Trout Lucas Jacob, Kleinman Arthur
Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, MA, United States.
Front Sociol. 2020 Oct 26;5:579991. doi: 10.3389/fsoc.2020.579991. eCollection 2020.
Covid-19 is an inherently social disease, with exposure, illness, care, and outcomes stratified along familiar social, economic, and racial lines. However, interventions from public health and clinical medicine have focused primarily on the scale-up of technical and biomedical solutions that fail to address the social contexts driving its distribution and burden. Fused with a moment of reckoning with racial injustice and economic inequality in the U.S. and across the world, these disparities charge policy leaders to develop, study, and share a response grounded in social medicine. As a yardstick for formulating, evaluating, and implementing health policy and care delivery, social medicine recommends at least three things: integrating health, social, and economic responses; bringing care to the points of greatest need; and focusing on broad equity-driven reforms in the pandemic's wake. With these tools, Covid-19 presents us with an opportunity to address the inequities that the disease highlights, exploits, and may otherwise entrench.
新冠病毒病本质上是一种社会性疾病,其暴露、患病、护理及结局情况依常见的社会、经济和种族界限而分层。然而,公共卫生和临床医学的干预措施主要集中在扩大技术和生物医学解决方案的规模上,而这些方案未能解决导致其传播和负担的社会背景问题。在美国乃至全球对种族不公和经济不平等进行反思的时刻,这些差异促使政策制定者制定、研究并分享基于社会医学的应对措施。作为制定、评估和实施卫生政策及医疗服务的衡量标准,社会医学至少建议三件事:整合卫生、社会和经济应对措施;将护理送到最需要的地方;关注疫情过后以广泛公平为导向的改革。借助这些工具,新冠病毒病为我们提供了一个机会,来解决该疾病所凸显、利用并可能进一步加剧的不平等问题。