Ross-Lee B, Kiss L E, Weiser M A
Ohio University College of Osteopathic Medicine, Athens 45701-2979.
J Am Osteopath Assoc. 1994 Aug;94(8):664-71.
The scandalous disparity between the health indicators for minority and nonminority and poor and nonpoor populations is of such long standing that it has lost th power to shock. The authors review the landmark studies of the past year which document discrimination in the healthcare system. They reiterate the most compelling statistics of mortality, birth, the AIDS epidemic, destructive health habits, and poverty. They trace the impact of healthcare policy on these vulnerable populations and address the myth that malpractice claims are filed more frequently by the poor. They conclude that equality is instrumental to the improvement of the nation's health demographics; the persistence of economic, social, and political discrimination will continue to create barriers even if financial access is assured through a pluralistic approach to healthcare reform. Ultimately, they predict that any healthcare reform that does not address minority issues is doomed to fail if all three areas driving the national "crisis"--access, cost, and quality--do not encompass minority-specific healthcare strategies.
少数族裔与非少数族裔、贫困人群与非贫困人群在健康指标上存在的令人震惊的差距由来已久,以至于人们对此已不再感到震惊。作者回顾了过去一年的一些具有里程碑意义的研究,这些研究记录了医疗体系中的歧视现象。他们重申了关于死亡率、出生率、艾滋病疫情、有害健康的习惯以及贫困问题的最有说服力的统计数据。他们追溯了医疗政策对这些弱势群体的影响,并驳斥了穷人更频繁地提出医疗事故索赔这一谬论。他们得出结论,平等对于改善国家的健康人口统计数据至关重要;即使通过多元化的医疗改革确保了经济上的可及性,但经济、社会和政治歧视的持续存在仍将继续造成障碍。最终,他们预测,如果推动全国“危机”的三个领域——可及性、成本和质量——不包含针对少数族裔的医疗策略,那么任何不解决少数族裔问题的医疗改革都注定要失败。