Department of Medicine, University of Illinois Chicago School of Medicine, Chicago, IL, USA.
Department of Pediatrics, David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA, USA.
Lancet Child Adolesc Health. 2024 Feb;8(2):159-174. doi: 10.1016/S2352-4642(23)00262-6.
Societal systems act individually and in combination to create and perpetuate structural racism through both policies and practices at the local, state, and federal levels, which, in turn, generate racial and ethnic health disparities. Both current and historical policy approaches across multiple sectors-including housing, employment, health insurance, immigration, and criminal legal-have the potential to affect child health equity. Such policies must be considered with a focus on structural racism to understand which have the potential to eliminate or at least attenuate disparities. Policy efforts that do not directly address structural racism will not achieve equity and instead worsen gaps and existing disparities in access and quality-thereby continuing to perpetuate a two-tier system dictated by racism. In Paper 2 of this Series, we build on Paper 1's summary of existing disparities in health-care delivery and highlight policies within multiple sectors that can be modified and supported to improve health equity, and, in so doing, improve the health of racially and ethnically minoritised children.
社会制度通过地方、州和联邦各级的政策和实践单独或组合作用，制造和延续结构性种族主义，这反过来又造成了种族和族裔健康方面的差异。在包括住房、就业、医疗保险、移民和刑事司法在内的多个领域，当前和历史上的政策方法都有可能影响儿童健康公平。必须考虑这些政策，重点关注结构性种族主义，以了解哪些政策有可能消除或至少减轻差异。如果政策努力不直接解决结构性种族主义问题，就无法实现公平，反而会加剧机会和质量方面的差距和现有差异，从而继续延续由种族主义决定的双重制度。在本系列论文的第 2 篇中，我们在第 1 篇论文总结现有医疗服务差异的基础上，重点介绍了多个领域内可以进行修改和支持的政策，以改善健康公平，并由此改善少数族裔儿童的健康。
