. While the notion of raising awareness of racism through socio-political education is not new, given the way racism has morphed into new narratives in health institutional settings, it has become critical to support allies to make informing efforts to address racism as a fundamental cause of health inequities. In this paper, we make the case for anti-racism praxis as a tool to address inequities in public health, and focus on describing an anti-racism praxis framework to inform the training and support of allies. The limited work on anti-racism rarely articulates the unique challenges or needs of allies or targets of racism, but we seek to help fill that gap. Our anti-racism praxis for allies includes five core elements: reflexive relational praxis, structural power analysis, socio-political education, monitoring and evaluation and systems change approaches. We recognize that racism is a modifiable determinant of health and racial inequities can be eliminated with the necessary political will and a planned system change approach. Anti-racism praxis provides the tools to examine the interconnection and interdependence of cultural and institutional factors as a foundation for examining where and how to intervene to address racism.

摘要

种族主义是一个“恶劣”的公共卫生问题,它加剧了新西兰、美国和其他地方的人群之间的系统性健康不平等。虽然文献已经研究了种族主义及其对健康的影响,但描述如何干预公共卫生中的种族主义的工作还不够发达。虽然通过社会政治教育提高对种族主义认识的概念并不新鲜,但鉴于种族主义在卫生机构环境中已经演变成新的叙述,支持盟友努力将种族主义作为健康不平等的根本原因告知变得至关重要。在本文中,我们提出反种族主义实践作为解决公共卫生不平等的工具,并侧重于描述反种族主义实践框架,以为盟友提供培训和支持。关于反种族主义的有限工作很少阐明盟友或种族主义目标的独特挑战或需求,但我们试图帮助填补这一空白。我们的盟友反种族主义实践包括五个核心要素:反思关系实践、结构权力分析、社会政治教育、监测和评估以及系统变革方法。我们认识到,种族主义是健康的可改变决定因素,只要有必要的政治意愿和有计划的系统变革方法,就可以消除种族不平等。反种族主义实践提供了工具,可用于检查文化和制度因素的相互联系和相互依存关系,作为检查在何处以及如何进行干预以解决种族主义的基础。

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