Social conditions, health equity, and human rights.
Social conditions, health equity, and human rights.
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社会条件、健康公平和人权。
DOI：
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发表时间：
2010
期刊：
影响因子：
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通讯作者：
P. Braveman
中科院分区：
文献类型：
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作者：
P. Braveman
健康公平和人权领域有不同的语言、观点和行动工具，但它们有几个共同的基本概念。本文探讨了人权和健康公平之间的联系，特别侧重于目前的知识如何社会条件可能会影响健康和健康不平等的影响，衡量健康公平的评估。社会条件在健康方面的作用在以下两个方面得到了明确处理：（1）健康公平的概念要求社会条件以及其他可改变的健康决定因素方面的公平;（2）享有健康所需的适当生活水平的权利。所有人权-公民权利和政治权利以及经济权利和社会权利-的不可分割性和相互依存性，加上受教育的权利，含蓄但毫不含糊地支持必须解决健康的社会（包括政治）决定因素，从而有助于健康公平的概念基础。享有能达到的最高标准健康的权利加强了这一概念，并指导了健康公平的衡量，因为这意味着公平比较的参照群体应当是具有最佳健康条件的群体。不歧视和平等的人权原则也加强了健康公平的概念基础，确定了健康状况和健康决定因素（包括社会条件）方面的不平等反映了缺乏健康公平的群体;并将歧视定义为不仅包括有意的偏见，而且包括具有无意歧视效果的行动。反过来，健康公平也可对人权作出重大贡献：（1）关于健康不平等的研究提供了更多的理解和经验证据，说明社会条件作为健康决定因素的重要性;（2）更具体地说，指明了如何为衡量和问责的目的落实健康权的概念，而这一直难以实现。人权法律和原则以及健康公平概念和技术方法可以成为相互加强的有力工具，不仅有助于围绕共同价值观建立认识和共识，而且还可以指导对人权和健康公平的分析和加强衡量。
The fields of health equity and human rights have different languages, perspectives, and tools for action, yet they share several foundational concepts. This paper explores connections between human rights and health equity, focusing particularly on the implications of current knowledge of how social conditions may influence health and health inequalities, the metric by which health equity is assessed. The role of social conditions in health is explicitly addressed by both 1) the concept that health equity requires equity in social conditions, as well as in other modifiable determinants, of health; and 2) the right to a standard of living adequate for health. The indivisibility and interdependence of all human rights--civil and political as well as economic and social--together with the right to education, implicitly but unambiguously support the need to address the social (including political) determinants of health, thus contributing to the conceptual basis for health equity. The right to the highest attainable standard of health strengthens the concept and guides the measurement of health equity by implying that the reference group for equity comparisons should be one that has optimal conditions for health. The human rights principles of non-discrimination and equality also strengthen the conceptual foundation for health equity by identifying groups among whom inequalities in health status and health determinants (including social conditions) reflect a lack of health equity; and by construing discrimination to include not only intentional bias, but also actions with unintentionally discriminatory effects. In turn, health equity can make substantial contributions to human rights 1) insofar as research on health inequalities provides increasing understanding and empiric evidence of the importance of social conditions as determinants of health; and, more concretely, 2) by indicating how to operationalize the concept of the right to health for the purposes of measurement and accountability, which have been elusive. Human rights laws and principles and health equity concepts and technical approaches can be powerful tools for mutual strengthening, not only by contributing toward building awareness and consensus around shared values, but also by guiding analysis and strengthening measurement of both human rights and health equity.