谁是Flexnerian-剥夺的黑人美国人? 美国医学教育中的历史代表性的定量分析
Carmen Black1,2,3,4, Johnice Littlejohn5, Ayesha Clarke6
1Institute of Living at Hartford Hospital, Hartford, CT, USA. carmengblack@gmail.com.
Journal of racial and ethnic health disparities
|November 6, 2025
概括
柔性剥夺黑人美国人 (FDBAs),也被称为种族黑人美国人 (EBAs),在医学教育中仍然代表性不足. 目前基于种族的数据掩盖了历史上的不平等,可能会使FDBA/EBA的代表性恶化.
科学领域:
- 医学教育 医学教育
- 社会历史上的正义.
- 卫生公平性健康公平性
背景情况:
- 1910年的弗莱克斯纳报告在1910年限制了超过35,000名在美国祖先的黑人美国人的教育机会 (弗莱克斯纳尔-剥夺黑人美国人-FDBAs).
- 在社会历史正义框架内,FDBAs被称为种族黑人美国人 (EBA),代表黑人美国人,在奴隶制以来的美国历史基础上拥有血统.
- 了解这些特定小组在医学教育中的代表性对于解决历史不平等至关重要.
研究的目的:
- 评估FDBA/EBA在美国医学教育中的代表性,与普通人群相比.
- 分析黑人美国人的社会历史和种族小组在医学教育中是如何被代表的.
- 鉴别出因历史因素而导致的医疗教育获取差异.
主要方法:
- 利用基于种族的医学学生人口统计数据从2021-2022年到2024-2025年,以大致估计FDBA/EBA的代表性.
- 开发了一个代表性得分 (R-score) 来量化子组的代表性相对于一般人口.
- 定义的R得分<1作为代表不足,R得分>1作为代表过多.
主要成果:
- 在医学教育中,FDBA/EBA的代表性不足,约占其种族内部份额的一半 (R=0.51) 和种族间份额的三分之一以下 (R=0.30).
- 非FDBA子组 (非洲人,非加勒比人,其他) 显示出明显的过度代表性,种族内R得分为2.7和种族间R得分为1.6.
- 非洲妇女表现出明显的过度代表性 (R=4.4在种族内).
结论:
- 基于种族的统计数据不准确地反映了Flexnerian问责制和历史剥夺.
- 最近的"股权"举措可能无意中将FDBA/EBA的代表性降至历史低点,同时增加非FDBA的代表性.
- 除种族之外的数据分类对于历史问责制至关重要,因为贫困是通过血统而不是种族传播的.
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