Lillie-Blanton M, Martinez R M, Taylor A K, Robinson B G
Department of Health Policy and Management, Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD 21205.
Int J Health Serv. 1993;23(3):555-84. doi: 10.2190/MNCJ-NB8E-M0WA-1FGM.
Women of all races have faced incredible challenges as they sought to realize the promises of America. For women of color, these challenges were compounded by the second-class citizenship of U.S. racial and ethnic minority population groups. In an effort to assess the quality of life experienced by Latina and African American women, this article provides descriptive information on racial/ethnic differences in women's social conditions, health status, exposure to occupational and environmental risks, and use of health services. When possible, indices are stratified by family income to limit the effects of social class on the comparison of racial differences. The authors provide evidence that Latina and African American women are more likely than nonminority women to encounter social environments (e.g., poverty, densely populated neighborhoods, hazardous work conditions) that place them at risk for ill-health and injury. Although persistent racial disparities in health are often attributed to the lifestyle behaviors of racial minority populations, they are undoubtedly a consequence of poorer social conditions as well as barriers in access to quality health services. To achieve further gains, public policies must reduce social inequalities (i.e., by gender, race, and social class) and assure greater equity in access to resources that facilitate healthier environments and lifestyles. Public health initiatives should be community-based, reflecting a shared partnership that actively engages minority women in decision-making about their lives.
所有种族的女性在努力实现美国所承诺的一切时都面临着巨大挑战。对于有色人种女性而言，美国种族和少数族裔群体的二等公民身份使这些挑战更加复杂。为了评估拉丁裔和非裔美国女性的生活质量，本文提供了有关女性社会状况、健康状况、职业和环境风险暴露以及医疗服务使用方面种族/族裔差异的描述性信息。如有可能，各项指标按家庭收入分层，以限制社会阶层对种族差异比较的影响。作者提供的证据表明，拉丁裔和非裔美国女性比非少数族裔女性更有可能遭遇使其面临健康不良和受伤风险的社会环境（例如贫困、人口密集的社区、危险的工作条件）。尽管健康方面持续存在的种族差异通常归因于少数族裔人群的生活方式行为，但它们无疑也是较差的社会状况以及获得优质医疗服务存在障碍的结果。为了取得进一步进展，公共政策必须减少社会不平等（即按性别、种族和社会阶层），并确保在获取有助于营造更健康环境和生活方式的资源方面实现更大公平。公共卫生倡议应以社区为基础，体现一种积极让少数族裔女性参与关乎其生活的决策的共享伙伴关系。
