社区恢复力:公共卫生的动态模型。

Wendy Ellis, William H Dietz, Kuan-Lung Daniel Chen
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引用次数: 6

摘要

目的:建立一个公共卫生3.0模型,以定义和测量社区恢复力(CR),作为衡量公平、解决结构性种族主义和改善人口健康的方法。设计:为了建立CR模型,我们回顾了医学、心理学、幼儿发展、神经生物学和灾难准备和响应方面的文献,并应用系统动力学建模来分析公共系统、政策和社区之间复杂的相互作用。主要成果措施:社会责任模式侧重于与住房、公共教育、执法和刑事司法部门的政策和做法相关的社区和人口健康成果,作为社会责任措施。该模型展示了这些系统的行为如何相互作用并产生诸如就业、无家可归、受教育程度、监禁以及心理和身体健康等结果指标。结果:住房、公立学校、执法和刑事司法方面的政策和做法可能会抑制家庭和社区的复原力,因为它们是由结构性种族主义塑造的,并影响促进最佳社区健康和福祉的资源的特征和性质。结论:社区恢复力是相关的、基于地的,并取决于居民的人口构成、基于地的种族主义和歧视的历史模式、司法政策和投资重点,所有这些都受到结构性种族主义的影响。对政策和实践的影响:利用系统动力学建模和CR方法,首席卫生战略家可以召集来自多个部门的合作伙伴,系统地识别、衡量和解决结构性种族主义造成的不平等现象,这种不平等导致并加剧了儿童和社区的不良经历。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Community Resilience: A Dynamic Model for Public Health 3.0.

Objective: To establish a model for Public Health 3.0 in order to define and measure community resilience (CR) as a method to measure equity, address structural racism, and improve population health.

Design: To develop the CR model, we conducted a literature review in medicine, psychology, early childhood development, neurobiology, and disaster preparedness and response and applied system dynamics modeling to analyze the complex interactions between public systems, policies, and community.

Main outcome measures: The CR model focuses on community and population health outcomes associated with the policies and practices of the housing, public education, law enforcement, and criminal justice sectors as CR measures. The model demonstrates how behaviors of these systems interact and produce outcome measures such as employment, homelessness, educational attainment, incarceration, and mental and physical health.

Results: The policies and practices within housing, public schools, law enforcement, and criminal justice can suppress resilience for families and communities because they are shaped by structural racism and influence the character and nature of resources that promote optimal community health and well-being.

Conclusions: Community resilience is relational and place-based and varies depending on the demographic makeup of residents, historical patterns of place-based racism and discrimination, jurisdictional policy, and investment priorities-all influenced by structural racism.

Implications for policy and practice: Using system dynamics modeling and the CR approach, chief health strategists can convene partners from multiple sectors to systematically identify, measure, and address inequities produced by structural racism that result in and contribute to adverse childhood and community experiences.

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