King G
Department of Community Medicine and Health Care, University of Connecticut Health Center, Farmington, Connecticut 06030, USA.
Ethn Dis. 1996 Winter-Spring;6(1-2):30-46.
Presented in this paper is a theoretical framework for understanding and applying the concept of institutional racism to the medical/health care system. Medicine and health are viewed as vital social institutions that reflect the norms, values and social stratification systems of the larger society. Institutional or systemic patterns of racism are legitimated and promulgated through accepted standards, criteria, and organizational processes within the medical health complex that have the effect of discriminating against the minority group. It is maintained that racism is manifested (overtly or covertly) through history, ideology, community relations, research, education and the professions, and differential treatment. Focusing on investigators who have conducted studies of "racial bias" in the diagnosis and treatment of coronary artery disease, the author discusses some of the shortcomings of this research, from an institution racism perspective. Differential treatment researchers are encouraged to include social theory as part of their analysis and to explain the practical significance of their findings for the equitable delivery of health care. It is suggested that, because of wider structural changes occurring in American society, issues related to racism within medical and health institutions will become increasingly more important.
本文提出了一个理论框架，用于理解制度性种族主义概念并将其应用于医疗/卫生保健系统。医学和健康被视为重要的社会制度，反映了更大社会的规范、价值观和社会分层系统。种族主义的制度性或系统性模式通过医疗卫生综合体中被认可的标准、准则和组织流程得以合法化和传播，这些标准、准则和流程具有歧视少数群体的作用。有人认为，种族主义通过历史、意识形态、社区关系、研究、教育和职业以及差别待遇（公开或隐蔽地）表现出来。作者以对冠状动脉疾病诊断和治疗中“种族偏见”进行研究的调查人员为重点，从制度性种族主义的角度讨论了这项研究的一些不足之处。鼓励差别待遇研究人员将社会理论纳入其分析，并解释其研究结果对公平提供医疗保健的实际意义。有人认为，由于美国社会正在发生更广泛的结构变化，医疗和卫生机构内部与种族主义相关的问题将变得越来越重要。
