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剖析结构性种族主义及其对健康的影响:是时候了。

Analyzing structural racism and its health impacts: it's about time.

作者信息

Krieger Nancy

机构信息

Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States.

出版信息

Am J Epidemiol. 2025 May 7;194(5):1166-1172. doi: 10.1093/aje/kwae392.

Abstract

It's about time. Since 2020, new work on structural racism and health has erupted in the United States, with 93% of the 1655 PubMed articles indexed by "structural racism" as of April 4, 2024 having been published during or since 2020. Among the 310 review articles included, most have focused either on improving conceptual, substantive, and methodologic clarity and precision about measuring and modeling structural racism, or reviewing evidence about its impacts on specific exposures or outcomes. However, only 2.5% of these 1655 articles are also indexed by the term "lifecourse" and its variants, and among the reviews considered here, none explicitly discuss issues involving etiologic period. Informed by ecosocial theory's temporal theorizing about pathways of embodiment, and also Latin American social medicine-collective health framings of "health-illness-disease processes," lifecourse models, and the construct of the "cancer control continuum," in this brief commentary I consider how time matters in relation to concrete examples involving structural racism and cancer and also inconsistent results reported by several studies using latent measures of structural racism. When it comes to structural racism and health, it truly is about time-and it is time for this work to tackle issues of time.

摘要

是时候了。自2020年以来,美国关于结构性种族主义与健康的新研究大量涌现,截至2024年4月4日,在1655篇被“结构性种族主义”编入索引的PubMed文章中,93%是在2020年期间或之后发表的。在所纳入的310篇综述文章中,大多数要么侧重于提高关于衡量和建模结构性种族主义的概念、实质和方法的清晰度与精确性,要么侧重于回顾其对特定暴露或结果影响的证据。然而,这1655篇文章中只有2.5%也被“生命历程”及其变体编入索引,并且在这里所考虑的综述中,没有一篇明确讨论涉及病因期的问题。基于生态社会理论关于体现途径的时间理论,以及拉丁美洲社会医学——“健康 - 疾病 - 病患过程”的集体健康框架、生命历程模型和“癌症控制连续体”的构建,在这篇简短的评论中,我思考了时间对于涉及结构性种族主义与癌症的具体例子以及几项使用结构性种族主义潜在测量方法的研究报告的不一致结果而言是如何重要的。当涉及到结构性种族主义与健康时,真的是关乎时间——并且现在是这项工作解决时间问题的时候了。

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