Social and structural determinants of health include historical, social, political, and economic forces, many of which are rooted in racism and inequality, that shape the relationship between environmental conditions and individual health. Unmet social needs can increase the risk of many conditions treated by obstetrician-gynecologists (ob-gyns), including, but not limited to, preterm birth, unintended pregnancy, infertility, cervical cancer, breast cancer, and maternal mortality. An individual health care professional's biases (whether overt or unconscious) affect delivery of care and may exacerbate and reinforce health disparities through inequitable treatment. Obstetrician-gynecologists and other health care professionals should seek to understand patients' health care decision making not simply as patients' individual-level behavior, but rather as the result of intersecting sociopolitical conditions, structural inequities, and social needs that create and maintain inequalities in health and health care. Recognizing the importance of social and structural determinants of health can help ob-gyns and other health care professionals to better understand patients, effectively communicate about health-related conditions and behavior, and contribute to improved health outcomes, including patients' experience of care and their trust in the health care system.

中文翻译：

---

在提供生殖保健时解决健康的社会和结构决定因素：ACOG 委员会第 11 号声明。


健康的社会和结构决定因素包括历史、社会、政治和经济力量，其中许多力量植根于种族主义和不平等，这些力量塑造了环境条件与个人健康之间的关系。未满足的社会需求会增加妇产科医生 （ob-gyns） 治疗许多疾病的风险，包括但不限于早产、意外怀孕、不孕症、宫颈癌、乳腺癌和孕产妇死亡率。个体医疗保健专业人员的偏见（无论是公开的还是无意识的）会影响护理的提供，并可能通过不公平的治疗加剧和加剧健康差异。妇产科医生和其他医疗保健专业人员应寻求理解患者的医疗保健决策，而不仅仅是作为患者个人层面的行为，而是作为交叉的社会政治条件、结构性不平等和社会需求的结果，这些因素造成和维持健康和医疗保健方面的不平等。认识到健康的社会和结构决定因素的重要性可以帮助妇产科医生和其他医疗保健专业人员更好地了解患者，有效地沟通与健康相关的状况和行为，并有助于改善健康结果，包括患者的护理体验和他们对医疗保健系统的信任。