弥合研究与政策之间的差距:探索宫颈癌高差异城市县移民健康的政治决定因素。

IF 1.8
Marcela Nava, Monica Cañizares, James Earl, Hemali Patel, Lucy Ren
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引用次数: 0

摘要

背景:在美国,尽管宫颈癌具有可预防性和早期发现可治愈性,但其对西班牙裔移民社区的负担却不成比例。这些持续存在的差异代表了一个“邪恶的问题”,其特点是证据有争议、数据碎片化和卫生政策环境政治化。方法本研究以德克萨斯州塔兰特县为例,探讨多层次治理结构如何影响移民健康不平等。根据邪恶问题的概念和健康的政治决定因素(PDoH)框架,我们通过政策科学的视角分析档案数据,以研究选举、法律和制度力量如何使移民妇女获得挽救生命的护理的障碍永续存在。结果:从我们的分析中得出了四个关键主题:(1)扩大排斥的被动政治环境;(2)法律模糊性形成的决策;(3)通过制度设计被动执行移民政策;(4)公共和私人医疗保健系统之间的责任转移。这些动态因素限制了移民获得预防性保健和延迟治疗的机会,从而共同维持了健康差距。结论宫颈癌差异不仅仅是个体健康行为的结果,而是由结构和政治力量产生和维持的。解决这些差异需要跨学科伙伴关系和基于地方的战略,以应对地方治理中存在的体制障碍。我们呼吁在研究人员、社区利益相关者和政策制定者之间建立战略联盟,以促进共同问责制,并制定响应性的、公平驱动的政策,以解决移民社区的宫颈癌和其他可预防的疾病。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Bridging the Gap Between Research and Policy: Exploring Political Determinants of Immigrant Health in an Urban County With High Cervical Cancer Disparities.

BackgroundCervical cancer disproportionally burdens Hispanic immigrant communities in the United States, despite its preventable nature and curability when detected early. These persistent disparities represent a "wicked problem," characterized by contested evidence, fragmented data, and a politicized health policy environment.MethodsThis study uses Tarrant County, Texas-a high-disparity urban region-as a case study to explore how multilevel governance structures shape immigrant health inequities. Drawing on the concept of wicked problems and the political determinants of health (PDoH) framework, we analyze archival data through a policy science lens to examine how electoral, legal, and institutional forces perpetuate barriers to life-saving care for immigrant women.ResultsFour key themes emerged from our analysis: (1) a reactive political environment that amplifies exclusion, (2) decision-making shaped by legal ambiguity, (3) passive enforcement of immigration policies through institutional design, and (4) blame-shifting between public and private healthcare systems. These dynamics collectively sustain health disparities by limiting access to preventive care and delaying treatment among immigrant populations.ConclusionFindings demonstrate that cervical cancer disparities are not solely the result of individual health behaviors but are produced and sustained by structural and political forces. Addressing these disparities requires interdisciplinary partnerships and place-based strategies that confront the institutional barriers embedded in local governance. We call for strategic alliances among researchers, community stakeholders, and policymakers to foster shared accountability and develop responsive, equity-driven policies for addressing cervical cancer and other preventable conditions in immigrant communities.

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