Structural violence

结构性暴力
  • 文章类型: Journal Article
    背景:哥伦比亚境内流离失所者人数众多,由于冲突被迫迁移。三分之一的流离失所妇女在青春期怀孕,与五分之一的非流离失所人口相比,除了这些群体之间的健康和资源不平等。从经历青春期怀孕的流离失所妇女的角度来看,现有的定性信息有限。这项研究探讨了结构性暴力在他们的经历中的特点。
    方法:采用定性方法。参与者是通过故意抽样招募的,使用关键线人和滚雪球抽样技术。在玻利瓦尔市进行了14次半结构化访谈,波哥大,涉及11名在过去10年中开始生育年龄为15-19岁的流离失所妇女,和4名参与者的母亲。使用结构性暴力的理论框架对数据进行了分析,和使用主题分析进行分类的紧急主题。
    结果:怀孕在许多方面被认为是有利的,但这与随之而来的不利情况相矛盾。结构性暴力嵌入生活故事中,表现为贫困和难以获得可靠的收入,怀孕后得不到医疗和教育。制度和人际歧视混淆了这些挑战。
    结论:青春期怀孕是一种矛盾的经历,由于日常生存中结构和文化暴力的复杂相互作用,这既代表了安全网,也代表了陷阱。政策制定者必须考虑围绕青少年怀孕的背景的重要性,并解决影响这些职位妇女的系统性不利因素。
    哥伦比亚的暴力冲突使许多人被迫离开家园,成为“国内流离失所者”。与未流离失所的妇女相比,国内流离失所的妇女在青春期更有可能怀孕。这项工作试图更多地了解经历青春期怀孕的流离失所妇女的日常生活,通过采访。对访谈进行了分析,并使用“结构性暴力”理论解释了结果。结构性暴力描述了诸如种族主义之类的社会结构,性别歧视,战争和贫穷决定人生的选择,导致痛苦和不平等。这项工作发现,流离失所妇女青春期的怀孕和孕产在许多方面都是积极的,地位和友谊。然而,这些女性在怀孕后也经历了许多挑战,例如被排除在教育之外,获得安全就业和难以获得医疗保健。这表明,结构性暴力在流离失所的青春期母亲的日常生活中以多种相互关联的形式存在。这项工作敦促决策者意识到围绕青春期怀孕和孕产的背景的复杂性,并解决妇女在这些情况下面临的结构性劣势。
    BACKGROUND: Colombia has high numbers of internally displaced people, forced to migrate due to the conflict. 1 in 3 displaced women undergo pregnancy during adolescence, compared to around 1 in 5 in the non-displaced population, alongside health and resource inequalities between these groups. There is limited qualitative information available from the perspectives of displaced women experiencing adolescent pregnancy. This research explores how structural violence may feature in their experiences.
    METHODS: Qualitative methods were used. Participants were recruited with purposive sampling, using key informants and snowball sampling technique. 14 semi-structured interviews were conducted in Ciudad Bolívar, Bogotá, involving 11 displaced women who began childbearing age 15-19 in the past 10 years, and 4 participants\' mothers. Data was analysed using the theoretical framework of structural violence, and emergent themes categorised using thematic analysis.
    RESULTS: Pregnancy was considered advantageous in many ways, but this was contradicted by resulting disadvantages that ensued. Structural violence was embedded in life stories, manifesting in poverty and difficulties accessing reliable income, poor access to healthcare and education following pregnancy. Institutional and interpersonal discrimination confounded these challenges.
    CONCLUSIONS: Pregnancy during adolescence was a contradictory experience, representing both a safety net and a trap due to a complex interplay of structural and cultural violence in everyday survival. Policymakers must consider the importance of the context surrounding adolescent pregnancy and address systematic disadvantages affecting women in these positions.
    The violent conflict in Colombia has left many people forced to leave their homes and become ‘internally displaced’. Internally displaced women are more likely to become pregnant during their adolescence than non-displaced women. This work tries to understand more about the everyday lives of displaced women who experience adolescent pregnancy, through interviews. The interviews were analysed and results interpreted using the theory of ‘structural violence’. Structural violence describes how social structures such as racism, sexism, war and poverty determine life choices, leading to suffering and inequality. The work found that pregnancy and motherhood in adolescence for displaced women was positive in many ways by bringing purpose, status and companionship. However, these women also experienced many challenges after pregnancy, such as exclusion from education and secure employment and difficulty accessing healthcare. This demonstrated that structural violence features in multiple interconnected forms in the daily lives of displaced adolescent mothers. The work urges policymakers to appreciate the complexity of context surrounding adolescent pregnancy and motherhood, and to address the structural disadvantages facing women in these situations.
