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Towards a theoretically grounded, social democratic public health 建立一个有理论基础的、社会民主的公共卫生
IF 2.8 3区 医学 Q1 Medicine Pub Date : 2022-10-20 DOI: 10.1080/09581596.2022.2119053
E. Speed, L. McLaren
The Editorial Board recently made revisions to Critical Public Health’s (CPH) Aims and Scopes. One change was to explicitly invite submissions focusing on the political economy of (public) health and to add political science and policy studies to the (non-exhaustive) indicative list of disciplinary perspectives that shed important light on issues of equity and power in public health. With those changes in mind, a recent paper by Walby, published in the European Journal of Social Theory (Walby, 2021) caught our eye. The paper considers the question of social theory as it relates to public health, specifically in the context of the COVID-19 pandemic. Briefly (the reader is encouraged to read the excellent full paper), Walby draws on Delanty’s (2020) review of the response of social theory to the impact of COVID-19, which identified six political philosophical positions on the relationship between the individual and society: utilitarian, Kantian, libertarian, biopolitical securitisation, postcapitalism, and behaviouralism. Walby points out that the concept of ‘social democracy’ is “curiously absent” amongst these positions. She defines social democracy in relation to public health as “a project, form of governance and societal formation, in which if one is sick, we are all potentially sick”. Its omission, Walby argues, is significant because “social democratic visions and practices underpin the theory and practice of ‘public health’” (2021, p. 24). In Walby’s view, a social democratic public health is one which offers “solidaristic provision of welfare to support [everyone]”, thus making it “both efficient and just simultaneously” (2021, p. 38). Here we see a combination of nuanced concerns around the intersection of effective governance and social justice. Critical theory in this journal has been, perhaps, skewed towards Foucauldian perspectives that position public health regimes as biopower, contributing to surveillance. There is a need for public health and other critical theorists to focus on the potential for a more positive, social democratic model of public health. In this editorial, we seek to address the question of what public health communities might have to do, to ensure that we foreground and prioritise social democratic visions and practices. Walby’s analysis raises three crucial issues for public health scholars to consider. Firstly, through the ways in which it mobilises different modes of social theory to characterise the public health response, it provides a modus for thinking about the form and function of social theory in the processes and practices of public health. In turn, this allows us to put into perspective some dominant trends – including blind spots – in critical public health. For example, through mobilizing the biopolitical perspective, Foucault is frequently invoked in critical contexts to analyze ‘state-authorized’ public health measures to contain communicable disease spread (including but not limited to COVID-19)
