McGrail Kimberlyn, Morgan Jeffrey, Siddiqi Arjumand
Centre for Health Services and Policy Research, UBC Health, The University of British Columbia, Vancouver, Canada.
Centre for Health Services and Policy Research, School of Population and Public Health, The University of British Columbia, Vancouver, Canada.
Lancet Reg Health Am. 2022 May;9:100232. doi: 10.1016/j.lana.2022.100232. Epub 2022 Mar 17.
We will likely look back on 2020 as a turning point. The pandemic put a spotlight on existing societal issues, accelerated the pace of change in others, and created some new ones too. For example, concerns about inequalities in health by income and race are not new, but they became more apparent to a larger number of people during 2020. The speed and starkness of broadening societal conversation, including beyond the direct effects of COVID-19, create an opportunity and motivation to reassess our understanding of health. Perhaps more importantly, it is an opportunity to reduce inequities in who has access to, who uses, and who benefits from the resources that promote health and well-being. To this end, we offer three questions to guide thinking about health and health inequities after 2020: (1) what do we mean by "health" and "health inequality and inequity"? (2) what are the structures and policies we put in place to support or promote health, and how effective are they? And (3) who has the power to shape structures and policies, and whose interests do those structures and policies serve?
我们可能会将2020年视为一个转折点。这场大流行病使现有的社会问题受到关注,加快了其他方面的变革步伐,还催生了一些新问题。例如,对健康方面收入和种族不平等的担忧并非新鲜事,但在2020年,更多人对此有了更明显的认识。社会讨论范围不断扩大,其速度之快、程度之深,包括超出了新冠疫情的直接影响,这为重新审视我们对健康的理解创造了契机和动力。或许更重要的是,这是一个减少在获取、使用促进健康和福祉的资源以及从中受益方面存在的不平等现象的机会。为此,我们提出三个问题,以引导对2020年后的健康及健康不平等问题的思考:(1)我们所说的“健康”以及“健康不平等和不公平”是什么意思?(2)我们为支持或促进健康而建立的结构和政策有哪些,它们的效果如何?以及(3)谁有能力塑造结构和政策,这些结构和政策服务于哪些人的利益?