让护士做好准备，引领健康差异的创新解决方案 | UCSF Nursing School

Preparing Nurses to Lead Innovative Solutions for Health Disparities

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Mags Hines, RN, was an educator and community organizer, and helped run the Berkeley Free Clinic before enrolling in the UCSF School of Nursing. 

“I had an understanding of social determinants of health through my work, seeing first-hand the structural factors impacting access to care,” says Hines.  But Hines credits “Race and Class Factors in Health Care Delivery,” a course offered in the school’s Master of Science program for giving them the framework to apply that knowledge in clinical and non-clinical settings. 

“As nurses, our daily reality of providing service – whether direct patient care, managerial or at a systems level – requires that we navigate the impacts of social determinants of health in a holistic and person-first way, and that approach is borne out in this class.” 

How Race and Class Impact Health Care Delivery

“Race and Class Factors in Health Care Delivery” examines how social determinants of health drive inequity. It grapples with the question, As a health care professional, what can I do to impact health disparities and advance health equity?  “Looking at the intersection of social determinants of health, toxic stress and violence, we explore how they contribute to the production of health inequality,” says professor Howard Pinderhughes, PhD, who teaches the course.

Master’s student Mariana Trujillo, RN, says the class broadened her understanding of the historical policies, often rooted in racism, that have contributed to social determinants of health. “The class made me take a step back and ask, ‘How can I make an impact on addressing health disparities and promoting racial justice?’”

By understanding factors that drive health inequity, says Pinderhughes, nurses are able to identify and formulate opportunities for intervention – both at the patient level and at systemic and policy levels. 

But Pinderhughes warns that the work to address social determinants cannot be done in isolation. He encourages students to get to know their community and identify allies also working to address social determinants. This includes health care colleagues.

It’s a sentiment echoed by Hines. “There’s an evolving landscape within the health care ecosystem to engage in conversations about health inequity, health disparities. The next step becomes how do we take this collective understanding and transform that into action?” 

全文翻译（仅供参考）

马格斯海因斯，注册护士，是一个教育家和社区组织者，并帮助运行伯克利免费诊所之前，注册在加州大学旧金山分校护理学院。

Hines说：“通过我的工作，我了解了健康的社会决定因素，亲眼看到了影响获得护理的结构性因素。” 但是海因斯认为，“医疗保健提供中的种族和阶级因素”是学校的一门课程。理学硕士课程 为他们提供了在临床和非临床环境中应用知识的框架。

“作为护士，我们提供服务的日常现实--无论是直接的病人护理、管理还是系统层面的服务--要求我们以整体和以人为本的方式应对健康的社会决定因素的影响，这种方法在本课程中得到了证实。”

种族和阶级如何影响医疗服务

“卫生保健提供中的种族和阶级因素”研究了健康的社会决定因素是如何推动不平等的。它解决了这样一个问题：作为一名卫生保健专业人员，我能做些什么来影响健康差距和促进健康平等？ 教授这门课程的霍华德·平德休斯博士说：“通过观察健康、有毒压力和暴力的社会决定因素的交叉点，我们探索了它们是如何导致健康不平等的。”

硕士生玛丽安娜·特鲁希略（Mariana特鲁希略），注册护士，说这门课拓宽了她对历史政策的理解，这些政策往往植根于种族主义，有助于健康的社会决定因素。“这门课让我退后一步，问，”我如何在解决健康差距和促进种族正义方面产生影响？“”

Pinderhughes说，通过了解导致健康不平等的因素，护士能够确定和制定干预机会--无论是在患者层面还是在系统和政策层面。

但是平德休斯警告说，解决社会决定因素的工作不能孤立地进行。他鼓励学生们去了解他们的社区，并确定同样致力于解决社会决定因素的盟友。这包括卫生保健部门的同事。

海因斯也表达了同样的观点。“在医疗保健生态系统中，有一个不断发展的格局，可以参与到关于健康不平等和健康差距的对话中。下一步是我们如何将这种集体理解转化为行动？”

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