Shekinah A. Fashaw-Walters (
Cydney M. McGuire, Indiana University, Bloomington, Indiana.
Health Aff (Millwood). 2023 Oct;42(10):1351-1358. doi: 10.1377/hlthaff.2023.00482.
Racial and ethnic health inequities are driven by multiple social and political factors. Race-neutral policies that overlook the role of racism in policy and in disparities may also contribute to inequities. In response, one broad policy-making approach has been to craft race-based policies that attempt to improve outcomes explicitly for specific racial groups. However, race-based policies can be politically infeasible. We propose a racism-conscious approach to policy making and health care practices that addresses racism and advances health equity. Using postacute and long-term care policies as a backdrop, we identify five key steps to creating racism-conscious policies that rest on continuous community engagement and policy evaluation. The proposed racism-conscious framework can be used to develop a new health policy or to redesign an existing policy, and it can work for federal, state, local, and organizational policies, practices, or both.
种族和民族健康不平等是由多种社会和政治因素驱动的。忽视种族主义在政策和差异中作用的不分种族的政策也可能导致不平等。为此,一种广泛的政策制定方法是制定基于种族的政策,试图明确为特定种族群体改善结果。然而,基于种族的政策在政治上可能不可行。我们提出了一种关注种族主义的政策制定和医疗保健实践方法,以解决种族主义问题并促进健康公平。我们以急性后期和长期护理政策为背景,确定了制定基于种族意识的政策的五个关键步骤,这些政策基于持续的社区参与和政策评估。所提出的关注种族主义的框架可用于制定新的卫生政策或重新设计现有的政策,并且可适用于联邦、州、地方和组织政策、实践或两者兼而有之。