公平的政策改变可以促进新泽西州的健康改善

A Policy Agenda for a Healthier, More Equitable New Jersey examines the obstacles standing in the way of health and racial equity and the policy actions needed to drive systemic change. The report offers policy recommendations in the areas of affordable housing, birth and reproductive justice, public health infrastructure, and community power-building.

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新泽西州普林斯顿大学罗伯特·伍德·约翰逊基金会(RWJF)今天发布的一份报告建议，以公平为基础的政策，将新泽西州转变为一个每个人都有公平机会实现最健康生活的地方——没有基于种族、民族、性别、性取向、能力或阶级的障碍。

一个更健康、更公平的新泽西州的政策议程审查阻碍健康和种族平等的障碍以及推动系统性变革所需的政策行动。该报告在负担得起的住房、生育和生殖司法、公共卫生基础设施和社区电力建设等领域提出了政策建议。

Maisha Simmons, RWJF’s senior director of New Jersey grantmaking.

Health inequity—the uneven distribution of social and economic resources affecting health—persists in New Jersey despite investments to date aimed at bridging disparities. A growing body of research identifies structural racism—unjust and unfair policies, practices, and norms underlying every aspect of our society—as the core of persistent inequity.

For years, RWJF has collaborated with local grantees, state policymakers, and diverse groups of partners to build a Culture of Health in New Jersey rooted in equity. This new report sparks the next phase of community action and impact.

Last year, a poll by the Eagleton Center for Public Interest Polling at Rutgers University for RWJF found that nearly everyone surveyed—about 90 percent—said they believe New Jersey should be a place where everyone has a just opportunity to achieve their healthiest life possible. Yet, when asked whether race and ethnicity majorly influence a person’s ability to lead a healthy life, only 33 percent agreed.

Just as a combination of personal experiences, race, gender, income, education, location, and other factors determine health in New Jersey, so too do they influence public awareness and perception of health inequities and their causes.

This uneven distribution of social and economic resources has a huge influence on people’s health. It persists amid renewed attention to and investment in addressing disparities, because investment alone cannot overcome unjust and unfair policies, practices, and norms embedded in society.

Research shows that achieving equitable outcomes requires more than robust investment. It requires prioritizing racial equity in all aspects of policymaking, building and sharing power with communities, targeting implementation strategies, and developing effective enforcement and accountability mechanisms.

“Since people created the policies and social practices that shape health opportunities, we can reinvent them. It will take leadership, collaboration, and engagement across all sectors and communities,” Simmons said. “Working toward racial equity requires deliberate, meaningful inclusion of residents of color. We can work together so everyone’s children and grandchildren can have the best possible future.”

Key policy recommendations include:

• Support equity-informed decisions and power-building
  • Establish a state task force to assess how New Jerseyans who are Black have been harmed throughout state history and propose actionable steps to policymakers.
  • Create and fund an interagency equity working group to provide leadership on cross-sector collaboration.
  • Assess the impact of significant new legislation and regulations on racial equity in New Jersey.
  • Acknowledge the presence and effects of structural racism and plan action.

• Ensure New Jerseyans have equitable access to affordable housing in communities of their choosing
  • Invest in more affordable and safe homes across all communities.
  • Promote racially equitable land use and zoning policy to provide opportunities for more people to live in neighborhoods that support good health and wellbeing.
  • Strategically implement and leverage innovative strategies to facilitate racially equitable homeownership.
  • Establish and fund a right-to-counsel for low-income renters.

• Improve maternal and infant health outcomes by enhancing care, support, and prevention to advance birth and reproductive justice
  • Continue supporting and investing in a diverse birthing workforce and implicit bias training to provide appropriate care across the maternal and infant care continuum.
  • Implement new Medicaid policy to support racial equity.
  • Enhance access to comprehensive reproductive health, including abortion care.
  • Enhance enforcement of the existing paid leave benefit and increase uptake.

