BACKGROUND Recent scholarship has increasingly identified global power asymmetries as the root cause of health inequities. This article examines how such asymmetries manifest in global governance for health, and how this impacts health outcomes. RESULTS We focus on the political-economic determinants of global health inequities, and how these determinants operate at different levels of social action (micro, meso, and macro) through distinct but interacting mechanisms. To clarify how these mechanisms operate, we develop an integrative framework for examining the links between global neoliberalism-the currently dominant policy paradigm premised on advancing the reach of markets and promoting ever-growing international economic integration-and global health inequities, and show how these mechanisms have macro-macro, macro-meso-macro, and macro-micro-macro manifestations. CONCLUSIONS Our approach enables the design of theoretically-nuanced empirical strategies to document the multiple ways in which the political economy entrenches or, alternatively, might ameliorate global health inequities.

中文翻译：

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全球卫生治理中的权力不对称：分析卫生不平等的政治经济决定因素的概念框架。

背景技术近来的学者越来越多地将全球力量不对称性视为健康不平等的根本原因。本文研究了这种不对称现象如何在全球卫生治理中表现出来，以及如何影响健康结果。结果我们关注于全球卫生不平等的政治经济决定因素，以及这些决定因素如何通过独特但相互作用的机制在社会行为的不同层面（微观，中观和宏观）运作。为了弄清这些机制的运作方式，我们建立了一个综合框架，以研究全球新自由主义（目前占主导地位的政策范式，以扩大市场范围和促进日益增长的国际经济一体化为前提）​​与全球卫生不平等之间的联系，并说明这些问题之间的关系。机制有宏观，宏观，宏观，宏观，和宏观-微观-宏观表现。结论我们的方法使理论上可行的经验策略的设计能够记录政治经济学根深蒂固或缓解全球卫生不平等的多种方式。