Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
Department of African and African American Studies and of Sociology, Harvard University, Cambridge, MA 02138, USA.
Int J Environ Res Public Health. 2019 Feb 19;16(4):606. doi: 10.3390/ijerph16040606.
This paper provides an overview of the scientific evidence pointing to critically needed steps to reduce racial inequities in health. First, it argues that communities of opportunity should be developed to minimize some of the adverse impacts of systemic racism. These are communities that provide early childhood development resources, implement policies to reduce childhood poverty, provide work and income support opportunities for adults, and ensure healthy housing and neighborhood conditions. Second, the healthcare system needs new emphases on ensuring access to high quality care for all, strengthening preventive health care approaches, addressing patients' social needs as part of healthcare delivery, and diversifying the healthcare work force to more closely reflect the demographic composition of the patient population. Finally, new research is needed to identify the optimal strategies to build political will and support to address social inequities in health. This will include initiatives to raise awareness levels of the pervasiveness of inequities in health, build empathy and support for addressing inequities, enhance the capacity of individuals and communities to actively participate in intervention efforts and implement large scale efforts to reduce racial prejudice, ideologies, and stereotypes in the larger culture that undergird policy preferences that initiate and sustain inequities.
本文概述了指向减少健康领域种族不平等的迫切需要采取的步骤的科学证据。首先,它认为应该开发机会社区,以尽量减少系统性种族主义的一些不利影响。这些社区提供儿童早期发展资源,实施减少儿童贫困的政策,为成年人提供工作和收入支持机会,并确保健康的住房和社区条件。其次,医疗保健系统需要新的重点,以确保所有人都能获得高质量的护理,加强预防保健方法,将患者的社会需求作为医疗服务的一部分,并使医疗保健劳动力多样化,以更紧密地反映患者人群的人口结构。最后,需要进行新的研究,以确定建立政治意愿和支持以解决健康方面社会不平等的最佳策略。这将包括提高对健康不平等普遍存在的认识水平的举措,培养对解决不平等问题的同理心和支持,增强个人和社区积极参与干预措施的能力,并实施大规模努力,以减少更大文化中的种族偏见、意识形态和刻板印象,这些偏见、意识形态和刻板印象支撑着引发和维持不平等的政策偏好。