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特殊健康需要儿童和青少年的健康公平:未来的愿景。

Health Equity for Children and Youth With Special Health Care Needs: A Vision for the Future.

机构信息

Departments of Physical Medicine Rehabilitation.

Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania.

出版信息

Pediatrics. 2022 Jun 1;149(Suppl 7). doi: 10.1542/peds.2021-056150F.

Abstract

Health equity is a key pillar in supporting a future in which CYSHCN enjoy a full life and thrive, as envisioned by experts and community partners who gathered in 2019 and 2020 to develop the Blueprint for Change: Guiding Principles for a System of Services for Children and Youth With Special Health Care Needs and Their Families. However, a variety of contextual factors impact health outcomes across the life course and intergenerationally and must be addressed to achieve this goal. For example, poverty and discrimination, including by some health care professionals and systems, are important, modifiable root causes of poor health outcomes. There are numerous barriers to achieving health equity, including political will, lack of resources, insufficient training, and limited cross-sector collaborations. Political, cultural, societal, and environmental interventions are necessary to eliminate health disparities and achieve health equity. The entities that serve CYSHCN should be equitably designed and implemented to improve health outcomes and address health disparities. Many entities that serve CYSHCN are taking positive steps through workforce development, policy changes, community engagement, and other means. The purpose of this article is to frame health equity for CYSHCN, detail their health disparities, review barriers to health equity, provide examples of strategies to advance health equity for them, and describe a path toward the future in which all CYSHCN have a fair and just opportunity to be as healthy as possible.

摘要

健康公平是支持未来的关键支柱,在这个未来中,患有特殊健康需求的儿童和青少年(CYSHCN)能够享受充实的生活并茁壮成长,这是 2019 年和 2020 年聚集在一起制定《变革蓝图:为有特殊健康需求的儿童和青年及其家庭提供服务的系统指导原则》的专家和社区合作伙伴的愿景。然而,各种背景因素会影响整个生命周期和代际的健康结果,必须加以解决才能实现这一目标。例如,贫困和歧视,包括一些医疗保健专业人员和系统的歧视,是造成健康结果不佳的重要、可改变的根本原因。实现健康公平存在许多障碍,包括政治意愿、资源不足、培训不足以及跨部门合作有限。需要进行政治、文化、社会和环境干预,以消除健康差距,实现健康公平。为改善健康结果和解决健康差距,服务 CYSHCN 的实体应该公平地设计和实施。许多为 CYSHCN 服务的实体正在通过劳动力发展、政策变革、社区参与和其他手段采取积极措施。本文的目的是为 CYSHCN 构建健康公平框架,详细说明他们的健康差距,审查健康公平的障碍,提供为他们推进健康公平的策略示例,并描述一条通往未来的道路,使所有 CYSHCN 都有公平公正的机会尽可能健康。

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