编辑委员会最近对《关键公共卫生》的目标和范围进行了修订。一个变化是明确邀请提交侧重于(公共)卫生的政治经济学的材料,并将政治科学和政策研究添加到(非详尽的)学科观点指示性清单中,这些观点对公共卫生中的公平和权力问题有重要的启示。考虑到这些变化,沃尔比最近发表在《欧洲社会理论杂志》(沃尔比,2021)上的一篇论文引起了我们的注意。本文考虑了与公共卫生有关的社会理论问题,特别是在新冠肺炎大流行的背景下。简言之(鼓励读者阅读优秀的全文),Walby借鉴了Delanty(2020)对社会理论对新冠肺炎影响的反应的评论,其中确定了关于个人与社会关系的六个政治哲学立场:功利主义、康德主义、自由主义、生物政治证券化、后资本主义和行为主义。沃尔比指出,“社会民主”的概念在这些立场中“奇怪地缺席”。她将与公共卫生相关的社会民主定义为“一个项目、治理形式和社会形成,在这个项目中,如果一个人生病了,我们都有可能生病”。沃尔比认为,它的遗漏意义重大,因为“社会民主愿景和实践支撑着‘公共卫生’的理论和实践”(2021,第24页)。在沃尔比看来,社会民主的公共卫生是指提供“团结一致的福利来支持[每个人]”,从而使其“既高效又公正”(2021,第38页)。在这里,我们看到了围绕有效治理和社会正义交叉点的微妙担忧的结合。这本杂志上的批判理论可能倾向于福柯式的观点,将公共卫生制度定位为生物权力,有助于监督。公共卫生和其他批判理论家需要关注建立一个更积极、社会民主的公共卫生模式的潜力。在这篇社论中,我们试图解决公共卫生社区可能必须做什么的问题,以确保我们展望并优先考虑社会民主愿景和实践。沃尔比的分析提出了公共卫生学者需要考虑的三个关键问题。首先,通过调动不同的社会理论模式来描述公共卫生反应,它为思考社会理论在公共卫生过程和实践中的形式和功能提供了一种方式。反过来,这使我们能够正确看待关键公共卫生领域的一些主导趋势,包括盲点。例如,通过调动生物政治视角,福柯经常在关键背景下被用来分析“国家授权”的公共卫生措施,以遏制传染病传播(包括但不限于新冠肺炎),如封锁、保持距离和追踪接触者,作为不公正的威权监督和纪律形式。沃尔比的讨论提出了如何平衡公共卫生的关键方法和社会民主方法的问题,传统上,这些方法侧重于公共卫生作为国家控制机构的一部分的作用,而社会民主方法是对抗新自由主义国家的堡垒。这给我们提出的一个问题是,如何最好地考虑沃尔比关于公共卫生国家干预的社会民主理论的含义,以及如何最好地将其发展为公共卫生中新自由主义的主导替代理论。粗略回顾一下本期刊的产出,很明显,这是CPH在很大程度上缺失的观点。我们认为,公共卫生的社会民主理论允许优先考虑为社会正义和民主利益而动员的公共卫生模式。例如,考虑拉丁美洲社会医学传统中的重要研究(例如Adams等人,2019)。《2022年关键公共卫生》,第32卷,第5期,589-591https://doi.org/10.1080/09581596.2022.2119053
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引用次数: 2
Policing and public health interventions into sex workers’ lives: necropolitical assemblages and alternative visions of social justice 警察和公共卫生干预性工作者的生活:死亡政治集会和社会正义的替代愿景
IF 2.8 3区 医学 Q1 Medicine Pub Date : 2022-10-18 DOI: 10.1080/09581596.2022.2096428
P. Grenfell, Rachel Stuart, J. Eastham, Aisling Gallagher, J. Elmes, L. Platt, M. O’Neill
ABSTRACT While extensive literature documents how criminalisation harms sex workers’ health and rights, limited research has critically examined how interactions between criminal-justice, health, and other systems shape support and justice for and by people who sell sex. We attend to this question by drawing on participatory, qualitative research with a diverse group of sex workers and other stakeholders in East London, UK. In addition to directly and structurally-violent enforcement practices, we identified wider, necropolitical assemblages and practices – across police, local and immigration authorities, health and social services – that disciplined sex workers’ lives, responsibilised them for their health, and defunded specialist services grounded in lived realities, amid tensions over sex-work governance. These effects – grounded in notions of community and vulnerability that often privileged residents’ concerns over threats to sex workers’ safety and health – impacted marginalised and minoritised cis and trans women the most. Those who worked on the street and used drugs, were migrants, and/or women of colour were particularly targeted for enforcement, discounted when reporting violence and impacted by service cuts. Yet participants’ appeals for redirection of funds from enforcement towards respectful, peer-led services reflected claims to social justice on their own terms. We recommend (re)commissioning health and support services that respond to sex workers’ diverse realities, with and by them, alongside concerted efforts to end policies and practices that criminalise, punish, and blame. This would help to alleviate the health and social harms that we document, in support of inclusive participation in health and broader social justice goals.
