Social and Structural Determinants of Health Inequities in Maternal Health.
Social and Structural Determinants of Health Inequities in Maternal Health.
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DOI：
10.1089/jwh.2020.8882
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Wallace M
中科院分区：
文献类型：
--
作者：
Crear-Perry J;Correa-de-Araujo R;Lewis Johnson T;McLemore MR;Neilson E;Wallace M
自世界卫生组织十多年前成立健康问题社会决定因素 (SDOH) 委员会以来，大量研究已经证明，社会决定因素（定义为人们出生、成长、生活、工作和年龄的条件）是临床护理和公共卫生系统中疾病风险和易感性的重要驱动因素。不幸的是，由于滥用和缺乏背景，该术语在护理系统中已经失去了意义。由于许多不同的健康结果仍然存在，包括黑人妇女孕产妇死亡率较高的风险，因此需要更深入地了解 SDOH 及其分布背后的力量。在本文中，我们将在评估有关这一主题的文献时，扩大对孕产妇健康的社会决定因素的审查，包括术语“健康的结构性决定因素”和“不平等的根本原因”。我们假设，结构性决定因素和根本原因的加入将把种族主义视为孕产妇健康结果不平等的一个原因，因为美国的许多社会和政治结构和政策都是源于种族主义、阶级主义和性别压迫。最后，我们将提出消除孕产妇健康结果不平等现象的建议实践和政策解决方案。
Since the World Health Organization launched its commission on the social determinants of health (SDOH) over a decade ago, a large body of research has proven that social determinants—defined as the conditions in which people are born, grow, live, work, and age—are significant drivers of disease risk and susceptibility within clinical care and public health systems. Unfortunately, the term has lost meaning within systems of care because of misuse and lack of context. As many disparate health outcomes remain, including higher risk of maternal mortality among Black women, a deeper understanding of the SDOH—and what forces underlie their distribution—is needed. In this article, we will expand our review of social determinants of maternal health to include the terms “structural determinants of health” and “root causes of inequities” as we assess the literature on this topic. We hypothesize that the addition of structural determinants and root causes will identify racism as a cause of inequities in maternal health outcomes, as many of the social and political structures and policies in the United States were born out of racism, classism, and gender oppression. We will conclude with proposed practice and policy solutions to end inequities in maternal health outcomes.
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