Division of Community Health Sciences, School of Public Health, University of California, Berkeley, California 94720, USA; email:
Division of Epidemiology, School of Public Health, University of California, Berkeley, California 94720, USA; email:
Annu Rev Public Health. 2018 Apr 1;39:169-188. doi: 10.1146/annurev-publhealth-040617-014230. Epub 2018 Jan 12.
An abundance of research has documented health inequalities by race and socioeconomic position (SEP) in the United States. However, conceptual and methodological challenges complicate the interpretation of study findings, thereby limiting progress in understanding health inequalities and in achieving health equity. Fundamental to these challenges is a lack of clarity about what race is and the implications of that ambiguity for scientific inquiry. Additionally, there is wide variability in how SEP is conceptualized and measured, resulting in a lack of comparability across studies and significant misclassification of risk. The objectives of this review are to synthesize the literature regarding common approaches to examining race and SEP health inequalities and to discuss the conceptual and methodological challenges associated with how race and SEP have been employed in public health research. Addressing health inequalities has become increasingly important as the United States trends toward becoming a majority-minority nation. Recommendations for future research are presented.
大量研究记录了美国在种族和社会经济地位(SEP)方面的健康不平等现象。然而,概念和方法上的挑战使得研究结果的解释变得复杂,从而限制了对健康不平等现象的理解和实现健康公平的进展。这些挑战的根本原因是缺乏对种族的清晰认识,以及这种模糊性对科学研究的影响。此外,SEP 的概念化和衡量方式存在很大差异,导致研究之间缺乏可比性,风险分类也存在很大错误。本综述的目的是综合关于检查种族和 SEP 健康不平等的常见方法的文献,并讨论与在公共卫生研究中使用种族和 SEP 相关的概念和方法上的挑战。随着美国逐渐成为一个以少数民族为主的国家,解决健康不平等问题变得越来越重要。提出了对未来研究的建议。