摘要尽管大量文献记录了刑事定罪如何损害性工作者的健康和权利,但有限的研究批判性地考察了刑事司法、健康和其他系统之间的互动如何影响对性交易者的支持和正义。我们通过与英国东伦敦的性工作者和其他利益相关者进行参与性、定性研究来解决这个问题。除了直接和结构性的暴力执法行为外,我们还发现了更广泛的、致命的政治集会和做法,包括警察、地方和移民当局,卫生和社会服务——在性工作治理的紧张局势中,约束性工作者的生活,让他们对自己的健康负责,并为基于现实生活的专业服务提供资金。这些影响基于社区和脆弱性的观念,这些观念往往使居民对性工作者的安全和健康威胁感到担忧,对被边缘化和少数族裔的顺性别和跨性别女性的影响最大。那些在街头工作和吸毒的人、移民和/或有色人种妇女尤其是执法的目标,在报告暴力行为时被忽视,并受到服务削减的影响。然而,参与者呼吁将资金从执法转向尊重他人、由同行主导的服务,这反映了他们对社会正义的主张。我们建议(重新)委托卫生和支持服务,与性工作者一起或由他们来应对性工作者的不同现实,同时共同努力结束将其定罪、惩罚和指责的政策和做法。这将有助于减轻我们记录的健康和社会危害,支持包容性参与健康和更广泛的社会正义目标。
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引用次数: 3
RELATIVES//Risks or, I am not your data: Ode to Delphrine’s walk, pt. II 亲戚//风险,或者,我不是你的数据:戴尔芬的散步颂歌,第二章
IF 2.8 3区 医学 Q1 Medicine Pub Date : 2022-10-07 DOI: 10.1080/09581596.2022.2096429
Ryan J. Petteway
You wish to plot us and scatter our bones between proximal and distal ends of a sphere, to partition our varied flesh the way a rock might divide a stream bringing forth alluvial futures, only to be siphoned off to water fields flooded with ill logics dressed in a discourse of common sense levied with citations designed to engulf our communities with precarity, armies of statistical engineers manufacturing measures of vulnerability to be paired with pink boa scarves and jet black stilettos,
你想把我们画出来,把我们的骨头分散在球体的近端和远端之间,像岩石分割河流一样分割我们不同的肉体,带来冲积物的未来,结果却被虹吸到充满病态逻辑的水域,这些逻辑披着常识的外衣,引用旨在用不稳定吞噬我们的社区,大批统计工程师制造脆弱性指标,搭配粉色蟒蛇围巾和深黑色细高跟鞋,
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引用次数: 1
The intersection of structure and agency within charitable community food programs in Toronto, Canada, during the COVID-19 pandemic: cultivating systemic change 新冠肺炎大流行期间,加拿大多伦多慈善社区食品计划的结构和机构交叉:培育系统性变革
IF 2.8 3区 医学 Q1 Medicine Pub Date : 2022-10-06 DOI: 10.1080/09581596.2022.2130740
Jenelle Regnier-Davies, Sara Edge, Nicole Austin
ABSTRACT Prior to the COVID–19 outbreak, food insecurity was already a serious public health problem in Canada, impacting 12.7 percent of households. In recent years, activists, practitioners and researchers from a range of health–related disciplines, have debated the legitimacy of food banks and other charitable food programs, contending that policy and programs at the federal level must be prioritized to address the underlying root causes of poverty. This paper challenges the discourse that charitable food programs prevent or distract from Canada’s social equity goals. Alternatively, this paper argues that programs and initiatives at the local level can emerge to bring short–term stability and self–sufficiency to local communities while also advocating for longer–term structural change. Drawing upon structuration theory and critical ecologies of anti–Black racism, we examine the work of BlackFoodToronto, a food sovereignty initiative, to illustrate the negotiation of power and agency, and how groups and networks react to and reshape confining and enabling structures through collaborative practice. In addressing Canada’s food security crisis, this paper offers an alternative perspective of community–based, nonprofit and charitable programs, which in practice, can help inform future food security policy and related health equity and community development strategies.
