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实现健康公平的进展需要关注根本原因。

Progress In Achieving Health Equity Requires Attention To Root Causes.

机构信息

Steven H. Woolf (

出版信息

Health Aff (Millwood). 2017 Jun 1;36(6):984-991. doi: 10.1377/hlthaff.2017.0197.

Abstract

Life expectancy and disease rates in the United States differ starkly among Americans depending on their demographic characteristics and where they live. Although health care systems are taking important steps to reduce inequities, meaningful progress requires interventions outside the clinic, in sectors such as employment, housing, transportation, and public safety. Inequities exist in each of these sectors, and barriers to educational attainment, higher-income jobs, and social mobility limit the opportunity of disadvantaged people to improve their circumstances. Financial institutions and other stakeholders are investing in cross-sector collaborations to remove these barriers and thereby strengthen local economies and population health. Meanwhile, recent trends suggest the need to widen the lens on health equity, to include not only the low-income residents of inner-city neighborhoods but also people in economically marginalized rural communities. Widening income inequality and stagnant wages, and their alarming health consequences, underscore the need for policies to help low-income and middle-class families and improve educational opportunities for their children.

摘要

美国人的预期寿命和疾病发病率因人口特征和居住地点的不同而存在显著差异。尽管医疗保健系统正在采取重要措施来减少不平等现象,但要取得有意义的进展,还需要在诊所以外的就业、住房、交通和公共安全等领域采取干预措施。这些部门都存在不平等现象,教育程度、高收入工作和社会流动性方面的障碍限制了弱势群体改善自身处境的机会。金融机构和其他利益攸关方正在投资跨部门合作,以消除这些障碍,从而加强地方经济和人口健康。与此同时,最近的趋势表明,有必要扩大卫生公平的视角,不仅包括城市内城区的低收入居民,还包括经济上处于边缘地位的农村社区的居民。不断扩大的收入不平等和工资停滞不前,以及由此带来的令人震惊的健康后果,突显了需要制定政策来帮助低收入和中等收入家庭,并为其子女提供更多的教育机会。

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