Department of Sociology, University of Illinois, Chicago, Illinois, USA.
Sociol Health Illn. 2022 Sep;44(8):1251-1269. doi: 10.1111/1467-9566.13514. Epub 2022 Aug 6.
The city government of Chicago adopted a 'racial equity' approach to tackle racial disparities in COVID-19 outcomes. Drawing on experience addressing core vulnerabilities associated with HIV risk, Chicago public health experts who designed COVID-19 mitigation initiatives recognised that the same social determinants of health drive racial disparities for both HIV and COVID-19. Yet, when building an infrastructure to respond to COVID-19, disease surveillance and data collection became the priority for investment ahead of other forms of public health work or the provision of social services. The building of a disease surveillance infrastructure that responded to and supplied data took precedence over addressing social determinants of poor health. Community-based organisations that might have otherwise organised for social service provision were incorporated into this infrastructure. Further, public health officials often failed to heed the lessons learned from their experience with HIV vulnerability. Based on qualitative analysis of 56 interviews with public health experts and policymakers in Chicago, we argue that the prioritisation of disease surveillance, coupled with a scarcity model of public health provision, undermined the city's attempt to redress racial inequities in outcomes. We argue that the economisation of pandemic response exacerbates health disparities, even when racial equity frameworks are adopted.
芝加哥市政府采取了“种族平等”方法来解决 COVID-19 结果中的种族差异。借鉴解决与 HIV 风险相关的核心脆弱性的经验，设计 COVID-19 缓解措施的芝加哥公共卫生专家认识到，同样的健康决定因素也是导致 HIV 和 COVID-19 种族差异的原因。然而，在建立应对 COVID-19 的基础设施时，疾病监测和数据收集成为投资的优先事项，而不是其他形式的公共卫生工作或社会服务的提供。建立应对和提供数据的疾病监测基础设施优先于解决健康不良的社会决定因素。原本可能组织社会服务提供的基于社区的组织被纳入了这一基础设施。此外，公共卫生官员经常未能吸取他们在 HIV 脆弱性方面的经验教训。基于对芝加哥 56 名公共卫生专家和政策制定者的定性分析，我们认为，疾病监测的优先化，加上公共卫生供应的稀缺模式，破坏了该市纠正结果中种族不平等的努力。我们认为，即使采用了种族平等框架，大流行病应对的经济化也会加剧健康差距。