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  • 文章类型: Journal Article
    背景:在曼尼托巴省和萨斯喀彻温省,在COVID-19大流行期间,土著群体之间先前存在的健康不平等现象加剧。卫生和社会服务部门的服务中断,再加上相互污名化的影响,对感染艾滋病毒的土著人民(IPLH)造成了不成比例的影响。IPLH通过位于加拿大广阔的殖民历史中的系统形式的污名经历结构性暴力和坏死的政治排斥。利用结构性暴力和坏死政治的理论基础,这项定性研究调查了COVID-19大流行如何放大了IPLH不平等的先前状态。
    方法:对60名参与者进行了半结构化访谈。样本包括有生活经验的人(n=45)以及为IPLH提供服务的人(n=15)。土著故事指导了数据收集和分析过程。每次面试中探讨的主题包括获得健康和社会服务,减少危害,物质使用,以及在COVID-19大流行期间提供服务的经验。主题分析用于确定每个故事中的共同主题。
    结果:我们的结果表明,COVID-19大流行暴露并放大了曼尼托巴省和萨斯喀彻温省IPLH的结构性暴力和坏死政治逻辑。具体来说,我们描述了结构性暴力和坏死政治是如何通过三个主要途径表现出来的-(I)限制和取消护理,(二)官僚主义和机构关怀政治,和(iii)加拿大医疗保健系统内的歧视和系统性种族主义。
    结论:曼尼托巴省和萨斯喀彻温省的COVID-19大流行引发了定居者殖民地和新自由主义护理机构内服务提供的巨大变化。对于那些对IPLH仍然开放的服务,掩蔽要求,问卷要求,调度要求,缺乏当面服务只是社区成员所描述的不利于获得护理的一些障碍。基于药物使用或艾滋病毒状况的医疗保健歧视的经验增加,进一步限制了获得所需服务的机会。
    BACKGROUND: Within Manitoba and Saskatchewan, pre-existing health inequities amongst Indigenous groups were intensified during the COVID-19 pandemic. Service disruptions in the health and social service sector-combined with the effects of intersectional stigma-disproportionately impacted Indigenous peoples living with HIV (IPLH). IPLH experience structural violence and necropolitical exclusion through systemic forms of stigma situated within Canada\'s expansive colonial history. Utilizing the theoretical foundations of structural violence and necropolitics, this qualitative study examines how the COVID-19 pandemic amplified preceding states of inequity for IPLH.
    METHODS: Semi-structured interviews were conducted with 60 participants. The sample comprised of those with lived experience (n = 45) as well as those who provided services for IPLH (n = 15). Indigenous Storywork guided the data collection and analysis process. Topics explored within each interview included access to health and social services, harm reduction, substance use, and experiences in providing services during COVID-19 pandemic. Thematic analysis was used to identify common themes throughout each story.
    RESULTS: Our results indicate that the COVID-19 pandemic exposed and amplified pre-existing forms of structural violence and necropolitical logics for IPLH within Manitoba and Saskatchewan. Specifically, we describe how structural violence and necropolitics are manifested via three main avenues- (i) restrictions and removal of care, (ii) bureaucracy and institutional care politics, and (iii) discrimination and systemic racism within the Canadian healthcare system.
    CONCLUSIONS: The COVID-19 pandemic within Manitoba and Saskatchewan sparked massive changes in service provision within settler-colonial and neoliberal institutions of care. For those services that remained open to IPLH, masking requirements, questionnaire requirements, scheduling requirements, and a lack of in-person services acted as only some of the barriers described by community members as detrimental to care access. Increased experiences of discrimination in health care on the basis of substance use or HIV status further limited access to needed services.