摘要在2019冠状病毒病爆发之前,粮食不安全已经是加拿大一个严重的公共卫生问题,影响了12.7%的家庭。近年来,来自一系列健康相关学科的活动家、从业者和研究人员就食品银行和其他慈善食品计划的合法性进行了辩论,认为必须优先考虑联邦层面的政策和计划,以解决贫困的根本原因。本文对慈善食品计划阻碍或分散加拿大社会公平目标的说法提出了质疑。或者,本文认为,地方一级的计划和举措可以为当地社区带来短期稳定和自给自足,同时也倡导长期的结构性变革。根据反黑人种族主义的结构理论和批判生态学,我们考察了粮食主权倡议BlackFoodToronto的工作,以说明权力和代理的谈判,以及团体和网络如何通过合作实践对限制和扶持结构做出反应并重塑其。在应对加拿大的粮食安全危机时,本文提供了一个基于社区、非营利和慈善项目的替代视角,这些项目在实践中有助于为未来的粮食安全政策以及相关的健康公平和社区发展战略提供信息。
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引用次数: 3
‘Ebola is a business’: an analysis of the atmosphere of mistrust in the tenth Ebola epidemic in the DRC “埃博拉是一门生意”:对刚果民主共和国第十次埃博拉疫情不信任气氛的分析
IF 2.8 3区 医学 Q1 Medicine Pub Date : 2022-10-06 DOI: 10.1080/09581596.2022.2128990
Sung-joon Park, H. Brown, Kennedy Muhindo Wema, N. Gobat, M. Borchert, Josepha Kalubi, Gaston Komanda, N. Morisho
ABSTRACT This paper examines the atmosphere of mistrust that permeated the response to the tenth Ebola epidemic in Eastern DRC (2018–2020). The concept of an ‘atmosphere of mistrust’ that we develop in this article directs attention to the elusive-yet-pervasive presence of mistrust in interactions between responders and communities during the Ebola epidemic. This analysis focuses on the popular notion that ‘Ebola is a business’. Our interviewees frequently used this saying during our research on the Ebola response to explain why mistrust had emerged, how it materialized, and against whom it was directed. Based on these interviews, we examine ‘Ebola is a business’ as a slogan that enabled people to voice mistrust. This slogan, as we aim to show, resonated with a wider atmosphere of mistrust that governed the emergency situation in Eastern DRC. In using it, people responded to their perceptions of mistrust whilst simultaneously perpetuating and extending this atmosphere of mistrust. Our analysis of the atmosphere of mistrust highlights the power of atmospheres in governing situations, mobilizing people, and disrupting structures of discrimination. It aims to contribute to a better understanding of the barriers inhibiting the collaborations between affected communities and responders, which are required to deliver effective epidemic responses. Moreover, we argue that voice and the atmosphere are important analytics for exploring the histories of mistrust that Ebola epidemics ask for.
本文考察了刚果民主共和国东部(2018-2020)应对第十次埃博拉疫情时弥漫的不信任气氛。我们在本文中提出的“不信任气氛”的概念将注意力引向埃博拉疫情期间响应者和社区之间互动中难以捉摸但普遍存在的不信任。本分析的重点是“埃博拉是一门生意”这一流行观念。在我们对埃博拉应对措施的研究中,我们的受访者经常使用这句话来解释不信任为什么会出现,它是如何实现的,以及它针对的是谁。根据这些采访,我们研究了“埃博拉是一门生意”这一口号,它使人们能够表达不信任。正如我们旨在表明的那样,这一口号与刚果民主共和国东部紧急局势中更广泛的不信任气氛产生了共鸣。在使用它的过程中,人们对不信任的感觉做出了反应,同时延续和扩大了这种不信任的气氛。我们对不信任气氛的分析强调了气氛在控制局势、动员人民和破坏歧视结构方面的力量。它的目的是促进更好地了解阻碍受影响社区和应对者之间进行有效流行病应对所必需的合作的障碍。此外,我们认为,声音和气氛是探索埃博拉疫情所要求的不信任历史的重要分析。
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引用次数: 4
From self- to other- surveillance: a critical commentary on the English policy framework for Fetal Alcohol Spectrum Disorder (FASD) 从自我监控到他人监控:英国胎儿酒精谱系障碍(FASD)政策框架评论
IF 2.8 3区 医学 Q1 Medicine Pub Date : 2022-10-04 DOI: 10.1080/09581596.2022.2130031
Ellie Lee, Rachel Arkell
ABSTRACT England now has a policy framework for Fetal Alcohol Spectrum Disorder (FASD). This proposes a suite of healthcare interventions, some of which attend to assessment and support for those who may be diagnosed with the disorder. Others, which are the focus of this commentary, have a stated goal of FASD prevention, to be achieved through embedding activities around alcohol abstention within maternity services and reproductive healthcare. Critical engagement with alcohol abstinence advocacy to pregnant women in this journal has linked this aspect of health promotion to larger debates about risk, moral panic, neoliberalism, self-surveillance, and forms of citizenship. The new English policies on FASD have, however, been the subject of relatively little academic engagement so far. In this commentary, after an initial summary of points from the relevant literature in Critical Public Health, we take public debate about the new English policy as our point of departure, highlighting the precautionary approach, the emphasis on monitoring, and contraceptive advocacy for at-risk women. We suggest an important shift in English policy, from presenting women as managers of risk via self-surveillance, to positioning them as in need of routine management and ‘other-surveillance’ within healthcare systems. This raises more general questions about the meaning of ‘autonomy’ and ‘support’ in healthcare.
