Addressing Health Disparities in the Rural United States: Advocacy as Caregiving among Community Health Workers and Promotores de Salud.
Addressing Health Disparities in the Rural United States: Advocacy as Caregiving among Community Health Workers and Promotores de Salud.
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解决美国农村地区的健康差距：倡导社区卫生工作者和健康促进者之间的护理。
DOI：
10.3390/ijerph17249223
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发表时间：
2020-12-10
影响因子：
--
通讯作者：
Castañeda H
中科院分区：
文献类型：
--
作者：
Logan RI;Castañeda H
美国农村人口面临着各种各样的健康差距，使获得保健的机会复杂化。社区卫生工作者(CHW)和他们的西班牙语同行Promotores de salud有充分的能力解决农村卫生服务问题，提供教育，并最终缩小这些差距。在本文中，我们基于两项独立研究的结果，对印第安纳州和德克萨斯州的社区卫生工作者进行比较，以(1)调查社区卫生工作者在农村社区中的独特作用，(2)了解他们的倡导努力如何代表一种中心形式的照料。利用人种学、定性数据--包括访谈、照片之声和参与者观察--我们分析了社区卫生组织如何将农村地区结构性脆弱的客户与资源、健康教育以及卫生和社会服务联系起来。我们对现有CHW学术的主要贡献是将倡导作为一种护理形式加以阐述，以改善个人健康结果，并以政策制定的形式引发结构性变化。最后，我们描述了在新冠肺炎之后，卫生福利院如何利用其在大流行之前发展和确立的倡导作为照顾者的作用，在解决农村人口之间的差距方面变得尤为关键。这些前线工作人员在解决差距方面比以往任何时候都更加重要，是克服美国卫生领域结构性脆弱性和不平等的关键力量。
Rural populations in the United States are faced with a variety of health disparities that complicate access to care. Community health workers (CHWs) and their Spanish-speaking counterparts, promotores de salud, are well-equipped to address rural health access issues, provide education, and ultimately assuage these disparities. In this article, we compare community health workers in the states of Indiana and Texas, based on the results of two separate research studies, in order to (1) investigate the unique role of CHWs in rural communities and (2) understand how their advocacy efforts represent a central form of caregiving. Drawing on ethnographic, qualitative data—including interviews, photovoice, and participant observation—we analyze how CHWs connect structurally vulnerable clients in rural areas to resources, health education, and health and social services. Our primary contribution to existing scholarship on CHWs is the elaboration of advocacy as a form of caregiving to improve individual health outcomes as well as provoke structural change in the form of policy development. Finally, we describe how CHWs became especially critical in addressing disparities among rural populations in the wake of COVID-19, using their advocacy-as-caregiving role that was developed and well-established before the pandemic. These frontline workers are more vital than ever to address disparities and are a critical force in overcoming structural vulnerability and inequities in health in the United States.
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影响因子：
2.3
作者：
Findley, Sally;Matos, Sergio;Reich, Douglas
通讯作者：
Reich, Douglas
影响因子：
5.1
作者：
Islam, Nadia;Shapiro, Ephraim;Trinh-Shevrin, Chau
通讯作者：
Trinh-Shevrin, Chau
影响因子：
1.4
作者：
George R;Gunn R;Wiggins N;Rowland R;Davis MM;Maes K;Kuzma A;McConnell KJ
通讯作者：
McConnell KJ
影响因子：
5.9
作者：
Johnson, Diane;Saavedra, Patricia;Sun, Eugene;Stageman, Ann;Grovet, Dodie;Alfero, Charles;Maynes, Carmen;Skipper, Betty;Powell, Wayne;Kaufman, Arthur
通讯作者：
Kaufman, Arthur
影响因子：
2.3
作者：
Goldfield, Norbert I.;Crittenden, Robert;Lee Rosenthal, Elizabeth
通讯作者：
Lee Rosenthal, Elizabeth