寄生虫的复原力:公共卫生准备的下一阶段必须解决社区之间的权力失衡问题。

IF 2.1 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Health Security Pub Date : 2023-11-01 Epub Date: 2023-10-26 DOI:10.1089/hs.2023.0022
Mitch H Stripling, Jordan Pascoe
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引用次数: 0

摘要

社区复原力是一个系统在不受干扰的情况下保持其基本功能的能力,是公共卫生准备的基石。然而,正如目前所实践的那样,社区复原力通常侧重于定义的社区特征,以描述脆弱性或社会资本等因素。这忽略了在新冠肺炎大流行期间,一些社区的居民(作为“必要的工人”)被要求为了其他人留在更富裕的社区而牺牲自己的福祉。利用全球护理链理论,我们分析了富裕社区的恢复力如何依赖于抽走其他不太富裕社区的劳动力,从而产生我们所说的寄生性恢复力。我们认为,公共卫生当局应该优先考虑了解这种社区的相互依赖性并解释其寄生性,以防止在未来的流行病中造成无意伤害。否则,任何依赖这种劳动力的公共卫生应急措施(新冠肺炎疫情应对措施也是如此)都取决于剥削性做法,这些做法产生了应对措施试图解决的差异。我们探索了这一想法的理论基础和实际效果,为准备企业提供了一套初步的理论工具,使其从社区恢复力模式转变为社区更新模式。社区更新模式基于一种基本的护理伦理,在这种伦理中,系统被重新设计,在公共卫生应对过程中变得更加亲社会。我们相信,这种模式可以更成功地解决我们在公共卫生紧急情况下看到的劳动力和健康结果的悲惨不平等问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Parasitic Resilience: The Next Phase of Public Health Preparedness Must Address Power Imbalances Between Communities.

Community resilience, a system's ability to maintain its essential functions despite disturbance, is a cornerstone of public health preparedness. However, as currently practiced, community resilience generally focuses on defined neighborhood characteristics to describe factors such as vulnerability or social capital. This ignores the way that residents of some neighborhoods (as "essential workers") were required during the COVID-19 pandemic to sacrifice their wellbeing for the sake of others staying at home in more affluent neighborhoods. Using the global care chain theory, we analyze the way that the resilience of affluent neighborhoods depends on siphoning off the labor of other, less affluent neighborhoods, creating what we call the parasitic nature of resilience. We argue that understanding this neighborhood interdependence-and accounting for its parasitic nature-should be prioritized by public health authorities to prevent unintentional harm in future pandemics. Otherwise, any public health emergency response that relies on this labor (as did the COVID-19 pandemic response) depends on exploitative practices that produce the very disparities the response is trying to address. We explore the theoretical grounding and practical effects of this idea to provide the preparedness enterprise with an initial set of theoretical tools to move from a model of community resilience to one of community renewal. The community renewal model is based on an underlying ethics of care, in which systems are redesigned to become more prosocial during a public health response. We believe this model can more successfully address the tragic inequities in labor and health outcomes that we see during public health emergencies.

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来源期刊
Health Security
Health Security PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
4.80
自引率
6.10%
发文量
70
期刊介绍: Health Security is a peer-reviewed journal providing research and essential guidance for the protection of people’s health before and after epidemics or disasters and for ensuring that communities are resilient to major challenges. The Journal explores the issues posed by disease outbreaks and epidemics; natural disasters; biological, chemical, and nuclear accidents or deliberate threats; foodborne outbreaks; and other health emergencies. It offers important insight into how to develop the systems needed to meet these challenges. Taking an interdisciplinary approach, Health Security covers research, innovations, methods, challenges, and ethical and legal dilemmas facing scientific, military, and health organizations. The Journal is a key resource for practitioners in these fields, policymakers, scientific experts, and government officials.
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