英国现在有了胎儿酒精谱系障碍(FASD)的政策框架。这提出了一套医疗保健干预措施,其中一些是对那些可能被诊断患有这种疾病的人进行评估和支持。作为本评论的重点,其他国家有明确的预防非酒精性疾病的目标,将通过在产妇服务和生殖保健中纳入有关戒酒的活动来实现。该杂志对孕妇戒酒倡导的批判性参与将健康促进的这一方面与更大的关于风险、道德恐慌、新自由主义、自我监督和公民形式的辩论联系起来。然而,到目前为止,英国关于FASD的新政策一直是相对较少的学术参与的主题。在这篇评论中,在对《关键公共卫生》相关文献的要点进行初步总结之后,我们将公众对英国新政策的辩论作为我们的出发点,强调预防方法,强调监测,以及对高危妇女的避孕宣传。我们建议英国政策的重要转变,从通过自我监督将女性视为风险管理者,到将她们定位为需要日常管理和医疗保健系统中的“他人监督”。这就提出了关于医疗保健中“自主”和“支持”的意义的更普遍的问题。
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引用次数: 0
Vulnerability and antimicrobial resistance 易感性和抗菌素耐药性
IF 2.8 3区 医学 Q1 Medicine Pub Date : 2022-09-22 DOI: 10.1080/09581596.2022.2123733
Alexander Broom, M. Peterie, Katherine Kenny, J. Broom, A. Kelly‐Hanku, L. Lafferty, C. Treloar, T. Applegate
ABSTRACT It is now well-recognised that antimicrobial resistance (AMR), or the ability of organisms to resist currently available antibiotics and other antimicrobial drugs, represents one of the greatest dangers to human health in the 21st Century. As of 2022, AMR is a top-10 global public health threat. Various national and transnational initiatives have been implemented to address accelerating AMR, and the pressure to find local and global solutions is increasing. Despite this urgency, surprisingly limited progress is being made in rolling back or even slowing resistance. A multitude of perspectives exist regarding why this is the case. Key concerns include an enduring dependency on market-driven drug development, the lacklustre governance and habitual over-prescribing of remaining antimicrobial resources, and rampant short-termism across societies. While rarely presented in such terms, these disparate issues all speak to the social production of vulnerability. Yet vulnerability is rarely discussed in the AMR literature, except in terms of ‘disproportionate effects’ of AMR. In this paper, we offer a reconceptualisation of vulnerability as manifest in the AMR scene, showing that vulnerability is both a predictable consequence of AMR and, critically, productive of AMR to begin with. We underline why comprehending vulnerability as embodied, assembled, multivalent and reproduced through surveillance matters for international efforts to combat resistance.
