Cultural trauma as a fundamental cause of health disparities.
Cultural trauma as a fundamental cause of health disparities.
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DOI：
10.1016/j.socscimed.2021.114574
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发表时间：
2022-01
影响因子：
5.4
通讯作者：
Link, Bruce G.
中科院分区：
文献类型：
--
作者：
Subica, Andrew M.;Link, Bruce G.
健康差距不成比例地影响世界各地的少数文化群体（如土著、移民、难民）；尽管在健康和医学方面取得了共同的进步，但它跨越了时间、疾病状态和风险因素。根本原因理论认为，重要的社会因素（如社会经济地位、耻辱、种族主义）通过限制公平获得保护健康的资源而产生健康差异。然而，现有文献并没有利用根本原因理论来描述文化创伤对健康差异的影响：一个压迫性的统治群体通过武力、武力威胁或压迫性政策对另一个群体的文化资源进行压倒性的、经常持续的身体或心理攻击。本文提出了一个新的概念模型，详细描述了文化创伤及其可能通过破坏三种保护健康的文化资源（文化模式、制度和土地）来破坏健康和创造差异的机制。在文化创伤之后，我们认为受影响的群体在社会上处于不利地位，面临普遍的压力、耻辱和资源减少，使几代人之间的健康差距永久化。因此，文化创伤可能是健康差异的一个未被认识到的根本原因，为通过有针对性的研究、干预和政策促进健康公平提供了潜在的途径。
Health disparities disproportionately affect minority cultural groups (e.g., Indigenous, immigrant, refugee) worldwide; enduring across time, disease states, and risk factors despite co-occurring advancements in health and medicine. Fundamental cause theory holds that important social factors (e.g., socioeconomic status, stigma, racism) produce health disparities by restricting equitable access to health-protective resources. Yet, extant literature has not utilized fundamental cause theory to describe the health disparities impact of cultural trauma: an overwhelming, often ongoing physical or psychological assault by an oppressive dominant group on another group’s cultural resources through force, threats of force, or oppressive policies. This paper presents a novel conceptual model detailing cultural trauma and the mechanisms through which it may disrupt health and create disparities by damaging three health-protective cultural resources: cultural modes, institutions, and lands. Following cultural trauma, we propose affected groups are socially disadvantaged and exposed to pervasive stress, stigma, and diminished resources, perpetuating health disparities across generations. Consequently, cultural trauma may represent an unrecognized fundamental cause of health disparities, offering potential avenues for promoting health equity through targeted research, interventions, and policies.
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