Reframing inequality? The health inequalities turn as a dangerous frame shift
Reframing inequality? The health inequalities turn as a dangerous frame shift
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DOI：
10.1093/pubmed/fdw140
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发表时间：
2017-12-01
影响因子：
4.4
通讯作者：
Lynch, Julia
中科院分区：
文献类型：
--
作者：
Lynch, Julia
背景许多国家的政治家都接受了健康不平等源于社会经济不平等的概念，但欧洲各国政府在很大程度上未能制定减少潜在社会不平等的政策。方法数据来自2012年至2015年期间对欧洲4个国家政策制定者的84次深入访谈，对最近的健康不平等政策文件进行定性内容分析，和二次文献上的障碍，实施循证健康不平等policy.Results制度和政治障碍是有效的政策的重要障碍。决策机构以及与新自由主义相关的思想和做法都强化了医疗个人主义的健康模式，加强了与增加公平的政策相对立的物质利益行为者，并破坏了解决社会问题根本原因的政策行动。结论对大多数政治家来说，将不平等医疗化比直接解决收入和工资不平等问题更有吸引力，但它导致了社会不平等问题的框架，使其在技术上很难解决。政策制定者应考虑采用更传统的税收、再分配和劳动力市场监管方案，以减少健康不平等和潜在的社会不平等。
Background Politicians in many countries have embraced the notion that health inequalities derive from socioeconomic inequalities, but European governments have for the most part failed to enact policies that would reduce underlying social inequalities.Methods Data are drawn from 84 in-depth interviews with policy-makers in four European countries between 2012 and 2015, qualitative content analysis of recent health inequalities policy documents, and secondary literature on the barriers to implementing evidence-based health inequalities policies.Results Institutional and political barriers are important barriers to effective policy. Both policy-making institutions and the ideas and practices associated with neoliberalism reinforce medical-individualist models of health, strengthen actors with material interests opposed to policies that would increase equity, and undermine policy action to tackle the fundamental causes of social ( including health) inequalities.Conclusions Medicalizing inequality is more appealing to most politicians than tackling income and wage inequality head-on, but it results in framing the problem of social inequality in a way that makes it technically quite difficult to solve. Policy-makers should consider adopting more traditional programs of taxation, redistribution and labor market regulation in order to reduce both health inequalities and the underlying social inequalities.