• Center equity in a modern public health system
  • Provide adequate and flexible funding and maximize existing assets to support public health services and capabilities.
  • Establish a state Public Health Institute to facilitate collaboration within and across sectors to improve health equity.
  • Increase state investments to transform public health data systems to center equity and include practical, flexible data-sharing processes.
    

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“当我们改变叙述，转移权力，为了共同利益团结人民时，我们可以实现一个新的现实。我们期待着与政策制定者、慈善伙伴、有色人种社区领袖、学术和商业领袖以及倡导者合作，在我们的家乡推进健康和种族平等。RWJF新泽西拨款高级主管Maisha Simmons说．

健康不平等——影响健康的社会和经济资源分配不均——在新泽西州仍然存在，尽管迄今为止的投资旨在弥合差距。越来越多的研究发现，结构性种族主义——潜藏在我们社会各个方面的不公正和不公平的政策、做法和规范——是持续不平等的核心。

多年来，RWJF与当地受资助者、州决策者和不同的合作伙伴团体合作，在新泽西州建立了一种以公平为基础的卫生文化。这份新报告激发了下一阶段的社区行动和影响。

去年,罗格斯大学伊格尔顿公共利益调查中心为RWJF进行的一项民意调查发现几乎所有被调查的人——大约90%——都说他们认为新泽西应该是一个每个人都有公平机会实现最健康生活的地方。然而，当被问及种族和民族是否主要影响一个人过上健康生活的能力时，只有33%的人表示同意。

正如个人经历、种族、性别、收入、教育、地点和其他因素共同决定了新泽西州的健康状况一样，这些因素也影响着公众对卫生不平等及其原因的认识和看法。

这种社会和经济资源的不平衡分配对人们的健康产生了巨大影响。在重新关注和投资于解决差距的情况下，这种差距仍然存在，因为仅靠投资无法克服社会中根深蒂固的不公正和不公平的政策、做法和规范。

研究表明，实现公平的结果需要的不仅仅是强劲的投资。它要求在政策制定的各个方面优先考虑种族平等，与社区建立和分享权力，制定有针对性的实施战略，并制定有效的执法和问责机制。

“既然是人们创造了塑造健康机会的政策和社会实践，我们就可以重塑它们。这需要所有部门和社区的领导、合作和参与。”“努力实现种族平等需要有意、有意义地包容有色人种居民。我们可以共同努力，让每个人的子孙都能拥有最好的未来。”

主要政策建议包括:

• 支持公平决策和权力建设
  • 建立一个州特别工作组，评估新泽西州黑人在整个州历史上是如何受到伤害的，并向政策制定者提出可行的步骤。
  • 创建并资助一个跨部门公平工作组，为跨部门合作提供领导。
  • 评估新泽西州重要的新立法和法规对种族平等的影响。
  • 承认结构性种族主义的存在和影响，并计划采取行动。

• 确保新泽西人在他们选择的社区有公平的机会获得负担得起的住房
  • 在所有社区投资建设更多负担得起的安全住房。
  • 促进种族平等的土地使用和分区政策，为更多的人提供机会，使他们生活在有利于健康和福祉的社区。
  • 战略性地实施和利用创新战略，促进种族平等的住房所有权。
  • 建立并资助低收入租房者获得法律咨询的权利。

• 通过加强护理、支持和预防，促进生育和生殖正义，改善孕产妇和婴儿健康结果
  • 继续支持和投资于多样化的分娩队伍和隐性偏见培训，以便在母婴护理连续体中提供适当的护理。
  • 实施新的医疗补助政策，支持种族平等。
  • 增加获得全面生殖健康，包括堕胎护理的机会。
  • 加强执行现有的带薪休假福利，并增加雇员的吸收。

• 现代公共卫生体系中的中心公平
  • 提供充足和灵活的资金，最大限度地利用现有资产，以支持公共卫生服务和能力。
  • 建立国家公共卫生研究所促进部门内和部门间的合作，以改善卫生公平。
  • 增加国家投资，将公共卫生数据系统转变为以公平为中心，并包括实用、灵活的数据共享流程。