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结构性种族主义、健康的社会决定因素和健康不平等:住房和大规模监禁的相互影响。

Structural Racism, the Social Determination of Health, and Health Inequities: The Intersecting Impacts of Housing and Mass Incarceration.

机构信息

Kim M. Blankenship is with the Sociology Department, American University, Washington, DC. Alana Rosenberg is with the Epidemiology of Microbial Diseases Department, Yale School of Public Health, New Haven, CT. Penelope Schlesinger and Danya E. Keene are with the Department of Social and Behavioral Sciences, Yale School of Public Health. Allison K. Groves is with the Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA.

出版信息

Am J Public Health. 2023 Jan;113(S1):S58-S64. doi: 10.2105/AJPH.2022.307116.

Abstract

Public health researchers have directed increasing attention to structural racism and its implications for health equity. The conceptualization of racism as historically rooted in systems, structures, and institutions of US society has important implications for addressing social determinants of health (SDOH). It requires theorizing SDOH as embedded in and expressions of racially oppressive historical structures that are manifested in and maintained by policies, programs, and practices in multiple domains that dynamically intersect to reinforce and reproduce in new ways: race inequities in health. We develop this argument using housing, a SDOH recognized as reflecting longstanding racist practices and policies that, among other things, have restricted the affordable housing options of Black people to segregated neighborhoods with limited resources. We argue that understanding and addressing the health inequities resulting from structural racism associated with housing requires simultaneously understanding and addressing how housing intersects with mass incarceration, another SDOH and manifestation of structural racism. We suggest that unless these intersections are intentionally analyzed and confronted, efforts to address the impacts of housing on racial health disparities may produce new forms of health inequities. (. 2023;113(S1):S58-S64. https://doi.org/10.2105/AJPH.2022.307116).

摘要

公共卫生研究人员越来越关注结构性种族主义及其对健康公平的影响。将种族主义概念化为历史上根植于美国社会的制度、结构和机构,这对解决社会决定健康因素(SDOH)具有重要意义。它要求将 SDOH 理论化为嵌入和表达种族压迫性的历史结构,这些结构表现在多个领域的政策、计划和实践中,并通过这些政策、计划和实践得以维持,这些领域动态地相互交织,以新的方式加强和复制:健康方面的种族不平等。我们使用住房来发展这一论点,住房是一个公认的 SDOH,反映了长期存在的种族主义做法和政策,这些做法和政策除其他外,限制了黑人获得负担得起的住房选择,只能居住在资源有限的隔离社区。我们认为,要理解和解决与住房相关的结构性种族主义导致的健康不平等问题,就需要同时理解和解决住房与大规模监禁之间的关系,大规模监禁是另一个 SDOH 和结构性种族主义的表现。我们认为,除非这些交叉点被有意分析和面对,否则解决住房对种族健康差距的影响的努力可能会产生新的形式的健康不平等。(。2023 年;113(S1):S58-S64。https://doi.org/10.2105/AJPH.2022.307116)。

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