Ann Am Thorac Soc. 2017 May;14(5):814-826. doi: 10.1513/AnnalsATS.201702-167WS.
Health disparities related to race, ethnicity, and socioeconomic status persist and are commonly encountered by practitioners of pediatric and adult pulmonary, critical care, and sleep medicine in the United States. To address such disparities and thus progress toward equality in respiratory health, the American Thoracic Society and the National Heart, Lung, and Blood Institute convened a workshop in May of 2015. The workshop participants addressed health disparities by focusing on six topics, each of which concluded with a panel discussion that proposed recommendations for research on racial, ethnic, and socioeconomic disparities in pulmonary, critical care, and sleep medicine. Such recommendations address best practices to advance research on respiratory health disparities (e.g., characterize broad ethnic groups into subgroups known to differ with regard to a disease of interest), risk factors for respiratory health disparities (e.g., study the impact of new tobacco or nicotine products on respiratory diseases in minority populations), addressing equity in access to healthcare and quality of care (e.g., conduct longitudinal studies of the impact of the Affordable Care Act on respiratory and sleep disorders), the impact of personalized medicine on disparities research (e.g., implement large studies of pharmacogenetics in minority populations), improving design and methodology for research studies in respiratory health disparities (e.g., use study designs that reduce participants' burden and foster trust by engaging participants as decision-makers), and achieving equity in the pulmonary, critical care, and sleep medicine workforce (e.g., develop and maintain robust mentoring programs for junior faculty, including local and external mentors). Addressing these research needs should advance efforts to reduce, and potentially eliminate, respiratory, sleep, and critical care disparities in the United States.
在美国,儿科和成人肺脏、重症监护和睡眠医学从业者经常遇到与种族、民族和社会经济地位相关的健康差异。为了解决这些差异,从而在呼吸健康方面实现平等,美国胸科学会和美国国立心肺血液研究所于 2015 年 5 月召开了一次研讨会。研讨会参与者通过关注六个主题来解决健康差异问题,每个主题都以小组讨论结束,小组讨论提出了关于肺脏、重症监护和睡眠医学领域种族、民族和社会经济差异研究的建议。这些建议涉及推进呼吸健康差异研究的最佳实践(例如,将广泛的族裔群体细分为已知在感兴趣的疾病方面存在差异的亚群)、呼吸健康差异的风险因素(例如,研究新烟草或尼古丁产品对少数族裔人群呼吸疾病的影响)、解决医疗保健和护理质量方面的公平性(例如,对《平价医疗法案》对呼吸和睡眠障碍的影响进行纵向研究)、个性化医学对差异研究的影响(例如,在少数族裔人群中实施大规模的药物遗传学研究)、改善呼吸健康差异研究的设计和方法学(例如,使用减少参与者负担并通过让参与者作为决策者参与来建立信任的研究设计),以及实现肺脏、重症监护和睡眠医学领域劳动力的公平性(例如,为初级教员制定和维护强大的指导计划,包括本地和外部导师)。解决这些研究需求应有助于减少并可能消除美国在呼吸、睡眠和重症监护方面的差异。