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美国的结构性种族主义与肥胖相关癌症不公平现象:挑战与研究重点。

Structural Racism and Obesity-Related Cancer Inequities in the United States: Challenges and Research Priorities.

机构信息

Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA.

Cape Fox Facilities Services, Manassas, VA 20109, USA.

出版信息

Int J Environ Res Public Health. 2024 Aug 17;21(8):1085. doi: 10.3390/ijerph21081085.

Abstract

Structural racism has been identified as a fundamental cause of health disparities. For example, racial, ethnic, and economic neighborhood segregation; concentrated poverty; community disinvestment; and sociocultural context influence obesity and cancer disparities. Effects of structural racism are also evident through neighborhood obesogenic conditions such as limited access to affordable and healthy foods and physical activity opportunities within segregated communities that contribute to obesity and obesity-related cancer disparities. This article describes and expands on cross-cutting themes raised during a webinar held by the National Cancer Institute (NCI): (1) how structural factors, including neighborhood segregation and obesogenic conditions within racial and ethnic disadvantaged communities, influence disparities in the United States; (2) current research challenges and best ways to address them; and (3) selected priorities of the NCI aimed at addressing multilevel and intersecting factors that influence obesity-related cancer disparities. Further research is needed to understand how residential segregation and neighborhood obesogenic conditions influence cancer prevention and control across the continuum. Identifying the best approaches to address obesity and cancer disparities using social determinants of health framework and community-engaged approaches guided by a structural racism lens will allow researchers to move beyond individual-level approaches.

摘要

结构性种族主义被认为是健康差异的根本原因。例如,种族、民族和经济上的邻里隔离;集中贫困;社区投资不足;以及社会文化背景影响肥胖和癌症的差异。结构性种族主义的影响也通过邻里肥胖环境明显体现,例如在隔离社区中获得负担得起的健康食品和体育活动机会有限,导致肥胖和与肥胖相关的癌症差异。本文描述并扩展了美国国家癌症研究所(NCI)网络研讨会提出的跨领域主题:(1)结构性因素,包括邻里隔离和种族和民族弱势群体社区内的肥胖环境,如何影响美国的差异;(2)当前的研究挑战和解决这些挑战的最佳方法;(3)NCI 的重点领域旨在解决影响肥胖相关癌症差异的多层次和交叉因素。需要进一步研究了解居住隔离和邻里肥胖环境如何影响癌症预防和控制的连续性。使用健康的社会决定因素框架和以结构性种族主义视角为指导的社区参与方法来确定解决肥胖和癌症差异的最佳方法,将使研究人员能够超越个人层面的方法。

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