"They treated me like crap and I know it was because I was Native": The healthcare experiences of Aboriginal peoples living in Vancouver's inner city
"They treated me like crap and I know it was because I was Native": The healthcare experiences of Aboriginal peoples living in Vancouver's inner city
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DOI：
10.1016/j.socscimed.2017.01.053
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发表时间：
2017-04-01
影响因子：
5.4
通讯作者：
Kerr, Thomas
中科院分区：
文献类型：
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作者：
Goodman, Ashley;Fleming, Kim;Kerr, Thomas
越来越多的证据表明，由于种族主义，原住民经常经历医疗保健不平等。然而，探索使用非法物质的土著人民的医疗保健经验的研究是有限的，研究很少考虑到耻辱的多种解释如何相互交叉，并有助于边缘化人口的经验。我们的研究旨在探讨使用非法药物和/或非法酒精（APWUID/A）居住在温哥华市中心的原住民的医疗保健经验。由APVVUID/A组成的社区研究小组采用土著方法，领导了研究设计、数据收集和分析。同侪促进谈话圈探讨社区成员的经验，获得医疗服务和病人提供者的遭遇。使用交叉性框架，我们的研究表明，土著人民之间的医疗保健不平等是如何通过系统性的种族主义和歧视而永久化的。污名化的种族陈规定型观念被认为对个人态度和临床实践产生负面影响。参与者的医疗解雇的经验往往导致脱离照顾或延迟照顾。研究结果表明，医疗服务提供者必须了解影响医疗保健中种族差异和临床实践中个人态度的结构和历史力量。迫切需要在非法药物使用的背景下制定适当的疼痛管理临床协议。在保健方面重视土著人民和文化对于解决土著和非土著加拿大人之间的健康差距至关重要。(C)2017爱思唯尔有限公司版权所有
There is growing evidence that Aboriginal peoples often experience healthcare inequalities due to racism. However, research exploring the healthcare experiences of Aboriginal peoples who use illicit substances is limited, and research rarely accounts for how multiple accounts of stigma intersect and contribute to the experiences of marginalized populations. Our research aimed to explore the healthcare experiences of Aboriginal peoples who use illicit drugs and or illicit alcohol (APWUID/A) living in Vancouver's inner city. Using Indigenous methodologies, a community research team comprised of APVVUID/A led the study design, data collection and analysis. Peer-facilitated talking circles explored community members' experiences accessing healthcare services and patient-provider encounters. Using an intersectionality framework, our research demonstrated how healthcare inequalities among Aboriginal peoples are perpetuated by systemic racism and discrimination. Stigmatizing racial stereotypes were perceived to negatively influence individual attitudes and clinical practice. Participants' experiences of medical dismissal often resulted in disengagement from care or delay in care. The findings suggest healthcare providers must understand the structural and historical forces that influence racial disparities in healthcare and personal attitudes in clinical practice. Adequate clinical protocols for pain management within the context of illicit substance use are urgently needed. The valuation of Aboriginal peoples and cultures within healthcare is paramount to addressing the health gap between Aboriginal and non-Aboriginal Canadians. (C) 2017 Elsevier Ltd. All rights reserved.