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  • 文章类型: Journal Article
    这篇评论涉及结构性暴力-护理中被忽视和未被识别的伤害。护理实践中的结构性暴力是指种族主义的暴力影响,阶级,同性恋恐惧症,以及对弱势群体和贫困群体的其他偏见。作为最大和最值得信赖的健康行业之一,集体护理在照顾LGBTQ+青年时,有能力利用他们的影响力来减轻结构性暴力的有害影响。
    This commentary addresses structural violence - an overlooked and unrecognized harm within nursing. Structural violence within nursing practice refers to the violent impacts of racism, classism, homophobia, and transphobia as well as other biases on vulnerable and underprivileged groups. As one of the largest and most trusted health professions, collectively nursing has the power to leverage their influence to mitigate the harmful effects of structural violence when caring for LGBTQ+ youth.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    尽管近年来生物人类学的伦理改革取得了进展,在美国博物馆和大学中,涉及历史文献收藏(HDC)的工作仍然缺乏道德标准。这些死者的集合是在19世纪末至20世纪中叶根据针对社会边缘化社区的解剖学法律创建的,并允许在未经他们同意的情况下对这些人进行解剖。由于与个人相关的广泛信息,并提供给研究人员,这些收藏已成为21世纪生物人类学理论和方法发展的基础资源。认识到研究需要道德准则,教学和培训,社区参与,以及涉及HDC的策展,我们举办了一个研讨会,叫做“伦理期货”,Research,和生物人类学教学”,2021年11月15日至17日。在这里,我们总结了研讨会参与者之间关于这些主题的对话和主要共识,以便在整个领域更广泛地推进这些道德考虑。
    Although ethical reforms in biological anthropology have gained ground in recent years, there is still a scarcity of ethical standards for work involving historical documented collections (HDCs) at US museums and universities. These collections of deceased individuals were created in the late 19th to mid-20th centuries under anatomy laws that targeted socially marginalized communities and allowed for the dissection of these individuals without their consent. Due to the extensive information associated with the individuals and made available to researchers, these collections have served as foundational resources for theory and methods development in biological anthropology into the 21st century. Recognizing the need for ethical guidelines for research, teaching and training, community engagement, and curation involving HDCs, we held a workshop called \"Ethical Futures for Curation, Research, and Teaching in Biological Anthropology\" on November 15-17, 2021. Here we summarize the conversations and major points of consensus among the workshop participants on these topics in order to advance these ethical considerations more broadly across the field.
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  • 文章类型: Journal Article
    目标:生殖正义确定了所有人的三项核心生殖权利:(1)不生育子女的权利;(2)生育子女的权利;(3)在安全和健康的环境中父母子女的权利。我们的目的是说明粮食不安全侵犯了所有这三个权利,因此是生殖正义以及更广泛的性健康和生殖健康的紧迫问题。方法:采用现象学方法,我们概述了粮食不安全和生殖正义之间的潜在途径。结果:粮食不安全和生殖正义之间有许多潜在的途径,包括进入性关系以获得物质支持,与性传播感染和不孕症有关,结构性暴力,食品和其他基本必需品之间的优先次序和支出权衡,营养不良的生物学影响,有限的生殖选择,人口控制措施,社会耻辱和排斥。被边缘化的人不成比例地受到粮食不安全及其后果的影响,对性健康和快乐以及生殖正义都有影响。结论:有粮食不安全经历的人之间有意义和公平的合作,人权和生殖正义活动家,和学者对于敏感地将这项工作背景化并动员更广泛的社会变革至关重要。
    Objective: Reproductive Justice identifies three core reproductive rights for all people: (1) the right to not have a child; (2) the right to have a child; and (3) the right to parent children in safe and healthy environments. We aim to illustrate that food insecurity infringes upon on all three of these rights and so is a pressing issue for reproductive justice and for sexual and reproductive health more broadly. Methods: Using a phenomenological approach, we outline potential pathways between food insecurity and reproductive justice. Results: There are numerous potential pathways between food insecurity and reproductive justice, including entry into sexual relationships for material support, links to sexually transmitted infections and infertility, structural violence, prioritization and spending tradeoffs between food and other basic necessities, biological impacts of malnutrition, restricted reproductive choices, population control measures, and social stigma and exclusion. Marginalized people are disproportionately impacted by food insecurity and its consequences, with implications for sexual health and pleasure and for reproductive justice. Conclusions:Meaningful and equitable collaboration between people with lived experience of food insecurity, human rights and reproductive justice activists, and academics is critical to sensitively contextualize this work and mobilize broader social change.
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  • 文章类型: Journal Article
    BACKGROUND: This paper highlights the role of cultural and structural gaps that shape illness experiences of women with manifestations of female genital schistosomiasis (FGS) and their impacts upon mental well-being.
    METHODS: Using ethnography, case study narrative accounts of women manifesting symptoms of FGS, as well as interviews with health workers within FGS-endemic rural fishing communities in Cameroon, we present experiences of women affected by FGS, alongside information on FGS health service provision.
