POV：仇恨的公共卫生后果

图片由Flickr贡献者提供 lacroix04

During the past three weeks, I have found myself riveted by the media accounts of the 查理Hebdo massacre in Paris, where 3 men, purportedly motivated by a desire to avenge satirical cartoons demeaning the prophet Muhammad, killed 12 people and injured 11 others。 A total of 20 people were killed between January 7 and 9, as the 查理Hebdo shootings were followed by police involvement and subsequent shoot-outs on the outskirts of Paris。 这些事件——让人想起2013年波士顿马拉松爆炸案——震惊了法国，并在巴黎引发了反对极端主义和大规模暴力的大规模示威活动。

然而，巴黎的事件也大胆地揭示了不那么明显的仇恨犯罪对公共卫生的影响——仇恨行为要平凡得多，也平凡得多，每天都触及数百万人的生活。

过去二十年的人口健康新濠影汇线上赌场研究不断阐明，偏见、歧视和隔离，以及仇恨和对抗，如何对健康产生有害和普遍的影响。 A 新濠影汇线上赌场研究 last February in the 美国公共卫生杂志, for example, linked lesbian, gay, bisexual, and transgender (LGBT) youth suicide in Boston with neighborhood-level LGBT hate crimes involving assaults and found that sexual minority high school students who lived in neighborhoods with higher rates of assault were significantly more likely to report suicidal thoughts or attempts。 A 同伴的新濠影汇线上赌场研究 found evidence of a higher prevalence of marijuana use among these same LGBT students in higher hate crime neighborhoods。 Yet 另一项新濠影汇线上赌场研究, published last year in 社会科学与医学， found that “structural stigma,” defined as antigay prejudice at the community level, was associated with higher all-cause mortality, especially from suicides, violence, and cardiovascular disease, among LGBT residents。 加州大学洛杉矶分校法学院的Ilan Meyer提出了一个概念性框架，将歧视和偏见与LGBT人群在敌对的社会环境中出现的精神健康障碍联系起来。

在个人层面上，歧视已被证明会对健康产生负面影响，因为社会关系会影响健康行为，并起到缓冲压力的作用，而压力反过来又会影响免疫功能、心血管活动和疾病的进展。 A Harvard Medical School 新濠影汇线上赌场研究 found that respondents to a national health survey who personally perceived any kind of major lifetime discrimination were more likely to have major depression。 对特定集体事件后的歧视也进行了新濠影汇线上赌场研究。 Arab Americans living in the United States who perceived abuse after the 9/11 attacks were more likely to report high levels of psychological distress and lower levels of happiness, a 2010年的新濠影汇线上赌场研究 found。

文献远远超出了受到特定歧视的少数民族对健康的负面影响。 One 最近的新濠影汇线上赌场研究 found that racial resentment was associated with smoking among non-Hispanic whites, suggesting that the consequences of hate reach both minority out-groups and those in majority groups。 此外，关于种族隔离（通常是社区种族紧张关系的代表）与健康状况之间的关系，也有大量文献。 一项系统综述发现，隔离隔离与黑人较高的怀孕风险和死亡率有关。 A 纸 that I coauthored in 2011 estimated that about 176,000 deaths annually from heart disease and other causes might be attributed to racial segregation。

目睹仇恨的极端表达——少数人杀害数十人——引起了全世界的关注，向我们残忍地展示了仇恨如何以最丑陋的形式撕裂文明的结构。 但也许从这一可怕事件中产生的最发人深市的反思不是这是一个孤立的事件，而是仇恨和不容忍弥漫在我们的日常生活中，对个人和社区健康产生了重大影响。 它的核心是阐明人口健康的根本原因，阐明影响我们日常生活并构成产生健康条件的社会结构。 在我看来，这表明，对公众健康的关注与对影响人们健康条件的社会正义问题的关注是密不可分的。

除了健康之外，还有许多理由可以说明为什么在一个多元化、开明的社会中不应该有仇恨和不容忍。 但健康是一个共同和普遍的愿望。 最大限度地增进人民健康的愿望应该激励我们。 它应该推动我们与威胁我们成为更健康的人的潜力的社会裂痕接触。 这有力地证明了社会正义议程在积极的公共卫生方法中的核心作用，这种方法涉及了解和创造促进人口健康的条件。

桑德罗盔状突起物是一名教授 d波士顿大学公共卫生学院的sean说。 可以联系到他 sgalea@bu。edu。

“POV” is an 意见页面 that provides timely commentaries from students, faculty, and staff on a variety of issues: on-campus, local, state, national, or international。 Anyone interested in submitting a piece, which should be about 700 words long, should contact Rich Barlow at barlowr@bu。edu。 但是今天 保留拒绝或编辑提交的权利。 所表达的观点仅代表作者的观点，并不代表波士顿大学的观点。