Centre for Health, Law & Society, University of Bristol, Bristol, BS8 1RJ, United Kingdom.
The Vaccine Centre, Department of Global Health and Development, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, United Kingdom.
Soc Sci Med. 2022 Sep;309:115237. doi: 10.1016/j.socscimed.2022.115237. Epub 2022 Aug 7.
The COVID-19 pandemic has disproportionately impacted ethnic minorities in the global north, evidenced by higher rates of transmission, morbidity, and mortality relative to population sizes. Orthodox Jewish neighbourhoods in London had extremely high SARS-CoV-2 seroprevalence rates, reflecting patterns in Israel and the US. The aim of this paper is to examine how responsibilities over health protection are conveyed, and to what extent responsibility is sought by, and shared between, state services, and 'community' stakeholders or representative groups, and families in public health emergencies. The study investigates how public health and statutory services stakeholders, Orthodox Jewish communal custodians and households sought to enact health protection in London during the first year of the pandemic (March 2020-March 2021). Twenty-eight semi-structured interviews were conducted across these cohorts. Findings demonstrate that institutional relations - both their formation and at times fragmentation - were directly shaped by issues surrounding COVID-19 control measures. Exchanges around protective interventions (whether control measures, contact tracing technologies, or vaccines) reveal diverse and diverging attributions of responsibility and authority. The paper develops a framework of public health relations to understand negotiations between statutory services and minority groups over responsiveness and accountability in health protection. Disaggregating public health relations can help social scientists to critique who and what characterises institutional relationships with minority groups, and what ideas of responsibility and responsiveness are projected by differently-positioned stakeholders in health protection.
新冠疫情大流行在全球北方的少数民族中造成了不成比例的影响,这表现在传播率、发病率和死亡率相对于人口规模较高。伦敦的正统犹太社区的 SARS-CoV-2 血清阳性率极高,反映了以色列和美国的模式。本文旨在探讨在公共卫生紧急情况下,健康保护责任是如何传递的,以及在多大程度上由国家服务部门、“社区”利益相关者或代表团体以及家庭承担和分担责任。该研究调查了公共卫生和法定服务利益相关者、正统犹太教监护人以及英国家庭在疫情爆发的第一年(2020 年 3 月至 2021 年 3 月)期间如何在伦敦实施健康保护。在这些群体中进行了 28 次半结构化访谈。研究结果表明,机构关系——包括它们的形成和有时的分裂——直接受到围绕 COVID-19 控制措施的问题的影响。围绕保护干预措施(无论是控制措施、接触者追踪技术还是疫苗)的交流揭示了责任和权威的多样性和分歧。本文提出了一个公共卫生关系框架,以了解法定服务部门和少数群体之间在健康保护方面的响应能力和问责制的谈判。分解公共卫生关系可以帮助社会科学家批评谁和什么构成了与少数群体的机构关系,以及不同立场的利益相关者在健康保护方面投射出什么样的责任和响应观念。