Systemic racism and US health care
Systemic racism and US health care
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DOI：
10.1016/j.socscimed.2013.09.006
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发表时间：
2014-02-01
影响因子：
5.4
通讯作者：
Bennefield, Zinobia
中科院分区：
文献类型：
--
作者：
Feagin, Joe;Bennefield, Zinobia
本文借鉴了一种主要的社会科学理论方法——系统种族主义理论——来评估几十年来关于美国医疗保健和公共卫生机构种族维度的实证研究。从17世纪开始，对有色人种的压迫在白人种族框架下变得系统化和合理化——包括种族主义的刻板印象、意识形态、形象、叙事和情感。我们回顾了有关种族剥削性医疗和公共卫生实践的历史文献，这些实践有助于产生和维持这种针对有色人种的种族框架和相关结构性歧视。我们考察了当代关于医疗实践中的种族差异、白人临床医生的种族框架以及有色人种患者和医生的观点的研究，以证明整个医疗保健和公共卫生机构中系统性种族主义的持续现实。我们从研究中得出结论，制度化的白人社会经济资源、歧视和几个世纪以来的奴隶制、种族隔离和当代白人压迫造成的种族化框架严重限制和限制了许多有色人种获得充足的社会经济资源——以及充足的医疗保健和健康结果。公正地处理健康和医疗保健领域持续存在的种族“差异”需要一种现实地评估美国社会白人种族主义根源和当代种族主义现实的概念范式。我们简要地总结了一些成功的公共政策的例子，这些公共政策在美国和其他国家的医疗保健和公共卫生方面带来了种族和阶级差异的结构性变化。(C) 2013 Elsevier Ltd.版权所有。
This article draws upon a major social science theoretical approach-systemic racism theory-to assess decades of empirical research on racial dimensions of U.S. health care and public health institutions. From the 1600s, the oppression of Americans of color has been systemic and rationalized using a white racial framing-with its constituent racist stereotypes, ideologies, images, narratives, and emotions. We review historical literature on racially exploitative medical and public health practices that helped generate and sustain this racial framing and related structural discrimination targeting Americans of color. We examine contemporary research on racial differentials in medical practices, white clinicians' racial framing, and views of patients and physicians of color to demonstrate the continuing reality of systemic racism throughout health care and public health institutions. We conclude from research that institutionalized white socioeconomic resources, discrimination, and racialized framing from centuries of slavery, segregation, and contemporary white oppression severely limit and restrict access of many Americans of color to adequate socioeconomic resources-and to adequate health care and health outcomes. Dealing justly with continuing racial "disparities" in health and health care requires a conceptual paradigm that realistically assesses U.S. society's white-racist roots and contemporary racist realities. We conclude briefly with examples of successful public policies that have brought structural changes in racial and class differentials in health care and public health in the U.S. and other countries. (C) 2013 Elsevier Ltd. All rights reserved.