    RESULTS: Our results show how gendered power dynamics in decision making, gendered experiences around menstrual health and structural gaps in service provision, combine and lead to poor mental well-being. Subfertility brings a heavy psychosocial toll from external blame and rejection, exacerbated by internalised stigma and the challenge of not being able to fulfil cultural and gendered social norms.
    CONCLUSIONS: Gender analysis is key to developing context-embedded understanding and addressing FGS-related challenges. With context-specific experiences demonstrating FGS comorbidity with mental ill health, there is a need to prioritise mental health integration at policy level through a person-centred approach. Furthermore, to address stigma and discrimination, campaigns to raise awareness in Cameroon, and beyond, are needed.
    BACKGROUND: Cet article met en évidence le rôle des lacunes culturelles et structurelles qui façonnent les expériences des femmes atteintes de schistosomiase génitale féminine (SGF) et leur impact sur le bien-être mental.
    UNASSIGNED: À l\'aide de l\'ethnographie, de récits d\'études de cas de femmes présentant des symptômes de schistosomiase génitale féminine, et d\'entretiens avec des agents de santé au sein de communautés de pêcheurs ruraux endémiques de la schistosomiase génitale féminine au Cameroun, nous présentons les expériences des femmes touchées par le SGF, ainsi que des informations sur les services de santé liés au SGF.
    UNASSIGNED: Nos résultats montrent comment la dynamique du pouvoir dans la prise de décision, les expériences de la santé menstruelle et les lacunes structurelles dans la fourniture de services, interagissent et conduisent à un manque de bien-être psychologique. La sous-fécondité entraîne un lourd fardeau psychosocial du fait du blâme et de rejet externes auxquelles sont assujetties les personnes souffrant de la maladie, ce qui est exacerbé par la stigmatisation intériorisée et le défi que représente leur incapacité à respecter les normes sociales culturelles et sexospécifiques.
    CONCLUSIONS: L\'analyse de genre est essentielle pour développer une compréhension intégrée au contexte et pour relever les défis liés aux SGF. les défis liés à l\'ESF. Avec des expériences spécifiques au contexte démontrant la comorbidité de la FGS avec la mauvaise santé mentale, il est nécessaire de donner la priorité à l\'intégration de la santé mentale au niveau politique par le biais d\'une approche centrée sur la personne. l\'intégration de la santé mentale au niveau politique par une approche centrée sur la personne. En outre, pour lutter contre la stigmatisation et la stigmatisation et la discrimination, des campagnes de sensibilisation sont nécessaires au Cameroun et au-delà.
    BACKGROUND: En este documento se pone de relieve el papel de las brechas culturales y estructurales que dan forma a las experiencias de enfermedad de las mujeres con manifestaciones de Esquistosomiasis Genital Femenina (EGF), y sus impactos en el bienestar mental.
    UNASSIGNED: Utilizando la etnografía, estudios de caso mediante relatos narrativos de mujeres que manifiestan síntomas de EGF y entrevistas con trabajadores sanitarios de comunidades pesqueras rurales endémicas en Camerún, presentamos las experiencias de las mujeres afectadas por la EGF, junto con información sobre la prestación de servicios sanitarios para la EGF.
    RESULTS: Nuestros resultados muestran cómo la dinámica de poder de género en la toma de decisiones, las experiencias de género en torno a la salud menstrual y las deficiencias estructurales en la prestación de servicios se combinan y conducen a un bienestar mental deficiente. La subfertilidad conlleva un alto coste psicosocial debido a la culpa y el rechazo externos, exacerbados por el estigma interiorizado y el reto de no poder cumplir las normas culturales y de género.
    UNASSIGNED: El análisis de género es clave para desarrollar una comprensión integrada en el contexto y abordarlos retos relacionados con la EGF. Dado que las experiencias específicas de cada contexto demuestran la comorbilidad de las EGF con la enfermedad mental, es necesario priorizar la integración de la salud mental en las políticas a través de un enfoque centrado en la persona. Además, para hacer frente al estigma y la discriminación, son necesarias campañas de sensibilización en Camerún y en otros lugares.
