Ruqaiijah Yearby is with The Institute for Healing Justice & Equity, Saint Louis, MO, and the Moritz College of Law, The Ohio State University, Columbus. Crystal Lewis is with The Institute for Healing Justice & Equity and The Ohio State University. Charysse Gibson was with The Institute for Healing Justice & Equity.
Am J Public Health. 2023 Jan;113(S1):S65-S71. doi: 10.2105/AJPH.2022.307166.
In 2010, the federal government and several state governments began using the social determinants of health (SDOH) framework to highlight contributing factors of health inequities and, in 2022, recognized that structural racism was associated with health inequities. Yet, efforts to eliminate health inequities have disproportionately focused on individualized solutions instead of addressing structural racism. Many racial/ethnic-minority workers have been segregated to low-wage occupations that lack access to paid sick leave, such as agricultural work, which has been associated with health inequities. Research shows these inequities are attributable to structural racism enforced through laws that structure the employment system to disadvantage agricultural workers, who are disproportionately racial/ethnic-minority individuals, which will not be addressed with individualized solutions. In this article, we explain why the current SDOH framework and efforts to eliminate health inequities are inadequate, discuss Yearby's revised SDOH framework that includes structural racism as one of the root causes of health inequities, and illustrate how Yearby's revised SDOH framework better captures the impact of structural racism, which is associated with health inequities for agricultural workers. (. 2023;113(S1):S65-S71. https://doi.org/10.2105/AJPH.2022.307166).
2010 年，联邦政府和几个州政府开始使用社会决定因素健康（SDOH）框架来强调健康不平等的促成因素，并且在 2022 年，认识到结构性种族主义与健康不平等有关。然而，消除健康不平等的努力过于侧重于个体化解决方案，而没有解决结构性种族主义问题。许多少数族裔工人被隔离到低工资职业，这些职业缺乏带薪病假，例如农业工作，这与健康不平等有关。研究表明，这些不平等是由于通过法律强制执行的结构性种族主义造成的，这些法律构建了就业系统，使农业工人处于不利地位，而农业工人大多是少数族裔，个体化解决方案无法解决这个问题。在这篇文章中，我们解释了为什么当前的 SDOH 框架和消除健康不平等的努力是不够的，讨论了 Yearby 将结构性种族主义作为健康不平等的根源之一的修订后的 SDOH 框架，并说明了 Yearby 的修订后的 SDOH 框架如何更好地捕捉与农业工人的健康不平等相关的结构性种族主义的影响。（。2023；113（S1）：S65-S71。https://doi.org/10.2105/AJPH.2022.307166）。
