National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.
National Center for Chronic Disease and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
Ethn Dis. 2019 Feb 21;29(Suppl 1):103-112. doi: 10.18865/ed.29.S1.103. eCollection 2019.
Health inequities are well-documented, but their economic dimensions have received less attention. In this report, we describe four economic dimensions of health inequities in the United States. First, we describe an economic conceptual framework that connects poverty and health inequities at both individual and population levels and conveys the concept of reverse causality, where poverty worsens health inequities and health inequities worsen poverty. This framework can help us understand the key elements of health inequity and its drivers. Second, we describe economic measurements used for quantifying the economic burden of health inequalities and summarize the empirical findings from studies. Third, we review the evidence on the return-on-investment of economic interventions that are aimed at reducing health inequities. Finally, we highlight the importance of cross disciplinary perspectives from economics and implementation research in effectively delivering interventions that can mitigate health inequities.
健康不平等现象已有大量记载，但人们对其经济层面的关注较少。在本报告中，我们描述了美国健康不平等现象的四个经济层面。首先，我们描述了一个经济概念框架，该框架将个人和人口层面的贫困与健康不平等联系起来，并传达了反向因果关系的概念，即贫困加剧了健康不平等，而健康不平等又加剧了贫困。该框架可以帮助我们理解健康不平等及其驱动因素的关键要素。其次，我们描述了用于量化健康不平等经济负担的经济衡量指标，并总结了相关研究的实证发现。第三，我们回顾了旨在减少健康不平等的经济干预措施的投资回报证据。最后，我们强调了经济学和实施研究的跨学科视角对于有效实施能够减轻健康不平等的干预措施的重要性。
