From the Department of Radiology (J.E.J.), Providence Little Company of Mary Medical Center, Torrance, California
Department of Radiology (J.E.J.), Division of Neuroimaging and Neurointervention, Stanford University School of Medicine, Stanford, California.
AJNR Am J Neuroradiol. 2022 Mar;43(3):341-346. doi: 10.3174/ajnr.A7420. Epub 2022 Feb 17.
Health equity means that everyone has the opportunity to be as healthy as possible, but achieving health equity requires the removal of obstacles to health such as poverty, discrimination, unsafe environments, and lack of access to health care. The pandemic has highlighted the awareness and urgency of delivering patient-centered, high-value care. Disparities in care are antithetical to health equity and have been seen throughout medicine and radiology, including neuroradiology. Health disparities result in low value and costly care that is in conflict with evidence-based medicine, quality standards, and best practices. Although the subject of health equity is often framed as a moral or social justice issue, there are compelling economic arguments that also favor health equity. Not only can waste in health care expenditures be countered but more resources can be devoted to high-value care and other vital national economic interests, including sustainable support for our health system and health providers. There are many opportunities for neuroradiologists to engage in the advancement of health equity, while also advancing the interests of the profession and patient-centered high-value care. Although there is no universal consensus on a definition of health equity, a recent report seeking clarity on the lexicon offered the following conceptual framework: "Health equity means that everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care." This definition contrasts with that of health disparities that contribute to inequitable care as a result of demographic differences among populations such as those attributable to race, sex, access, residence, socioeconomic status, insurance status, age, religion, and disability. In effect, the greater the health disparities and negative social determinants of health, the greater the health inequities will be.
健康公平意味着每个人都有机会尽可能地保持健康，但要实现健康公平，就需要消除贫困、歧视、不安全环境和缺乏医疗保健等健康障碍。大流行凸显了提供以患者为中心、高价值护理的意识和紧迫性。护理差距与健康公平背道而驰，在医学和放射学领域都有所体现，包括神经放射学。健康差距导致低价值和昂贵的医疗保健，与循证医学、质量标准和最佳实践相冲突。尽管健康公平的主题通常被视为道德或社会正义问题，但也有令人信服的经济论据支持健康公平。不仅可以对抗医疗保健支出中的浪费，而且可以将更多资源用于高价值护理和其他重要的国家经济利益，包括可持续支持我们的医疗体系和医疗保健提供者。神经放射学家有很多机会参与推进健康公平，同时也推进专业和以患者为中心的高价值护理的利益。尽管对于健康公平的定义没有普遍共识，但最近一份寻求明确词汇的报告提供了以下概念框架：“健康公平意味着每个人都有公平公正的机会尽可能保持健康。这需要消除贫困、歧视及其后果等健康障碍，包括无力感和无法获得公平薪酬、优质教育和住房、安全环境以及医疗保健的好工作。”这个定义与健康差距形成对比，健康差距导致护理不公平，因为人口之间存在差异，例如种族、性别、获得机会、居住地、社会经济地位、保险状况、年龄、宗教和残疾等。实际上，健康差距和负面健康社会决定因素越大，健康不公平就越大。