摘要:众所周知,抗菌素耐药性(antimicrobial resistance, AMR),即生物体对现有抗生素和其他抗微生物药物的耐药性,是21世纪人类健康面临的最大威胁之一。截至2022年,抗生素耐药性是全球十大公共卫生威胁之一。已经实施了各种国家和跨国倡议,以解决加速的抗生素耐药性问题,寻找地方和全球解决方案的压力正在增加。尽管如此紧迫,但在减少甚至减缓耐药性方面取得的进展却令人惊讶地有限。关于为什么会出现这种情况,存在多种观点。主要问题包括长期依赖市场驱动的药物开发、治理不力和习惯性过度使用剩余的抗微生物药物资源,以及整个社会普遍存在的短期主义。虽然很少以这种方式提出,但这些不同的问题都说明了脆弱性的社会生产。然而,除了AMR的“不成比例的影响”之外,在AMR文献中很少讨论脆弱性。在本文中,我们提供了脆弱性的重新概念化,在AMR场景中表现出来,表明脆弱性既是AMR的可预测结果,而且至关重要的是,从一开始就产生了AMR。我们强调为什么理解脆弱性是具体的、聚集的、多重的和通过监测再现的,这对国际上抗击耐药性的努力至关重要。
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引用次数: 5
Beyond Asian ‘mask culture’: understanding the ethics of face masks during the Covid-19 pandemic in Singapore 超越亚洲“口罩文化”:了解新加坡Covid-19大流行期间口罩的道德规范
IF 2.8 3区 医学 Q1 Medicine Pub Date : 2022-09-06 DOI: 10.1080/09581596.2022.2114315
L. Fearnley, Xiaomeng Wu
ABSTRACT During the Covid-19 pandemic, face masks became widely used and sometimes mandatory anti-infection devices across the world. While anti-mask protests emerged in several Western countries, nearly universal mask-wearing is commonly seen in Asian countries. Journalistic and popular accounts suggest that an Asian ‘mask culture’ explains the acceptance of mask-wearing and associates mask culture with political authoritarianism in Asian countries. Based on in-depth interviews conducted with residents of Singapore, an Asian city-state that implemented a mask mandate in 2020, we uncover a wide diversity of beliefs, motivations, and practices of mask-wearing that challenges the existence of a homogeneous ‘mask culture’. Drawing on a recent theoretical movement known as the anthropology of ethics, we draw attention to individual judgments and engagements with cultural norms and obligations in order to characterise how it became ‘desired and desirable’ for a diverse population of Singapore residents to wear masks.
摘要在新冠肺炎大流行期间,口罩在世界各地被广泛使用,有时是强制性的抗感染设备。虽然一些西方国家出现了反口罩抗议活动,但在亚洲国家几乎普遍佩戴口罩。记者和流行报道表明,亚洲的“口罩文化”解释了人们对戴口罩的接受,并将口罩文化与亚洲国家的政治威权主义联系起来。根据对2020年实施口罩强制令的亚洲城市国家新加坡居民的深入采访,我们发现了戴口罩的信仰、动机和做法的广泛多样性,这对同质的“口罩文化”的存在提出了挑战。根据最近一场被称为伦理人类学的理论运动,我们提请人们注意个人判断以及对文化规范和义务的参与,以描述不同人群的新加坡居民戴口罩是如何变得“渴望和可取”的。
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引用次数: 7
Predictive analytics in HIV surveillance require new approaches to data ethics, rights, and regulation in public health 艾滋病毒监测中的预测分析需要对公共卫生中的数据伦理、权利和监管采取新的方法
IF 2.8 3区 医学 Q1 Medicine Pub Date : 2022-08-25 DOI: 10.1080/09581596.2022.2113035
Stephen Molldrem, Anthony K. J. Smith, A. Mcclelland
ABSTRACT In recent years, applications of big data-driven predictive analytics in public health programs have expanded, offering promises of greater efficiency and improved outcomes. This commentary considers the turn toward predictive modeling in US-based HIV public health initiatives. Through two case studies, we analyze emergent ethical problems and risks. We focus on potential harms related to (1) classifying people living with HIV in public health systems, (2) new ways of combining and sharing individuals’ health data that predictive approaches employ, and (3) how new applications of big data in public health challenge the underlying logics and regulatory paradigms that govern data re-uses and rights in public health practice. Drawing on critical technology scholarship, critical bioethics, and advocacy by organized networks of people living with HIV, we argue that stakeholders should enter into a new range of reform-oriented conversations about the regulatory frameworks, ethical norms, and best practices that govern re-uses of HIV public health data in the era of predictive public health interventions that target individuals.
摘要近年来,大数据驱动的预测分析在公共卫生项目中的应用不断扩大,有望提高效率并改善结果。这篇评论考虑了美国艾滋病毒公共卫生倡议向预测建模的转变。通过两个案例分析,我们分析了突发的伦理问题和风险。我们关注与以下方面相关的潜在危害:(1)在公共卫生系统中对艾滋病毒感染者进行分类,(2)预测方法采用的组合和共享个人健康数据的新方法,以及(3)大数据在公共卫生中的新应用如何挑战公共卫生实践中管理数据重复使用和权利的基本逻辑和监管范式。利用关键技术学术、关键生物伦理学和有组织的艾滋病毒感染者网络的倡导,我们认为利益攸关方应该就监管框架、道德规范、,以及在针对个人的预测性公共卫生干预时代管理艾滋病毒公共卫生数据重复使用的最佳做法。
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引用次数: 6
On epidemiology as racial-capitalist (re)colonization and epistemic violence 论作为种族资本主义(再)殖民化和认识暴力的流行病学
IF 2.8 3区 医学 Q1 Medicine Pub Date : 2022-08-03 DOI: 10.1080/09581596.2022.2107486
Ryan J. Petteway
ABSTRACT This commentary reflects upon power-knowledge dynamics and matters of epistemic, procedural, and distributive justice that undergird epidemiological knowledge production related to racial health inequities in the U.S. Grounded in Foucault’s power-knowledge concepts—“objects”, “ritual”, and “the privileged”—and guided by Black feminist philosopher Kristie Dotson’s conceptualization of epistemic violence, it critiques the dominant positivist, reductionist, and extractivist paradigm of epidemiology, interrogating the settler-colonial and racial-capitalist nature of the knowledge production/curation enterprise. The commentary challenges epidemiology’s affinity for epistemological, procedural, and methodological norms that effectively silence/erase community knowledge(s) and nuance in favor of reductionist empirical representations/re-presentations produced by researchers who, often, have never stepped foot inside the communities they aver to model. It also expressly names the structurally racist reality of a “colorblind” knowledge production/curation system controlled by White scholars working from/for an invisibilized White scientific gaze. In this spirit, this commentary engages the public health critical race praxis principle of “disciplinary self-critique”, illuminating the inherent contradictions of a racial health equity discourse that fails to interrogate the racialized power dynamics underlying its knowledge production enterprise. In doing so, this commentary seeks to (re)frame and invite discourse regarding matters of epistemic violence and (re)colonization as manifest/legible within epidemiology research, suggesting that the structural racism embedded within – and perpetuated through – our collective work must be addressed to advance antiracist and decolonial public health futures. In this regard, I suggest the value of engaging poetry as praxis—as mode of knowledge production/expression to “center the margins” and offer counternarratives to epidemiology’s epistemic violence.
摘要:这篇评论反映了权力知识的动态以及知识、程序和分配正义的问题,这些问题支撑着与美国种族健康不平等有关的流行病知识生产。基于福柯的权力知识概念——“对象”、“仪式”,和“特权者”——在黑人女权主义哲学家Kristie Dotson对认识暴力的概念化的指导下,它批评了占主导地位的实证主义、还原主义和提取主义流行病学范式,质疑知识生产/策展企业的定居者殖民主义和种族资本主义性质。这篇评论挑战了流行病学对认识论、程序和方法论规范的亲和力,这些规范有效地沉默/抹去了社区知识和细微差别,支持由研究人员产生的简化主义经验表征/重新呈现,而这些研究人员往往从未涉足他们所主张的建模社区。它还明确指出了“色盲”知识生产/管理系统的结构性种族主义现实,该系统由白人学者控制,他们在看不见的白人科学凝视下工作。本着这种精神,这篇评论采用了“学科自我批评”的公共卫生批判种族实践原则,揭示了种族健康公平话语的内在矛盾,该话语未能质疑其知识生产企业背后的种族化权力动态。在这样做的过程中,这篇评论试图(重新)框定并邀请关于认知暴力和(重新)殖民化问题的讨论在流行病学研究中变得明显/清晰,表明必须解决我们集体工作中嵌入并通过集体工作延续的结构性种族主义问题,以推进反种族主义和非殖民化的公共卫生未来。在这方面,我认为诗歌作为实践的价值——作为知识生产/表达的模式,以“中心边缘”,并为流行病学的认识暴力提供反叙事。
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引用次数: 10
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Critical Public Health
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