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疫情应对中的公平性:一个以行动为导向的框架,用于指导公共卫生领域对重大传染病突发事件做出公平应对。

Equity in epidemic response: an action-oriented framework for guiding public health in equitable responses to major infectious disease emergencies.

作者信息

de-Winton Cummings Precious-Junia, Baker Kelly K, Appell Leah, Rios Marina Del, Diekema Daniel J, Kitzmann Tricia, Marroquin Naomi, Raymond Gus, Carvour Martha L

机构信息

Department of Epidemiology, University of Iowa (UI) College of Public Health (CPH), 145 N Riverside Drive, Iowa City, IA, 52242, USA.

Department of Internal Medicine, University of Iowa Carver College of Medicine (CCOM), 200 Hawkins Drive, Iowa City, IA, 52242, USA.

出版信息

Int J Equity Health. 2025 Mar 12;24(1):69. doi: 10.1186/s12939-025-02433-2.

Abstract

BACKGROUND

A rapid and equitable response is paramount to mitigating the spread and impact of an infectious disease public health emergency. Unfortunately, public health responses often integrate equity as a secondary component rather than a foundational one-a decision that can result in disproportionate effects of the epidemic on vulnerable populations and that may further fuel or worsen the ongoing health emergency. This paper introduces a framework grounded in health equity principles to guide the design and implementation of response efforts during infectious disease emergencies.

METHODS

The Equity in Epidemic Response framework was developed by critically appraising and synthesizing several established models into an integrated framework, with active engagement from health professionals specializing in epidemiology, medicine, global health, mental health, community health, and health policy.

RESULTS

The framework covers six high-impact areas that should be addressed during an infectious disease public health emergency: community partnerships and engagement; communication; social and economic conditions; data systems and methods; health infrastructure and supply chains for preventives, therapeutics, and diagnostics; and accessibility of outbreak resources and essential health services. Key priorities and assessment indicators within each area were identified.

CONCLUSIONS

Given the increasing threat of emerging and re-emerging infectious diseases, this framework reinforces the need to prioritize equitable approaches in responding to infectious disease public health emergencies to minimize health consequences, particularly among vulnerable populations. This framework is designed as a practical tool for public health professionals to guide major aspects of an epidemic response, ensuring thorough and equitable implementation of response efforts.

摘要

背景

迅速且公平的应对措施对于减轻传染病公共卫生紧急事件的传播和影响至关重要。不幸的是,公共卫生应对措施往往将公平作为次要组成部分,而非基础要素——这一决策可能导致疫情对弱势群体产生不成比例的影响,并可能进一步加剧或恶化当前的卫生紧急情况。本文介绍了一个基于健康公平原则的框架,以指导传染病紧急事件应对工作的设计和实施。

方法

通过严格评估和综合多个既定模型,将其整合为一个框架,积极邀请了专门从事流行病学、医学、全球卫生、心理健康、社区卫生和卫生政策的卫生专业人员参与,从而开发出了疫情应对公平性框架。

结果

该框架涵盖了传染病公共卫生紧急事件期间应解决的六个高影响领域:社区伙伴关系与参与;沟通;社会和经济状况;数据系统与方法;预防、治疗和诊断的卫生基础设施及供应链;以及疫情资源和基本卫生服务的可及性。确定了每个领域的关键优先事项和评估指标。

结论

鉴于新出现和再次出现的传染病威胁日益增加,该框架强化了在应对传染病公共卫生紧急事件时优先采用公平方法的必要性,以尽量减少健康后果,尤其是在弱势群体中。该框架旨在作为公共卫生专业人员的实用工具,以指导疫情应对的主要方面,确保应对措施得到全面且公平的实施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/270d/11900141/a0322fa0d0b5/12939_2025_2433_Fig1_HTML.jpg

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