School of Public Administration, University of Central Florida , Orlando, Florida, USA.
School of Social Work, University of Central Florida , Orlando, Florida, USA.
Soc Work Public Health. 2020 Apr 1;35(4):152-162. doi: 10.1080/19371918.2020.1767750. Epub 2020 May 31.
This article explores why racial and income health disparities continue to exist in the United States. Poverty and racism are the primary drivers of the social problem which impact social determinants of health for vulnerable populations. The theoretical frameworks of conflict theory and critical race theory contextualize the causes and provide direction for overhauling public health policy in general and the Patient Protection and Affordable Care Act (Affordable Care Act) in particular. Although the Affordable Care Act was implemented to increase health coverage, economic and racial health inequities still exist in the United States. Policy recommendations for improving the health and welfare of low-income minorities include: 1) impacting poverty itself by desegregating urban areas of concentrated poverty, and 2) impacting racial discrimination in health care by putting the voices of African-American patients in the forefront to inform culturally relevant policy and practice.
本文探讨了为何在美国,种族和收入健康差距仍然存在。贫困和种族主义是这一社会问题的主要驱动因素,影响着弱势群体的健康社会决定因素。冲突理论和批判种族理论的理论框架使原因具体化,并为全面改革公共卫生政策,特别是《患者保护与平价医疗法案》(平价医疗法案)提供了方向。尽管实施《平价医疗法案》是为了增加医疗保健的覆盖范围,但美国的经济和种族健康不平等仍然存在。改善低收入少数族裔的健康和福利的政策建议包括:1)通过消除贫困集中地区的种族隔离来影响贫困本身,以及 2)通过将非裔美国患者的声音置于最前沿,以告知文化相关的政策和实践,从而影响医疗保健中的种族歧视。