Because residents of rural areas in the United States experience a persistent disadvantage in life expectancy relative to their urban counterparts, it is critical to consider the structural and social determinants that affect the health of rural populations. White Americans constitute 3 out of every 4 (76%) rural residents, and there is growing evidence that rurality is a predictor of poor health status for White Americans in ways that are not present for racially minoritized populations or nonrural White populations. We offer a framework to describe Whiteness as a fundamental determinant of the health of rural White Americans, which is useful to more precisely characterize and address the heterogeneous yet unique factors that drive their health. While Whiteness is a dynamic system that typically upholds White Americans' social supremacy, we provide examples of intermediate (e.g., rural culture, environment) and intrapersonal (e.g., psychosocial) factors through which Whiteness can harm rural White Americans' health (e.g., chronic disease, mental health). We conclude with a discussion of implications and recommendations that may help to advance research to promote health and well-being among rural White Americans. (Am J Public Health. Published online ahead of print December 5, 2024:e1-e9. https://doi.org/10.2105/AJPH.2024.307904).

中文翻译：

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白人：美国农村白人健康的根本决定因素。


由于美国农村地区的居民相对于城市居民的预期寿命持续处于劣势，因此考虑影响农村人口健康的结构性和社会决定因素至关重要。美国白人占每 4 个农村居民中就有 3 个 （76%），越来越多的证据表明，农村是美国白人健康状况不佳的预测指标，而少数族裔人口或非农村白人人口则不存在。我们提供了一个框架，将白人描述为美国农村白人健康的根本决定因素，这有助于更精确地描述和解决驱动他们健康的异质但独特的因素。虽然白人是一个通常维护美国白人社会至上地位的动态系统，但我们提供了白人可能损害美国农村白人健康（例如，慢性病、心理健康）的中间（例如，农村文化、环境）和内部（例如，社会心理）因素的示例。最后，我们讨论了可能有助于推进研究以促进美国农村白人的健康和福祉的意义和建议。（美国公共卫生杂志。2024 年 12 月 5 日提前在线发布：e1-e9。https://doi.org/10.2105/AJPH.2024.307904）。