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美国的结构性种族主义和健康不平等:证据与干预。

Structural racism and health inequities in the USA: evidence and interventions.

机构信息

New York City Department of Health and Mental Hygiene, Long Island City, NY, USA.

Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

出版信息

Lancet. 2017 Apr 8;389(10077):1453-1463. doi: 10.1016/S0140-6736(17)30569-X.

Abstract

Despite growing interest in understanding how social factors drive poor health outcomes, many academics, policy makers, scientists, elected officials, journalists, and others responsible for defining and responding to the public discourse remain reluctant to identify racism as a root cause of racial health inequities. In this conceptual report, the third in a Series on equity and equality in health in the USA, we use a contemporary and historical perspective to discuss research and interventions that grapple with the implications of what is known as structural racism on population health and health inequities. Structural racism refers to the totality of ways in which societies foster racial discrimination through mutually reinforcing systems of housing, education, employment, earnings, benefits, credit, media, health care, and criminal justice. These patterns and practices in turn reinforce discriminatory beliefs, values, and distribution of resources. We argue that a focus on structural racism offers a concrete, feasible, and promising approach towards advancing health equity and improving population health.

摘要

尽管人们越来越关注理解社会因素如何导致健康状况不佳,但许多学者、政策制定者、科学家、当选官员、记者和其他负责定义和应对公众舆论的人仍然不愿意将种族主义视为种族健康不平等的根本原因。在本报告中,这是美国卫生公平与平等系列报告中的第三份报告,我们使用当代和历史的视角来讨论研究和干预措施,这些研究和干预措施涉及到被称为结构性种族主义对人口健康和健康不平等的影响。结构性种族主义是指社会通过相互加强的住房、教育、就业、收入、福利、信贷、媒体、医疗保健和刑事司法系统来助长种族歧视的所有方式。这些模式和做法反过来又强化了歧视性的信仰、价值观和资源分配。我们认为,关注结构性种族主义为推进健康公平和改善人口健康提供了一种具体、可行和有前途的方法。

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