Addressing Systemic Racism in Nursing Homes: A Time for Action
Addressing Systemic Racism in Nursing Homes: A Time for Action
复制标题
DOI：
10.1016/j.jamda.2021.02.023
复制
发表时间：
2021-04-05
影响因子：
7.6
通讯作者：
Zimmerman, Sheryl
中科院分区：
文献类型：
--
作者：
Sloane, Philip D.;Yearby, Ruqaiijah;Zimmerman, Sheryl
美国为老年人提供的长期服务和支持是在一个复杂的、种族隔离的系统中提供的，在为居民提供护理的机会、过程和结果方面存在显着的种族差异，这种差异在 2019 年冠状病毒病大流行期间被放大。这些差异在很大程度上是美国社会长期存在的结构性、人际和文化种族主义模式的结果，这些模式总体上代表了系统性种族主义的基础，这种种族主义渗透到长期护理系统的组织、管理、监管和公共服务中。系统性种族主义在产生所观察到的差异方面所起作用的机制有很多。长期护理从根本上与地理位置相关，从而反映了与居住隔离相关的差异。其他基本驱动因素包括有利于拥有财力的人的分散的支付系统，以及系统性低估长期护理人员价值的报销政策。因此，消除这些环境中健康结果的差异需要采取全面的方法来消除系统性种族主义在促进种族差异方面的作用。(c) 2021 年由爱思唯尔公司代表 AMDA（急性后和长期护理医学协会）出版。
Long-term services and supports for older persons in the United States are provided in a complex, racially segregated system, with striking racial disparities in access, process, and outcomes of care for residents, which have been magnified during the Coronavirus Disease 2019 pandemic. These disparities are in large measure the result of longstanding patterns of structural, interpersonal, and cultural racism in US society, which in aggregate represent an underpinning of systemic racism that permeates the long-term care system's organization, administration, regulations, and human services. Mechanisms underlying the role of systemic racism in producing the observed disparities are numerous. Long-term care is fundamentally tied to geography, thereby reflecting disparities associated with residential segregation. Additional foundational drivers include a fragmented payment system that advantages persons with financial resources, and reimbursement policies that systematically undervalue long-term care workers. Eliminating disparities in health outcomes in these settings will therefore require a comprehensive approach to eliminating the role of systemic racism in promoting racial disparities.(c) 2021 Published by Elsevier Inc. on behalf of AMDA -The Society for Post-Acute and Long-Term Care Medicine.