The Identity Vitality-Pathology model: A novel theoretical framework proposing "identity state" as a modulator of the pathways from structural to health inequity.
The Identity Vitality-Pathology model: A novel theoretical framework proposing "identity state" as a modulator of the pathways from structural to health inequity.
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身份活力-病理学模型：一种新颖的理论框架，提出“身份状态”作为从结构性不平等到健康不平等路径的调节器。
DOI：
10.1016/j.socscimed.2022.115495
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发表时间：
2022-12
影响因子：
5.4
通讯作者：
Bey, Ganga S.
中科院分区：
文献类型：
--
作者：
Bey, Ganga S.
有力的证据基础（Krieger，2014; Marmot和艾伦，2014; Conrad和Barker，2010; Adler和Stewart，2010;威廉姆斯和柯林斯，2001; Crocker和Major，1989年）提供了重要的，但可以说，对导致由人口统计学特征（如社会经济特征）定义的群体之间特定健康结果差异的因果因素的概念化不完整位置、种族、民族和性别。关注特定疾病结果的患病率或发生率的群体差异的大小，对结构性不平等滋生健康不平等的方式进行了不完整的评估（Ward等人，2019年）。这种衡量差距的反事实方法需要假设一种正常或最佳的健康状态，而这种健康状态传统上是基于在许多社会理论（Turner和Avison，2003年; Krieger，1990年; Crocker和Major，1989年）认为美国最有特权的社会地位的个人（白色男性）中观察到的结果。这种方法确实正确地断言，社会不利地位不公正地剥夺了个人获得最佳健康状态的机会。然而，白色男性参照物忽略了两个重要的考虑因素：第一，由于这些过程与社会群体成员的相互依赖性，许多影响健康的过程在社会群体中是不可比较的（Bey等人，2016，2018 a，2018 b，2019; Schwartz，2017; Slavich和欧文，2014; Harnois和Ifatunji，2011），第二，不公正的优势也可能破坏最佳健康（Bey等人，二〇一六年; Fujishiro，2009年），这一想法挑战了白色男性作为健康模式的概念。研究人员就建立健康规范的挑战进行了广泛的辩论（Metzl，2003，2009; Amundson，2000）。本书的目的不是进一步讨论这个问题，而是要说明，就像疾病是由相对匮乏引起的一样，也有一些病理是由相对过剩引起的。社会建构的支配地位和从属地位都赋予了对特定疾病的脆弱性和对其他疾病的复原力。要更准确地描述结构性不平等产生不平等健康的机制，就需要重新定义健康和疾病的概念，使其更包容占主导地位的群体成员所表现出的往往是正常化的病理症状。
A strong evidence base (Krieger, 2014; Marmot and Allen, 2014; Conrad and Barker, 2010; Adler and Stewart, 2010; Williams and Collins, 2001; Crocker and Major, 1989) offers important, while arguably, incomplete conceptualizations of the causal factors contributing to differences in specific health outcomes between groups defined by demographic characteristics such as socioeconomic position, race, ethnicity, and gender. Focusing on the magnitude of group differences in the prevalence or incidence of a specific disease outcome has yielded an incomplete assessment of the ways in which structural inequity breeds health inequity (Ward et al., 2019). Such counterfactual methods of measuring disparities necessitate the assumption of a normal or optimal health state, which has traditionally been based on outcomes observed among individuals occupying what many social theories (Turner and Avison, 2003; Krieger, 1990; Crocker and Major, 1989) consider the most privileged social position in the United States: White men. This approach does correctly assert that social disadvantage unjustly deprives individuals of access to optimal health states. However, the White male referent overlooks two important considerations: one, that many health-impacting processes are not comparable across social groups due to the interdependency of these processes with social group membership (Bey et al., 2016, 2018a, 2018b, 2019; Schwartz, 2017; Slavich and Irwin, 2014; Harnois and Ifatunji, 2011), and two, that unjust advantage can also be disruptive of optimal health (Bey et al., 2016; Fujishiro, 2009), an idea which challenges the notion of the White male as a model of health.Researchers have debated extensively on the challenge of establishing norms of health (Metzl, 2003, 2009; Amundson, 2000). The aim of this work is not to further engage this discussion but rather to contend that like illness resulting from relative deprivation, there are pathologies which arise from relative excess. Socially-constructed dominance and subordinance each confer vulnerability to specific diseases and resilience against others. A more accurate characterization of the mechanisms by which structural inequity acts to yield unequal health requires reconceptualizing notions of health and illness to be more inclusive of the often normalized symptoms of pathology exhibited by members of dominant-status groups.
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影响因子：
8.5
作者：
Batavia, Chelsea;Nelson, Michael Paul;Wallach, Arian D.
通讯作者：
Wallach, Arian D.
影响因子：
3.9
作者：
Crocker, J
通讯作者：
Crocker, J
影响因子：
5
作者：
Conrad, Peter;Barker, Kristin K.
通讯作者：
Barker, Kristin K.
影响因子：
4.7
作者：
Bey, G. S.;Jesdale, B.;Kiefe, C.
通讯作者：
Kiefe, C.
DOI：
10.1111/j.1749-6632.2009.05337.x
发表时间：
2010-01-01
期刊：
BIOLOGY OF DISADVANTAGE: SOCIOECONOMIC STATUS AND HEALTH
影响因子：
--
作者：
Adler, Nancy E.;Stewart, Judith
通讯作者：
Stewart, Judith