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解决收入相关健康不平等问题的政策逻辑:一种问题导向的方法。

The Logic of Policies to Address Income-Related Health Inequity: A Problem-Oriented Approach.

机构信息

Division of General Medicine and Clinical Epidemiology, Department of Medicine, University of North Carolina at Chapel Hill School of Medicine; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill.

出版信息

Milbank Q. 2022 Jun;100(2):370-392. doi: 10.1111/1468-0009.12558. Epub 2022 Mar 22.

Abstract

Policy Points  Income is a fundamental cause of health across the life course. To address income-related health inequities, we need a set of overlapping and complementary policy approaches rather than focusing on a single policy.  During their lives, individuals inhabit different roles with regard to their ability to earn wages, and at any given time, only about 50% of the US population are expected to earn wages, while the rest (e.g., children, older adults, those who are disabled, unemployed, students, and/or caregivers) are not.  Three key "branch points" for designing policy approaches to address income-related health inequity are (1) should the needed good or service be obtained on the market? (2) do policy beneficiaries currently earn income? and (3) have policy beneficiaries earned income previously? The responses to these questions suggest one of four policy approaches: social services, social enfranchisement, social insurance, or social assistance.

摘要

政策要点 收入是贯穿整个生命历程的健康的根本原因。为了解决与收入相关的健康不平等问题,我们需要一套重叠且互补的政策方法,而不是只关注单一政策。 在他们的一生中,个人在赚取工资的能力方面扮演着不同的角色,而在任何特定时间,只有大约 50%的美国人口预计将赚取工资,而其余的人(例如儿童、老年人、残疾人士、失业者、学生和/或照顾者)则不赚取工资。 设计解决与收入相关的健康不平等问题的政策方法的三个关键“分支点”是:(1)是否需要在市场上获得所需的商品或服务?(2)政策受益人目前是否有收入?(3)政策受益人以前是否有收入?对这些问题的回答表明有四种政策方法之一:社会服务、社会赋权、社会保险或社会援助。

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