Institutional Distrust among African Americans and Building Trustworthiness in the COVID-19 Response: Implications for Ethical Public Health Practice.
Institutional Distrust among African Americans and Building Trustworthiness in the COVID-19 Response: Implications for Ethical Public Health Practice.
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DOI：
10.1353/hpu.2021.0010
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发表时间：
2021
影响因子：
1.4
通讯作者：
Warren RC
中科院分区：
文献类型：
--
作者：
Best AL;Fletcher FE;Kadono M;Warren RC
由于长期存在的社会、政治、经济和环境不公正，非裔美国人不成比例地受到COVID-19相关疾病和死亡率的影响;制度上的不信任加剧了COVID-19的不平等。在缺乏信任的情况下，公共卫生当局没有充分履行其专业和道德义务，以保护非裔美国人社区免受COVID-19的负面影响。由于机构的不信任是由个人和集体的经验，不值得信赖，我们提出了一个范式的转变，从增加非洲裔美国人之间的信任，以增加整个美国的医疗和公共卫生机构/系统之间的可信度。这篇叙述性综述扩展了描述社会决定因素如何导致COVID-19不平等的文献，展示了制度不信任如何随着时间的推移而发展，并通过不公正的制度得到加强。此外，我们说明了机构不信任对COVID-19不公平的后果，并提供了通过道德公共卫生实践建立可信度的建议。
African Americans are disproportionately affected by COVID-19-related disease and mortality due to long-standing social, political, economic, and environmental injustice; and COVID-19 inequities are exacerbated by institutional distrust. In the absence of trust, public health authorities have not adequately fulfilled their professional and ethical obligations to protect African American communities from the negative effects of COVID-19. As institutional distrust is shaped by individual and collective experiences of untrustworthiness, we propose a paradigm shift from increasing trust among African Americans to increasing trustworthiness among medical and public health institutions/systems throughout the United States. This narrative review extends the literature describing how social determinants contribute to COVID-19 inequities by demonstrating how institutional distrust develops over time and is reinforced through systems of injustice. Additionally, we illustrate consequences of institutional distrust for COVID-19 inequities and provide recommendations for building trustworthiness through ethical public health practice.
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