Center for Diversity and Health Equity, American Academy of Family Physicians, Leawood, Kansas, USA
Fam Med Community Health. 2022 Jul;10(3). doi: 10.1136/fmch-2022-001732.
As a social determinant of health, poverty has been medicalised in such a way that interventions to address it have fallen on the shoulders of healthcare systems and healthcare professionals to reduce health inequities as opposed to creating and investing in a strong social safety net. In our current fee-for-service model of healthcare delivery, the cost of delivering secondary or even tertiary interventions to mitigate the poor health effects of poverty in the clinic is much more costly than preventive measures taken by communities. In addition, this leads to increasing burnout among the healthcare workforce, which may ultimately result in a healthcare worker shortage. To mitigate, physicians and other healthcare workers with power and privilege in communities systematically disenfranchised may take action by being outspoken on the development and implementation of policies known to result in health inequities. Developing strong advocacy skills is essential to being an effective patient advocate in and outside of the exam room.
作为健康的社会决定因素之一，贫困已被医学化，以至于解决贫困问题的干预措施落在了医疗保健系统和医疗保健专业人员的肩上，目的是减少健康不平等，而不是建立和投资强大的社会安全网。在我们当前的按服务收费的医疗保健提供模式中，在诊所提供二级甚至三级干预措施来减轻贫困对健康的不良影响的成本，比社区采取的预防措施要高得多。此外，这导致医疗保健工作者的倦怠感不断增加，这最终可能导致医疗保健人员短缺。为了缓解这种情况，在社区中拥有权力和特权的医生和其他医疗保健工作者可能会采取行动，公开反对制定和实施已知会导致健康不平等的政策。培养强有力的宣传技能对于在诊室外和诊室内成为有效的患者代言人至关重要。
