为什么每个人都应该关注健康差异——如何应对

作者:Genaro C. 阿马斯,美国心脏协会巴黎人

Softulka/iStock, Getty Images
(Softulka/iStock, Getty Images)

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The coronavirus pandemic and the equity movement have shined a spotlight on longstanding systemic problems that contribute to health disparities linked with factors such as race and ethnicity, 社会经济地位和性别认同.

但健康差异不仅影响那些面临健康问题的人. 在一个深度分裂和不确定的时代, 专家们看到了提醒人们每个人都是相互联系的机会.

"Not addressing inequities and not assuring opportunities for the most vulnerable in our society actually harm us all,博士说。. Lisa Cooper, founder and director of the Johns Hopkins Center for Health Equity in Baltimore. “我们都在为我们的经济和医疗保健系统付出代价."

成本是很高的.

Racial health disparities result in about $93 billion in excess medical care costs and $42 billion in lost productivity each year, 根据 2018年的分析 从W.K. 凯洛格基金会和非营利组织Altarum. 最重要的是价格昂贵, 差异阻碍了国家的整体健康, as groups who historically have had access to fewer resources have higher rates of illness and death from a variety of preventable conditions.

缩小卫生和保健方面的差距需要社区和立法方面的努力. 但同样重要的是,每个人每天都可以进行对话,以提高意识, 指出不公正,倡导变革, 库珀说.

“作为个人, you can hold yourself accountable by becoming more aware of how your own attitudes and behaviors perpetuate the problem,她说. "You can hold other people accountable by becoming an upstander or ally of people from marginalized groups. Many community organizations are now offering implicit bias and anti-racist upstander training."

People also can become involved in community endeavors and vote for policymakers who support equitable efforts, 库珀说.

A 美国心脏协会2020年的建议 defined health disparities as "a particular type of health difference that is closely linked with social, 经济, 环境方面的劣势. Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health" based on racial or ethnic background, 或其他与歧视或排斥有关的特征.

例如, many LGBTQ people report having experienced some form of discrimination at the doctor's office, 包括使用辱骂语言或拒绝提供服务, 根据美国心脏协会2020年的另一份报告 LGBTQ成年人的心血管健康. 在COVID患者中也是如此, 黑色的, 拉美裔, Asian and American Indian or Alaska Native patients have higher hospitalization and death rates than white patients, 据美国疾病控制与预防中心报道.

The pandemic widened health disparities and further exposed the impact of social determinants of health – the conditions in which people are born and live, 博士说. 萨尔瓦多Cruz-Flores, founding chair of the department of neurology at Texas Tech University Health Sciences Center El Paso.

例如, policies that promoted segregation in housing may explain why some neighborhoods have more uninsured or underinsured families. 反过来,这些家庭获得医疗保健的机会可能更少.

"Why should we think that it's right that somebody has a high risk of dying just because of where they live,克鲁兹-弗洛雷斯说. But narrowing the disparity gaps requires societal will "by driving policy change that can level the playing field and make society more equitable."

The killing of George Floyd last May reignited the racial and social justice movement and added urgency to the health equity issue, Cruz-Flores说. 事实上, 过去的一年, health organizations and medical societies such as the AHA and American Academy of Neurology committed to efforts to achieve equity and inclusiveness in health care.

在她即将出版的书《巴黎人官方网站》中?," Cooper draws from personal experiences growing up in the west African country of Liberia and working for three decades as an internist, professor and researcher to illustrate the causes and effects of deep-rooted inequities – and solutions to help reverse the trends.

当和病人谈论心脏健康时, 她鼓励低盐饮食,多吃水果和蔬菜, 建议按照处方服用药物, 每天至少步行20分钟.

But Cooper knows some of them live in neighborhoods where the corner store may sell mainly processed foods. Some may not be able to afford their medications – and others may not feel safe walking around their neighborhood.

她说:“所以,我要做的不仅仅是说说而已。.

It might mean working with an organization that trains community health workers to assist people with things like signing up for health insurance or obtaining financial assistance for utility bills so they can store food and medications safely, 库珀说. It could mean partnering with a grocery store to make fresh produce deliveries to certain neighborhoods or talking to a city official about creating safe green spaces or sidewalks.

“这听起来是个大问题,确实是,”库珀说. “但每个人都能做好自己的工作."

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