Abu-Saad Kathleen, Avni Shlomit, Kalter-Leibovici Ofra
Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel.
Strategic and Economic Planning Administration, Israel Ministry of Health, Jerusalem, Israel.
Isr J Health Policy Res. 2018 Feb 28;7(1):14. doi: 10.1186/s13584-018-0208-1.
Health disparities are a persistent problem in many high-income countries. Health policymakers recognize the need to develop systematic methods for documenting and tracking these disparities in order to reduce them. The experience of the U.S., which has a well-established health disparities monitoring infrastructure, provides useful insights for other countries.
This article provides an in-depth review of health disparities monitoring in the U.S. Lessons of potential relevance for other countries include: 1) the integration of health disparities monitoring in population health surveillance, 2) the role of political commitment, 3) use of monitoring as a feedback loop to inform future directions, 4) use of monitoring to identify data gaps, 5) development of extensive cross-departmental cooperation, and 6) exploitation of digital tools for monitoring and reporting. Using Israel as a case in point, we provide a brief overview of the healthcare and health disparities landscape in Israel, and examine how the lessons from the U.S. experience might be applied in the Israeli context.
The U.S. model of health disparities monitoring provides useful lessons for other countries with respect to documentation of health disparities and tracking of progress made towards their elimination. Given the persistence of health disparities both in the U.S. and Israel, there is a need for monitoring systems to expand beyond individual- and healthcare system-level factors, to incorporate social and environmental determinants of health as health indicators/outcomes.
在许多高收入国家,健康差距一直是个问题。卫生政策制定者认识到需要开发系统方法来记录和跟踪这些差距,以便缩小差距。美国拥有完善的健康差距监测基础设施,其经验能为其他国家提供有益见解。
本文深入回顾了美国的健康差距监测情况。对其他国家可能具有潜在相关性的经验教训包括:1)将健康差距监测纳入人群健康监测;2)政治承诺的作用;3)将监测用作反馈循环以指导未来方向;4)利用监测识别数据缺口;5)开展广泛的跨部门合作;6)利用数字工具进行监测和报告。以以色列为例,我们简要概述了以色列的医疗保健和健康差距情况,并探讨了如何将美国经验中的教训应用于以色列的情况。
美国的健康差距监测模式在记录健康差距和跟踪消除差距所取得的进展方面,为其他国家提供了有益的经验教训。鉴于美国和以色列都存在持续的健康差距,监测系统有必要超越个人和医疗保健系统层面的因素,将健康的社会和环境决定因素纳入健康指标/结果之中。