Levine Cheryl A, Jansson Daire R
Office of the Assistant Secretary for Preparedness and Response, US Department of Health and Human Services, Washington, DC, USA.
University of Tennessee, Knoxville, Tennessee, USA.
Disaster Med Public Health Prep. 2021 Jun 8:1-7. doi: 10.1017/dmp.2021.181.
Public health emergencies, including the coronavirus disease 2019 (COVID-19) pandemic, highlight disproportionate impacts faced by populations with existing disparities. Concepts and terms used to describe populations disproportionately impacted in emergencies vary over time and across disciplines, but United States (US) federal guidance and law require equal access to our nation's emergency resources. At all levels of emergency planning, public health and their partners must be accountable to populations with existing inequities, which requires a conceptual shift toward using the data-driven social determinants of health (SDOH). SDOH are conditions in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality of life outcomes and risks. This article reviews the historic use of concepts and terms to describe populations disproportionately impacted by emergencies. It also recommends a shift in emergency activities toward interventions that target the SDOH to adequately address long-standing systemic health disparities and socioeconomic inequities in the United States.
包括2019年冠状病毒病（COVID-19）大流行在内的突发公共卫生事件，凸显了存在现有差异的人群所面临的不成比例的影响。用于描述在紧急情况下受到不成比例影响的人群的概念和术语会随时间和学科而变化，但美国联邦指导方针和法律要求平等获取我国的应急资源。在各级应急规划中，公共卫生部门及其合作伙伴必须对存在现有不平等现象的人群负责，这需要在概念上转向使用数据驱动的健康社会决定因素（SDOH）。健康社会决定因素是指人们出生、生活、学习、工作、娱乐、礼拜和衰老的环境，这些环境会影响广泛的健康、功能以及生活质量结果和风险。本文回顾了用于描述受紧急情况影响不成比例的人群的概念和术语的历史用法。它还建议将应急活动转向针对健康社会决定因素的干预措施，以充分解决美国长期存在的系统性健康差异和社会经济不平等问题。
