加拿大医疗保健中的系统性种族主义:政策和公平分析
Kola Adegoke1,2, Abimbola Adegoke1,3, Deborah Dawodu3
1Department of Health & Biomedical Sciences, College of Health Professions, University of Texas, Rio Grande Valley, Edinburg, TX, USA.
Journal of primary care & community health
|November 4, 2025
概括
加拿大医疗保健中的系统性种族主义造成了不平等,特别是对土著和黑人患者以及受过外国培训的医生来说. 解决这一问题需要立法变革,强制性文化安全培训,以及改进数据收集,以实现公平的普遍医疗保健.
科学领域:
- 医疗保健政策 医疗保健政策
- 健康 公平 卫生 公平
- 系统性种族主义分析
背景情况:
- 加拿大医疗保健中的系统性种族主义通过在治理,监管和实践中嵌入不平等来破坏普遍覆盖.
- 虽然种族差异得到了记录,但使这些不平等持续存在的制度结构得到了有限的关注.
研究的目的:
- 批判性地研究加拿大医疗保健系统中种族主义的组织方面.
- 确定种族化的患者和国际教育的医生所面临的结构性障碍.
- 提供基于证据的政策建议,以打击医疗保健中的系统性种族主义.
主要方法:
- 采用叙述性审查框架,对各种数据源进行定性分析.
- 包括公众调查,政府审计,案件档案 (例如,布莱恩·辛克莱,乔伊斯·埃卡昆),以及同行评审的出版物 (2000-2024年).
- 进行了跨机构歧视,许可/劳动力排斥,患者/文化安全和问责缺口的专题编码.
主要成果:
- 观察到对土著和黑人患者的持续机构忽视,在紧急和孕产妇护理方面差异最严重.
- 在国际上受过教育的医生遇到不透明的资格认证,加剧了劳动力不平等.
- 系统故障,包括对患者的痛苦和文化需求的忽视,导致伤害,建议经常被忽视,表明对变化的抵抗.
结论:
- 加拿大医疗保健系统性种族主义表现为不采取改革行动和机构排斥.
- 反种族主义的立法巩固,强制性文化安全培训,种族分类数据收集和改革许可是至关重要的.
- 实现公平的全民医疗保健需要系统性变革,使治理与反种族主义和公平价值观保持一致,以确保安全,包容的护理.
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