Community Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, USA; Berkeley Center for Cultural Humility, University of California Berkeley, Berkeley, CA, USA.
Soc Sci Med. 2024 Jun;351:116251. doi: 10.1016/j.socscimed.2023.116251. Epub 2023 Oct 19.
Research focused on health disparities-whether relating to one's race/ethnicity, gender expression, sexual orientation, citizenship status, income level, etc.-constitutes a large, generative, and highly profitable portion of scholarship in academic, clinical, and government settings. Health disparities research is expressed as a means of bringing greater attention to, and ultimately addressing via evidence-based implementation science, acts of devaluation and oppression that have continually contributed to these inequities. Philosophies underlying health disparities research's expansive and growing presence mirror the formal logic and ethos of the Military Industrial Complex and the Prison Industrial Complex. The "Health Disparities Research Industrial Complex," operationalized in this article, represents a novel mutation and extension of these complexes, primarily being enacted through these three mechanisms: 1) The construction and maintenance of beliefs, behaviors, and policies in healthcare, and society more broadly, that create and sustain disadvantages in minority health; 2) the creation and funding of research positions that inordinately provide non-minoritized people and those without relevant lived experiences the ability to study health disparities as "health equity tourists"; and 3) the production of health disparities research that, due to factors one and two, is incapable of fully addressing the disparities. In this piece, these and other core elements of the Health Disparities Research Industrial Complex, and the research bubble that it has produced, are discussed. Additionally, strategies for reducing the footprint and impact of the Health Disparities Research Industrial Complex and better facilitating opportunities for meaningful implementation in the field are presented.
健康差异研究——无论是与种族/族裔、性别表达、性取向、公民身份、收入水平等有关——在学术、临床和政府环境中的学术研究中占据了很大一部分，且具有创造性和高盈利性。健康差异研究被视为一种手段，旨在通过循证实施科学，更多地关注并最终解决导致这些不平等的贬低和压迫行为。健康差异研究广泛而不断发展的存在背后的理念反映了军事工业综合体和监狱工业综合体的形式逻辑和精神。本文所操作的“健康差异研究产业综合体”是这些综合体的一种新的变异和扩展，主要通过以下三种机制来实施：1）在医疗保健和更广泛的社会中构建和维护信念、行为和政策，这些信念、行为和政策会造成和维持少数民族健康方面的劣势；2）创建和资助研究职位，这些职位使非少数化人群和那些没有相关生活经验的人能够作为“健康公平游客”来研究健康差异；3）由于前两个因素，健康差异研究无法充分解决差异问题。在这篇文章中，讨论了健康差异研究产业综合体的这些和其他核心要素，以及它所产生的研究泡沫。此外，还提出了减少健康差异研究产业综合体的足迹和影响的策略，并为该领域提供了更好的实施机会。
