Baah Foster Osei, Teitelman Anne M, Riegel Barbara
NewCourtland Center for Transitions & Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
Nurs Inq. 2019 Jan;26(1):e12268. doi: 10.1111/nin.12268. Epub 2018 Nov 29.
Scientific advances in health care have been disproportionately distributed across social strata. Disease burden is also disproportionately distributed, with marginalized groups having the highest risk of poor health outcomes. Social determinants are thought to influence health care delivery and the management of chronic diseases among marginalized groups, but the current conceptualization of social determinants lacks a critical focus on the experiences of people within their environment. The purpose of this article was to integrate the literature on marginalization and situate the concept in the framework of social determinants of health. We demonstrate that social position links marginalization and social determinants of health. This perspective provides a critical lens to assess the societal power dynamics that influence the construction of the socio-environmental factors affecting health. Linking marginalization with social determinants of health can improve our understanding of the inequities in health care delivery and the disparities in chronic disease burden among vulnerable groups.
医疗保健领域的科学进步在社会各阶层中的分布极不均衡。疾病负担的分布也不均衡,边缘化群体健康状况不佳的风险最高。社会决定因素被认为会影响边缘化群体的医疗保健服务提供和慢性病管理,但当前对社会决定因素的概念化缺乏对人们在其环境中的经历的关键关注。本文的目的是整合关于边缘化的文献,并将这一概念置于健康的社会决定因素框架中。我们证明,社会地位将边缘化与健康的社会决定因素联系起来。这一观点为评估影响影响健康的社会环境因素构建的社会权力动态提供了一个关键视角。将边缘化与健康的社会决定因素联系起来,可以增进我们对医疗保健服务中的不公平现象以及弱势群体中慢性病负担差异的理解。
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