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被忽视的健康不平等层面:少数族裔与交叉性

The Unheeded Layers of Health Inequity: Visible Minority and Intersectionality.

作者信息

Chowdhury Nashit, Turin Tanvir C

机构信息

Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada.

Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada.

出版信息

Int J Environ Res Public Health. 2025 Jun 26;22(7):1007. doi: 10.3390/ijerph22071007.

Abstract

Health disparities among marginalized populations persist in many developed countries despite substantial population health advancements, highlighting persistent systemic inequities. Visible minorities, defined as the non-White and non-Indigenous racialized population in Canada, face earlier disease onset, worse outcomes, barriers to care, and shorter life expectancy. Conventional single-axis research frameworks, which examine factors like race, gender, or socioeconomic status in isolation, often fail to capture the complex realities of these disparities. Intersectionality theory, rooted in Black feminist thought and Critical Race Theory, offers a crucial lens for understanding how multiple systems of oppression intersect to shape health outcomes. However, its application in health research remains inconsistent, with often inadequate and tokenistic applications of this theory attributable to the limitations of a research approaches and resources, as well as biases from researchers. Integrating intersectionality with other relevant frameworks and theories in population health, such as ecosocial theory that explains how social inequalities become biologically embodied to create health inequities, strengthens the capacity to analyze health inequities comprehensively. This article advocates for thoughtful application of intersectionality in research to understand health disparities among visible minorities, urging methodological rigor, contextual awareness, and a focus on actionable interventions. By critically embedding intersectional principles into study design, researchers can move beyond describing disparities to identifying meaningful, equity-driven solutions. This approach supports a deeper, more accurate understanding of health inequities and fosters pathways toward transformative change in public health systems.

摘要

尽管许多发达国家在总体人口健康方面取得了显著进步,但边缘化人群之间的健康差距依然存在,这凸显了长期存在的系统性不平等。在加拿大,可见少数群体被定义为非白人和非原住民的种族化人口,他们面临着疾病更早发作、预后更差、就医障碍以及预期寿命较短等问题。传统的单轴研究框架孤立地考察种族、性别或社会经济地位等因素,往往无法捕捉这些差距的复杂现实。交叉性理论植根于黑人女性主义思想和批判种族理论,为理解多种压迫制度如何相互交织以塑造健康结果提供了一个关键视角。然而,其在健康研究中的应用仍然不一致,由于研究方法和资源的限制以及研究人员的偏见,该理论的应用往往不足且流于表面。将交叉性与人口健康中的其他相关框架和理论(如生态社会理论,该理论解释了社会不平等如何在生物学上体现以造成健康不平等)相结合,增强了全面分析健康不平等的能力。本文倡导在研究中审慎应用交叉性理论以理解可见少数群体之间的健康差距,敦促研究方法严谨、具备情境意识并关注可采取行动的干预措施。通过批判性地将交叉性原则融入研究设计,研究人员可以超越描述差距,进而确定有意义的、以公平为导向的解决方案。这种方法有助于更深入、更准确地理解健康不平等,并促进公共卫生系统实现变革性改变的途径。

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