医学上的种族隔离. 一个美国人的视角
D D Brooks1, D R Smith, R J Anderson
1Community-Oriented Primary Care Program, Dallas, TX 75235.
JAMA
|November 20, 1991
概括
类似种族隔离的政策导致南非的可预防死亡和美国的种族差异. 以社区为导向的初级保健提供了一个有前途的战略,以改善两个国家的健康平等.
科学领域:
- 公共卫生 公共卫生
- 健康 公平 卫生 公平
- 健康的社会经济决定因素
背景情况:
- 南非的种族隔离政策导致了黑人非洲人中可预防的重大疾病和死亡率.
- 社会经济上的隔离,在美国被称为"功能性种族隔离",导致有色人种公民过度死亡和残疾.
- 目前的美国医疗保健系统未能解决未满足的健康需求和少数群体现有的障碍.
研究的目的:
- 突出南非种族隔离对健康的影响与美国种族健康差异之间的相似之处.
- 确定共同的战略,以改善两国的健康状况.
- 引入以社区为导向的初级保健 (COPC) 作为一个潜在的解决方案.
主要方法:
- 在南非和美国对健康状况和医疗保健系统失败的比较分析.
- 审查导致健康差异的社会经济因素.
- 对以社区为导向的初级保健 (COPC) 模式的检查.
主要成果:
- 可预防的发病率和死亡率与两个国家的压制性政策和社会经济隔离有关.
- 美国医疗保健系统在解决少数群体需求方面表现为分散和不足.
- 黑人南非人所需的健康改善策略与美国所需的策略相当.
结论:
- 解决健康差异需要解决类似于种族隔离和"功能性种族隔离"的系统性问题.
- 以社区为导向的初级保健 (COPC) 提出了一个可行的,以社区为基础的模型,以缓解医疗保健缺陷.
- 实施COPC可以促进南非和美国的健康公平.
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