Nickel Nathan C, Lee Janelle Boram, Chateau Joanne, Paillé Michael
1 Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Healthc Manage Forum. 2018 Nov;31(6):245-251. doi: 10.1177/0840470418791868. Epub 2018 Sep 17.
In 2017, the Commonwealth Fund released a report evaluating 11 countries' healthcare systems on a variety of domains; one of these domains was health equity. Canada's score on health equity placed it among the bottom three countries. This article applies a conceptual framework for health equity developed by the World Health Organization's Commission on the Social Determinants of Health to reflect upon and discuss mechanisms that may help to explain Canada's low score. We discuss the role that two societal-level constructs-income inequality and structural racism-play in shaping population health and health equity. We use publically available data to examine whether income inequality correlates with the Commonwealth Fund report's equity measures. We also comment on the role that Canada's history of colonialism may play in its health equity ranking.
2017年，英联邦基金会发布了一份报告，在多个领域对11个国家的医疗体系进行评估；其中一个领域是健康公平。加拿大在健康公平方面的得分使其位列得分最低的三个国家之一。本文应用世界卫生组织健康问题社会决定因素委员会制定的健康公平概念框架，对可能有助于解释加拿大低分的机制进行反思和讨论。我们讨论了两个社会层面的因素——收入不平等和结构性种族主义——在塑造人口健康和健康公平方面所起的作用。我们使用公开数据来检验收入不平等是否与英联邦基金会报告中的公平指标相关。我们还评论了加拿大殖民历史在其健康公平排名中可能发挥的作用。
