Assari Shervin, Zare Hossein
Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States.
Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States.
J Soc Math Hum Eng Sci. 2024;3(1). doi: 10.31586/jsmhes.2024.998. Epub 2024 Jul 27.
The intersection of race and place in shaping health disparities presents complex dynamics, as evidenced by studies in cities like Detroit, Baltimore, and Philadelphia, where predominantly Black and economically disadvantaged populations experience high overall rates of health problems. Surprisingly, these cities do not exhibit the most pronounced racial disparities. In contrast, areas with a higher percentage of White residents, indicative of greater income inequality, show stark differences in health outcomes between Black and White populations. This disparity underscores how conditions diverge more sharply between Black and White individuals in wealthier urban areas. This phenomenon suggests a complex and sometimes counterintuitive relationship among race, place, income, and income inequality in shaping racial health disparities. These dynamics have significant policy implications. Addressing health disparities requires nuanced strategies that recognize the multiplicative effects of race and income inequality on health outcomes. Policies focusing on areas with a high disease burden, such as Detroit, Philadelphia, and Baltimore can effectively mitigate disparities both locally and more broadly. Conversely, interventions targeting regions with lower disease prevalence, but higher racial disparities must be approached carefully to avoid exacerbating inequalities. In conclusion, understanding and addressing the complex drivers of health disparities demand comprehensive approaches that acknowledge the intertwined influences of race, income, and place. By prioritizing interventions that address economic disparities alongside health initiatives, policymakers can foster more equitable health outcomes across diverse communities.
种族与地域在塑造健康差异方面的交叉呈现出复杂的动态关系，底特律、巴尔的摩和费城等城市的研究证明了这一点，在这些城市中，主要为黑人且经济上处于不利地位的人群总体健康问题发生率很高。令人惊讶的是，这些城市并未表现出最明显的种族差异。相比之下，白人居民比例较高、表明收入不平等程度更大的地区，黑人和白人人口的健康结果存在明显差异。这种差异凸显了在较富裕城市地区黑人和白人个体之间的情况差异更为明显。这一现象表明，在塑造种族健康差异方面，种族、地域、收入和收入不平等之间存在复杂且有时违反直觉的关系。这些动态关系具有重大的政策意义。解决健康差异需要细致入微的策略，认识到种族和收入不平等对健康结果的倍增效应。针对底特律、费城和巴尔的摩等高疾病负担地区的政策可以有效减轻当地及更广泛范围内的差异。相反，针对疾病患病率较低但种族差异较高地区的干预措施必须谨慎实施，以免加剧不平等。总之，理解和解决健康差异的复杂驱动因素需要全面的方法，承认种族、收入和地域的相互交织影响。通过将解决经济差异的干预措施与健康倡议放在优先位置，政策制定者可以在不同社区促进更公平的健康结果。
