Improving Asian American health during the Syndemic of COVID-19 and racism.
Improving Asian American health during the Syndemic of COVID-19 and racism.
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DOI：
10.1016/j.eclinm.2022.101313
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发表时间：
2022-03
影响因子：
15.1
通讯作者：
Takeuchi DT
中科院分区：
文献类型：
--
作者：
Saw A;Yi SS;Ðoàn LN;Tsoh JY;Yellow Horse AJ;Kwon SC;Samoa R;Aitaoto N;Takeuchi DT
2019冠状病毒病对美国和全球各地的社区产生了负面影响，暴露了包括亚裔美国人在内的许多种族化和少数族裔群体在健康、社会和经济方面的不平等。最近的研究表明，由于较低的检测率和入院时更严重的疾病，亚裔美国人的全因死亡率和COVID-19病死率高于非西班牙裔白色美国人。1亚裔美国人，尤其是受教育程度较低的亚裔美国人，与所有其他美国种族群体相比，也经历了更多的失业，并且恢复就业的速度较慢。2这种影响是在反亚裔种族主义高涨的背景下经历的，其中近一半的仇恨事件包括反华或反移民言论。3.为了有效减轻疫情对亚裔美国人社区健康的长期影响，我们必须结合具体情况，采取协调一致的行动进行干预，认识到新的威胁以及在疫情期间加剧的原有威胁。因此，我们提出了一个Syndemic框架，以了解亚裔美国人在COVID-19背景下的健康状况，该框架解释了不成比例地影响亚裔美国人的威胁的相互关联，相互作用和协同作用，并由结构性种族主义驱动（图1）。结构性种族主义被定义为一种强化种族不平等的政策、规范和做法体系。结构性种族主义的一个例子是，在研究和决策方面，长期缺乏关于亚裔美国人的分类数据或分类数据质量低下，导致无法揭示现有的卫生不公平现象。
COVID-19 has negatively impacted communities across the United States and globally− exposing health, social, and economic inequities for many racialised and minoritised groups, including Asian Americans. Recent research suggests that due to lower testing rates and greater disease severity at hospital admittance, Asian Americans have higher excess all-cause mortality and COVID-19 case-fatality than non-Hispanic White Americans. 1 Asian Americans, particularly those less-educated, also experienced more job loss and were slower to regain employment compared to all other US racial groups. 2 Such impacts have been experienced in the context of surging anti-Asian racism, where almost half of hate incidents included anti-China or anti-immigrant rhetoric. 3 To effectively mitigate the long-term impacts of the pandemic on health in Asian American communities, we must contextualize and intervene in concerted efforts, recognizing new threats as well as pre-existing threats that have been exacerbated during the pandemic. Thus, we propose a Syndemic Framework to understand Asian American health in the context of COVID-19 that account for the interrelatedness, interaction and synergy of threats that disproportionately impact Asian Americans, and which are driven by structural racism (Figure 1). Structural racism is defined as a system of policies, norms, and practices that reinforce racial inequities. An example of structural racism is the perpetual lack of or poor-quality disaggregated data on Asian Americans in research and policymaking, which results in an inability to reveal existing health inequities.
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