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用于评估健康公平知识与行动一致性的工具。

A tool to assess alignment between knowledge and action for health equity.

机构信息

University of British Columbia, 1147 Research Road, Kelowna, BC, Canada.

Regional Practice Leader, Research & Knowledge Translation, Research Department, Interior Health, Kelowna, BC, Canada.

出版信息

BMC Public Health. 2020 Feb 12;20(1):224. doi: 10.1186/s12889-020-8324-6.

Abstract

Advancing health equity is a central goal and ethical imperative in public and global health. Though the commitment to health equity in these fields and among the health professions is clear, alignment between good equity intentions and action remains a challenge. This work regularly encounters the same power structures that are known to cause health inequities. Despite consensus about causes, health inequities persist-illustrating an uncomfortable paradox: good intentions and good evidence do not necessarily lead to meaningful action. This article describes a theoretically informed, reflective tool for assessing alignment between knowledge and action for health equity. It is grounded in an assumption that progressively more productive action toward health inequities is justified and desired and an explicit acceptance of the evidence about the socioeconomic, political, and power-related root causes of health inequities. Intentionally simple, the tool presents six possible actions that describe ways in which health equity work could respond to causes of health inequities: discredit, distract, disregard, acknowledge, illuminate, or disrupt. The tool can be used to assess or inform any kind of health equity work, in different settings and at different levels of intervention. It is a practical resource against which practice, policy, or research can be held to account, encouraging steps toward equity- and evidence-informed action. It is meant to complement other tools and training resources to build capacity for allyship, de- colonization, and cultural safety in the field of health equity, ultimately contributing to growing awareness of how to advance meaningful health equity action.

摘要

推进健康公平是公共卫生和全球卫生的核心目标和道德使命。尽管在这些领域和卫生专业人员中对健康公平的承诺是明确的,但良好的公平意愿和行动之间的一致性仍然是一个挑战。这项工作经常遇到同样的权力结构,这些权力结构是造成健康不平等的已知原因。尽管对原因达成了共识,但健康不平等仍然存在——这说明了一个令人不安的悖论:良好的意愿和良好的证据不一定会导致有意义的行动。本文描述了一种理论上有依据、反思性的工具,用于评估健康公平知识与行动之间的一致性。它基于这样一种假设,即朝着减少健康不平等的方向采取更有成效的行动是合理和可取的,并且明确接受有关健康不平等的社会经济、政治和权力根源的证据。该工具有意设计得简单,提出了六种可能的行动,这些行动描述了健康公平工作可以应对健康不平等原因的方式:诋毁、转移注意力、忽视、承认、阐明或扰乱。该工具可用于评估或为任何类型的健康公平工作提供信息,无论是在不同的环境中还是在不同的干预层面。它是一种实用的资源,可以对实践、政策或研究进行问责,鼓励朝着公平和循证行动迈进。它旨在补充其他工具和培训资源,以增强在健康公平领域的同盟、去殖民化和文化安全能力,最终提高人们对如何推进有意义的健康公平行动的认识。

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