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呼吁利用健康公平视角加速人类神经科学研究。

A call to leverage a health equity lens to accelerate human neuroscience research.

作者信息

Rebello Vida, Uban Kristina A

机构信息

Department of Health, Society and Behavior, Public Health, Henry and Susan Samueli College of Health Science, University of California, Irvine, Irvine, CA, United States.

Department of Population Health and Disease Prevention, Public Health, Henry and Susan Samueli College of Health Science, University of California, Irvine, Irvine, CA, United States.

出版信息

Front Integr Neurosci. 2023 Apr 17;17:1035597. doi: 10.3389/fnint.2023.1035597. eCollection 2023.

Abstract

Investigation of health inequities tend to be examined, in human neurosciences, as biological factors at the level of the individual. In actuality, health inequities arise, due largely in part, to deep-seated structural factors. Structural inequality refers to the systemic disadvantage of one social group compared to others with whom they coexist. The term encompasses policy, law, governance, and culture and relates to race, ethnicity, gender or gender identity, class, sexual orientation, and other domains. These structural inequalities include but are not limited to social segregation, the intergenerational effects of colonialism and the consequent distribution of power and privilege. Principles to address inequities influenced by structural factors are increasingly prevalent in a subfield of the neurosciences, i.e., cultural neurosciences. Cultural neuroscience articulates the bidirectional relationship between biology and environmental contextual factors surrounding research participants. However, the operationalization of these principles may not have the intended spillover effect on the majority of human neurosciences: this limitation is the overarching focus of the present piece. Here, we provide our perspective that these principles are missing and very much needed in all human neuroscience subdisciplines to accelerate our understanding of the human brain. Furthermore, we provide an outline of two key tenets of a health equity lens necessary for achieving research equity in human neurosciences: the social determinants of health (SDoH) framework and how to deal with confounders using counterfactual thinking. We argue that these tenets should be prioritized across future human neuroscience research more generally, and doing so is a pathway to further gain an understanding of contextual background intertwined with the human brain, thus improving the rigor and inclusivity of human neuroscience research.

摘要

在人类神经科学领域,对健康不平等的研究往往被视为个体层面的生物学因素。实际上,健康不平等很大程度上是由深层次的结构性因素导致的。结构性不平等是指一个社会群体相对于与其共存的其他群体所面临的系统性劣势。这个术语涵盖政策、法律、治理和文化,涉及种族、民族、性别或性别认同、阶级、性取向以及其他领域。这些结构性不平等包括但不限于社会隔离、殖民主义的代际影响以及由此产生的权力和特权分配。解决受结构性因素影响的不平等问题的原则在神经科学的一个子领域,即文化神经科学中越来越普遍。文化神经科学阐述了生物学与研究参与者周围环境背景因素之间的双向关系。然而,这些原则的实施可能不会对大多数人类神经科学产生预期的溢出效应:这一局限性是本文的总体关注点。在此,我们提出观点,认为这些原则在所有人类神经科学子学科中都缺失且非常必要,以加速我们对人类大脑的理解。此外,我们概述了在人类神经科学中实现研究公平所需的健康公平视角的两个关键原则:健康的社会决定因素(SDoH)框架以及如何使用反事实思维处理混杂因素。我们认为,这些原则应在更广泛的未来人类神经科学研究中得到优先考虑,这样做是进一步理解与人类大脑交织的背景环境的一条途径,从而提高人类神经科学研究的严谨性和包容性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a9c/10150449/32832880a49c/fnint-17-1035597-g001.jpg

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