Race, Healthcare, and Health Disparities: A Critical Review and Recommendations for Advancing Health Equity.

Autor: Macias-Konstantopoulos WL; Center for Social Justice and Health Equity, Department of Emergency Medicine, Boston, Massachusetts.; Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts., Collins KA; Tampa General Hospital, Tampa, Florida., Diaz R; University of California-Los Angeles, Department of Emergency Medicine, Los Angeles, California., Duber HC; University of Washington School of Medicine, Department of Emergency Medicine, Seattle, Washington.; Washington State Department of Health, Tumwater, Washington., Edwards CD; Samford University, Moffett & Sanders School of Nursing, Birmingham, Alabama., Hsu AP; Trinity Health Ann Arbor Hospital, Department of Emergency Medicine, Ypsilanti, Michigan., Ranney ML; Yale University, Yale School of Public Health, New Haven, Connecticut., Riviello RJ; University of Texas Health San Antonio, Department of Emergency Medicine, San Antonio, Texas., Wettstein ZS; University of Washington School of Medicine, Department of Emergency Medicine, Seattle, Washington., Sachs CJ; Ronald Reagan-UCLA Medical Center and David Geffen School of Medicine at University of California-Los Angeles, Department of Emergency Medicine, Los Angeles, California.
Jazyk: angličtina
Zdroj: The western journal of emergency medicine [West J Emerg Med] 2023 Sep; Vol. 24 (5), pp. 906-918.
DOI: 10.5811/westjem.58408
Abstrakt: An overwhelming body of evidence points to an inextricable link between race and health disparities in the United States. Although race is best understood as a social construct, its role in health outcomes has historically been attributed to increasingly debunked theories of underlying biological and genetic differences across races. Recently, growing calls for health equity and social justice have raised awareness of the impact of implicit bias and structural racism on social determinants of health, healthcare quality, and ultimately, health outcomes. This more nuanced recognition of the role of race in health disparities has, in turn, facilitated introspective racial disparities research, root cause analyses, and changes in practice within the medical community. Examining the complex interplay between race, social determinants of health, and health outcomes allows systems of health to create mechanisms for checks and balances that mitigate unfair and avoidable health inequalities. As one of the specialties most intertwined with social medicine, emergency medicine (EM) is ideally positioned to address racism in medicine, develop health equity metrics, monitor disparities in clinical performance data, identify research gaps, implement processes and policies to eliminate racial health inequities, and promote anti-racist ideals as advocates for structural change. In this critical review our aim was to (a) provide a synopsis of racial disparities across a broad scope of clinical pathology interests addressed in emergency departments-communicable diseases, non-communicable conditions, and injuries-and (b) through a race-conscious analysis, develop EM practice recommendations for advancing a culture of equity with the potential for measurable impact on healthcare quality and health outcomes.
Competing Interests: Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. No author has professional or financial relationships with any companies that are relevant to this study. There are no conflicts of interest or sources of funding to declare.
Databáze: MEDLINE
Externí odkaz: