通过健康与法律合作应对工作场所健康偏见。

Journal of law and health Pub Date : 2024-01-01
Barbara J Zabawa
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引用次数: 0

摘要

在当前的美国经济中,保健服务主要面向社会特权阶层,迎合大多数白人和高收入客户的需求。当边缘化群体在工作场所等地方遇到健康服务时,他们面对的是一个隐含偏见的行业。这些偏见包括:只强调个人行为的改变,而不考虑健康的社会决定因素(SDOH);对健康活动进行文化挪用,以获取资本利益;使用有偏见的健康衡量标准,如体重指数(BMI);以及对实现刻板健康身体的不断想象和期望。法律界必须清醒地认识到这些偏见,倡导更加公平的健康服务。健康-法律合作伙伴关系(WLPs)是律师可以用来解决当前工作场所健康计划中存在的不平等问题的一种工具。具体来说,律师可以通过认证 B 公司现有的员工援助计划 (EAP) 创建 WLP,以解决 SDOH 问题。本文的第一部分探讨了健康产业的现状,以及强调个人行为、健康活动的文化挪用、使用体重指数(BMI)和传播刻板的健康身体形象等偏见如何对历史上被边缘化的人群产生不利影响。第二部分探讨了工作场所健康计划,以及这些计划如何不仅融入了更广泛的健康产业中普遍存在的偏见,而且《可负担医疗法案》(ACA)和《美国残疾人法案》(ADA)下的工作场所健康法律如何鼓励它们这样做。第三部分探讨了 EAP 的历史和法律框架,以及雇主和雇员目前对 EAP 的使用情况。第三部分介绍了WLP的概念,描述了WLP的榜样--医疗法律伙伴关系(MLP),以及WLP如何采用MLP的许多相同概念并将其应用于工作场所健康计划。然后,本部分提供了如何在工作场所健康计划中开始实施 WLP 的路线图,以展示这些合作关系如何不仅能解决员工面临的 SDOH 问题,还能由致力于解决当前健康服务中存在的多种偏见的律师提供更广泛的宣传服务。
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Countering Workplace Wellness Bias Through Wellness-Legal Partnerships.

In the current United States economy, wellness is predominantly marketed to society's privileged individuals, catering to a mostly white and high-income clientele. When marginalized communities encounter wellness services, such as in the workplace, they are faced with an implicitly biased industry. These biases include an emphasis on individual behavior change without considering social determinants of health (SDOH), cultural appropriation of wellness activities for capitalistic gain, use of biased health measures like Body-Mass Index (BMI), and constant images of and expectations of achieving a stereotypical healthy body. The legal community must wake up to these biases and advocate for more equitable wellness services. Wellness-Legal Partnerships (WLPs) are one type of tool that lawyers can use to address inequities baked into current workplace wellness programming. Specifically, lawyers can create WLPs through existing Employee Assistance Programs (EAPs) at Certified B Corporations to address SDOH. Part I of this paper explores the current state of the wellness industry and how the biases of emphasizing individual behavior, cultural appropriation of wellness activities, use of BMI and broadcasting the stereotypical healthy body image adversely impact historically marginalized people. Part II examines workplace wellness programs and how those programs not only incorporate the biases prevalent in the wider wellness industry, but how workplace wellness laws under the Affordable Care Act (ACA) and the Americans with Disabilities Act (ADA) arguably encourage them to do so. Part III explores the history and legal framework of EAPs and their current use by employers and employees. Part III introduces the concept of WLPs by describing the WLP role model, Medical-Legal Partnerships (MLPs) and how WLPs can adopt many of the same MLP concepts and apply them to workplace wellness programs. Then, this Part offers a roadmap on how to start implementing WLPs in workplace wellness programs to demonstrate how these partnerships can not only address SDOH faced by employees, but also offer broader advocacy services by lawyers dedicated to addressing the multiple biases that currently exist in wellness services.

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