经济学人20201121 race and health

Race and health

种族与健康

A lack of data on race hampers efforts to tackle inequalities

缺乏种族数据阻碍了解决不平等的努力

Why governments need to overcome their qualms in gathering vital information

为什么政府在收集重要信息时需要克服疑虑

2020年11月21日|

COVID-19 IS NOT colour-blind. In England a black man is nearly four times more likely to die from the disease than a white man of a similar age. In the state of New York, in the first months of the pandemic, black and Hispanic children were more than twice as likely to lose a parent or caregiver to covid-19 than those who were white or Asian. Few countries publish health data filtered by race or ethnicity, but in those that do the pandemic seems to be killing more people from racial minorities.

COVID-19 (对待不同肤色的人)不是一视同仁的。在英格兰,黑人死于这种疾病的几率是年龄相仿的白人的四倍。在纽约州,新冠病毒大流行的头几个月,黑人和拉美裔儿童因为covid-19失去父母或照顾者的可能性是白人或亚裔儿童的两倍以上。很少有国家发布按种族或种族特点过滤的健康数据,但在那些新冠病毒大流行的国家中,这种流行病似乎正在杀死更多的少数民族。

That confirms public-health officials’ worst fears. Covid-19 has laid bare countries’ broad racial inequities in health and exacerbated them (see article). The virus has also highlighted the scarcity of decent data on ethnicity or race. Most governments do not know if the pandemic is hitting particular groups harder, let alone why. In April a mere 7% of reports published in leading journals about covid-19 deaths recorded ethnicity. In western Europe most countries collect information only on people’s “migrant status” (often, where parents were born), a flawed proxy.

这证实了公共卫生官员最担心的事情。Covid-19 暴露了各国在健康方面广泛存在的种族不平等,并加剧了这些不平等(见文章)。该病毒还突显出在种族或种族特点方面缺乏像样的数据。大多数政府不知道新冠病毒大流行是否正在对特定群体造成更大的打击,更不用说原因了。4月份,主要期刊上发表的有关 covid-19 死亡的报告中只有7%记录了种族特点。在西欧,大多数国家只收集人们“移民身份”(通常是父母出生地)的信息,这是一个有缺陷的指标。

Covid-19 should be a wake-up call. As in the debate about gender inequality, awareness of racial gaps has grown. Both suffer from too much intuitive argument and too little data. But whereas there has been something of a gender-data revolution, many remain uneasy about gathering data on ethnicity and race. Some countries, such as France, prohibit collecting such data. In Germany members of the Green party want to remove the word Rasse, a loaded term for “race”, from the constitution.

正如在关于性别不平等的辩论中一样,人们对种族差距的认识也有所提高。两者都遭受太多的直觉争论和太少的数据。但是,尽管发生了一场性别数据革命,但许多人仍然对收集种族和种族特点的数据感到不安。一些国家(例如法国)禁止收集此类数据。在德国,绿党成员希望从宪法中删除“ Rasse”一词,即“种族”一词。

Such anxieties should not be ignored. It is no coincidence that the countries and communities, including Jews and Roma, most opposed to registering race or ethnicity have often seen how it can be used to facilitate discrimination, segregation and even genocide. More recent reminders of the harm that such information can do in the wrong hands include the war in Ethiopia (see article).

这种焦虑不容忽视。绝大多数反对登记人种或种族的国家和社区,包括犹太人和罗姆人,都经常看到如何利用它来促进歧视,种族隔离甚至种族灭绝,这并非巧合。最近发生在埃塞俄比亚的战争让人们意识到这些信息在坏人手中可能造成的伤害(见文章)。

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Yet these are arguments for anonymising data, not ignoring them. Race itself is not the cause of most health differences, but it is often closely correlated with policy failures, such as access to education, health care or jobs, that do cause such disparities. It is only by understanding the roots of these failings that gaps can be reduced. Data should be carefully safeguarded and their use tightly regulated. Although recognising the sensitivity of information is crucial, so is gathering and sharing it.

但是,这些是使数据匿名化的理由,而不是忽略它们。种族本身并不是造成大多数健康差异的原因,但它往往与导致这种差异的政策失败密切相关,如获得教育、医疗保健或工作的机会。只有了解了这些失败的根源,才能缩小差距。数据应得到认真保护,并严格控制其使用。尽管认识到信息的敏感性至关重要,收集和共享信息也同样重要。

Inequalities and injustices can be tackled efficiently only once they become statistically visible. It was fear of inequality that led Britain, Finland and Ireland to make sure public bodies regularly gathered this data. Colombia, New Zealand and America, among the few places that collect statistics on indigenous people, use them to distribute federal funding. After Brazil started collecting data in the late 1990s by five different skin-colours, the gulf in infant mortality between indigenous and white babies became apparent. Public outrage led to serious efforts to start narrowing the gap. The Brazilian example shows that the data need to be granular. Catch-all terms such as “BAME” (Black, Asian or Minority Ethnic), used in Britain, are unhelpful. “Non-Western migrant” or “foreign born” contain even less information.

不平等和不公正只有在统计上可见后才能得到有效解决。由于担心不平等,导致英国,芬兰和爱尔兰确保公共机构定期收集该数据。哥伦比亚,新西兰和美国为数不多的收集土著人民统计数据的国家,都利用其来分配联邦资金。巴西在1990年代后期开始收集五种不同肤色人口的数据,数据显示土著和白人婴儿之间的婴儿死亡率差距明显。公众的不满导致人们开始认真努力以缩小差距。巴西的例子表明,数据需要细化。英国使用诸如“ BAME”(黑人,亚洲人或少数民族)之类的笼统的术语无济于事。“非西方移民”或“外国出生”所包含的信息甚至更少。

The data also provide a baseline. This lets you make comparisons and monitor progress. Canada makes regional ethnicity data available, in part, so that local employers can see whether their workforce is representative.

这些数据还提供了一个基线。这可以让你进行比较并监控进度。加拿大提供地区种族数据的部分目的是为了让当地雇主了解他们的劳动力是否具有代表性。

The relationship between ethnicity and other factors, such as health or school performance, can change over time. The children of migrants are often better off than their parents were. And although the health of black Americans is still worse than that of whites, the gap is narrowing. The health of poor Americans, by contrast, remains much worse than that of rich ones and the gap is widening. So it is crucial also to have data on other characteristics, such as deprivation, education and parental income.

种族与其他因素(例如健康或学校表现)之间的关系会随着时间而改变。移民的子女往往比父母的境况更好。尽管美国黑人的健康状况仍然比白人差,但差距正在缩小。相比之下,贫穷的美国人的健康状况仍然比富有的人差很多,而且差距正在扩大。因此,获取有关其他特征(如贫困,教育和父母收入)的数据也至关重要。

Collecting data is just the start. Governments must then resolve to use the information to grapple with the underlying causes of inequality in health, education or the labour market. But ignorance should not be a reason to hold back.

收集数据仅仅是开始。然后,各国政府必须下决心利用这些信息来解决健康,教育或劳动力市场中不平等的根本原因。但是,无知不应成为退缩的理由。

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