实施新法规促进健康但可能加剧不平等

R. Afshari, D. Bellinger
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引用次数: 5

摘要

不同人群健康状况的可避免的系统性差异被称为健康不平等。它们给个人和社会带来了巨大的社会和经济成本(1,2)。例如,根据加拿大统计局(3)的数据,加拿大第一民族人口的出生预期寿命(男性73岁,女性78岁)低于加拿大总人口(2017年预计分别为79岁和83岁)。在这篇评论中,我们以加拿大第一民族人口、沿海居民和自我收割的美洲原住民为例。毒理学监管可以被视为健康的决定因素,因为毒理学监管机构推出的政策影响卫生服务,并在社区层面有效。然而,这些政策可能会以系统的方式在人口亚群体中以不同的方式分配,这可能是不平等的根源。食用自家种植或自行收获的食品可能会接触到各种化学物质,但这些产品中的污染物水平通常不会受到检查机构的监测(4)。迄今为止,健康不平等的许多驱动因素已经被定义,如性别、种族和经济增长。然而,没有关于“不平等”和“潜在的食物毒性”的文献。我们在这篇社论中认为,尽管包括加拿大第一民族人口、沿海居民和美洲原住民在内的所有人口都从实施新的毒理学法规中受益,但一些少数群体的健康不平等程度可能会增加。加拿大卫生部已将所有零售鱼类可食用部分的最高含量设定为0.5 mg/kg(50 ppm),但有一些例外(5)。这一级别适用于商业鱼类,并由检查机构强制执行。然而,降低普通人群所承担风险的鱼类消费建议可能不会为包括第一民族(美洲原住民)在内的自给渔民带来太多健康益处。在另一个例子中,在1987年加拿大爆发遗忘性贝类中毒(ASP)之后,___________________原创文章编辑
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Implementing New Regulation Promotes Health but May Increase Inequality
Avoidable systematic differences in health status of different population groups are called health inequalities. They cause significant social and economic costs to both individuals and societies (1, 2). For example, life expectancy at birth among Canadian First Nation Population is lower (73 for males and 78 for females) than that of total Canadian population (79 and 83, respectively, projected for 2017) according to Statistics Canada (3). In this commentary, we used Canadian First Nation Population, coastal residents and Native American population who self-harvest as example. Toxicology regulation could be considered as a determinant of health, as policies introduced by regulatory toxicology agencies influence health services and are effective at the community level. These policies, however, could be distributed differently among the subgroups of the populations in a systematic manner, which may be a source of inequality. Consumption of home grown or self-harvested foods can result in exposure to various chemicals but such contaminant levels in these products are often not monitored by inspection agencies (4). To date, many drivers of health inequality have been defined, such as gender, race and economic growth. However, no literature is available on “inequality” and “potential food toxicity”. We argue in this editorial that while all population including Canadian First Nation Population, Coastal Residents and Native American population groups are benefitted from implementing new toxicology regulations, the magnitude of health inequalities might increase for some minority groups. Health Canada has set a maximum level of 0.5 mg/kg (50 ppm) in the edible portion of all retail fish, subject to some exceptions (5). This level is applied to commercial fish and enforced by the inspection agencies. However, fish consumption advisories that reduce the risk borne by the general population might not provide much health benefit to subsistence fishermen, which include First Nation (Native American) populations. In another example, and following an outbreak of amnesic shellfish poisoning (ASP) in Canada in 1987, which is ___________________ ORIGINAL ARTICLE EDITORIAL
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期刊介绍: Asia Pacific Journal of Medical Toxicology (APJMT) aims to expand the knowledge of medical toxicology and tries to provide reliable information in this field for medical and healthcare professionals. APJMT mainly focuses on research related to medical toxicology issues in the Asia Pacific region and publishes articles on clinical and epidemiological aspects of toxicology, poisonings emergency care, addiction, drug interactions and adverse effects. The journal accepts and welcomes high quality papers in the form of original articles and rarely review articles, case reports and scientific letters relevant to medical practice in toxicology.
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