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  • 文章类型: Journal Article
    2022年,弗吉尼亚Chickahominy印度部落与弗吉尼亚联邦大学梅西综合癌症中心合作,调查对当地垃圾填埋场附近潜在癌症群的担忧。虽然调查癌症集群是复杂的,由于长潜伏期和多因素的原因,社区对驱动癌症风险的结构性因素的担忧值得探索。因此,ChickahominyT.R.U.T.H.(信任,Research,理解,教,和治愈)项目是作为社区-学术伙伴关系创建的,目的是(1)确定与感知的癌症风险和护理相关的结构因素和障碍;(2)评估癌症知识,护理准入差距,和感知的风险,包括测试私人和社区水源;(3)开发和部署文化定制的癌症教育和资源导航,包括地下水安全教育,政策,和补救。我们将对垃圾填埋场四英里半径范围内的居民进行150次面对面访谈和水质测试,并在查尔斯市县居民中部署1000份结构化问卷。在本文中,我们提供正在进行的项目设计的概述,发展,以及支持项目目标的进展。这项合作调查旨在解决癌症健康差异,加强研究和卫生政策宣传,尊重一个服务不足的社区的神圣知识,为长期伙伴关系奠定基础,以指导未来的研究问题。
    In 2022, the Virginia Chickahominy Indian Tribe partnered with Virginia Commonwealth University Massey Comprehensive Cancer Center to investigate concerns about a potential cancer cluster near a local landfill. While investigating cancer clusters is complex due to long latency and multifactorial causes, the community\'s concerns about structural factors driving cancer risk warrant exploration. Thus, the Chickahominy T.R.U.T.H. (Trust, Research, Understand, Teach, and Heal) Project was created as a community-academic partnership to (1) identify structural factors and barriers associated with perceived cancer risk and care; (2) assess cancer knowledge, care access gaps, and perceived risks, including testing private and community water sources; (3) develop and deploy culturally tailored cancer education and resource navigation, including groundwater safety education, policies, and remediation. We will conduct 150 in-person interviews and water tests among residents within a four-mile radius of the landfill, and deploy 1000 structured questionnaires among Charles City County residents. In this paper, we provide an overview of the ongoing project design, development, and progress in support of the project\'s objectives. This collaborative investigation aims to address cancer health disparities, enhance research and health policy advocacy, and honor the sacred knowledge of an underserved community, laying the groundwork for a long-term partnership to guide future research questions.
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  • 文章类型: Journal Article
    这项研究调查了乌干达最近埃博拉疫情的复杂动态,强调疾病传播之间的相互作用,错误信息,和现有的社会脆弱性。强调贫困是一个核心要素,它探讨了社会经济因素如何加剧健康危机。这项研究审查了政治经济学的作用,医学多元化,卫生系统,以及传播错误信息的非正式网络,使应对工作更加复杂。通过综合分析,这项研究旨在阐明在资源有限的环境中抗击流行病面临的多方面挑战。它呼吁采取综合战略,不仅解决疾病的生物学方面,而且解决影响公共卫生结果的社会经济和信息生态系统。这一观点研究有助于更好地理解贫困,医学多元化,政治经济学,错误信息,和卫生事件相交,为未来的准备和应对举措提供见解。
    This research investigates the complex dynamics of Uganda\'s recent Ebola outbreaks, emphasizing the interplay between disease spread, misinformation, and existing societal vulnerabilities. Highlighting poverty as a core element, it delves into how socioeconomic factors exacerbate health crises. The study scrutinizes the role of political economy, medical pluralism, health systems, and informal networks in spreading misinformation, further complicating response efforts. Through a comprehensive analysis, this study aims to shed light on the multifaceted challenges faced in combating epidemics in resource-limited settings. It calls for integrated strategies that address not only the biological aspects of the disease but also the socioeconomic and informational ecosystems that influence public health outcomes. This perspective research contributes to a better understanding of how poverty, medical pluralism, political economy, misinformation, and health emergencies intersect, offering insights for future preparedness and response initiatives.
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  • 文章类型: Journal Article
    Miscarriages, stillbirths and neonatal deaths have received limited attention in global health programmes and research, even though pregnancy loss is common, traumatic and stigmatised. This paper seeks to illuminate lived experiences of pregnancy loss in southern Malawi, drawing on findings from semi-structured interviews and focus groups with women who have experienced loss, health professionals and community members, and observations of maternity care. Combining thematic and discourse analysis, we show how societal and medical discourses frame women as responsible for (failed) reproduction, and restrict possibilities to speak about, and respond to, loss. Some accounts and (care) practices invisibilise loss and associated suffering. However, invisibilisation may also be intended as support, and underscores rather than denies the social significance of parenthood. Other accounts (e.g. women emphasising faith and acceptance) constitute moral survival strategies to avoid the acquisition of a \'spoiled identity\'. We conclude that societal and medical discourses of loss enact stigmatised, subaltern subject positions for women experiencing pregnancy loss, create social suffering, and amount to a form of structural violence. Programmes and interventions should change these discourses.
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