Racism in European Health Care: Structural Violence and Beyond

Hamed, Sarah; Thapar‐Björkert, Suruchi; Bradby, Hannah; Ahlberg, Beth Maina

doi:10.1177/1049732320931430

Cited by 60 publications

(75 citation statements)

References 45 publications

(48 reference statements)

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“…This way, this social representation and its themes function as a way to attribute problems in health provision to immigrants rather than the Greek health system and the physicians working within it. In line with previous studies (Figgou et al, 2011; Hamed et al, 2020), participants attribute a sense of illegality and abnormality regarding immigrants’ behavior even when this refers to one of the most basic human rights such as the access to health (WHO, 2000). Participants also argued against health provision to immigrant patients, by dehumanizing them and constructing them as a mentally unstable group.…”

Section: Discussionsupporting

confidence: 81%

“…Apart from the commonly acknowledged cultural and organizational barriers identified, the notion of citizenship seems to play a key role in processes of inclusion and exclusion with regard to access to human rights (Andreouli & Dashtipour, 2014; Dell’Olio, 2017; Favell, 2016; Figgou, 2016), as citizenship has been identified as a determinant for health access (Asad & Clair, 2018). Discrimination and social integration policies (Kemppainen et al, 2018) as well as the fear of discrimination and prosecution due to their illegal status discourage immigrants from seeking health services (Hamed et al, 2020). The nature of these barriers seems to be a multifaceted challenge, as they stem from a variety of political, organizational, economic, and sociopsychological issues.…”

Section: Introductionmentioning

confidence: 99%

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Social Representations of Immigrant Patients: Physicians’ Discourse

2020

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With the global increase of migration and the effects of the economic crisis, health systems around the world are facing new challenges. In this context, we investigated the social representations of health provision to immigrant patients, held by physicians. We conducted 40 interviews with Greek physicians working in the public health system, the private health system, the health system in jails, and nongovernmental organizations. Using principles from thematic analysis, results show a social representation of immigrant patients as a burden to the health system. This social representation is constructed by themes focusing on immigrant patients as a group with mental health issues and on the construction of the health system as unable to provide health to noncitizens. Results are discussed in relation to current issues of social exclusion and the need to protect the human right of health.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Social Representations of Immigrant Patients: Physicians’ Discourse

2020

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“…Such type of structural racism that prevails in European health care, is normalized and is enacted through invisible, subtle practices by HPs (consciously or unconsciously) that leads to unequal access to treatment. 51 This further leads to perceived racism, as stated by participants to be treated differently from the ethnic Norwegians and is associated with lack of trust in healthcare and refrain from seeking treatment.…”

Section: Discussionmentioning

confidence: 99%

Treatment Experiences with Norwegian Health Care among Immigrant Men Living with Co-Occurring Substance Use- and Mental Health Disorders

et al. 2020

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Immigrants are considered at risk of psychological distress and therefore involvement in substance abuse, due to a variety of pre- and post-migration factors. Further, there is lower treatment engagement, a higher dropout rate, and less frequent hospitalizations among this group compared to the general population. There are few studies on the subjective understanding of co-occurring substance use disorder (SUD) and mental health disorder (MHD) among immigrants in Norway. This qualitative study aims to explore the treatment experiences of immigrant men living with co-occurring SUD and MHD. Within a collaborative approach, individual interviews were conducted with 10 men of immigrant background, living with co-occurring SUD and MHD, who had treatment experiences from the Norwegian mental health and addiction services. Data were analyzed using a systematic text condensation. The analysis yielded 6 categories where participants described their treatment experiences in mental health and addiction services in Norway as: lack of connection, lack of individually tailored treatment, stigma and discrimination preventing access to treatment, health professionals with multi-cultural competence, care during and after treatment, and raising awareness and reducing stigma. A significant finding was the mention by participants of the value of being seen and treated as a “person” rather than their diagnosis, which may increase treatment engagement. They further mentioned aftercare as an important factor to prevent relapse. This study provides an enhanced understanding of how immigrant men living with co-occurring SUD and MHD experienced being treated in Norwegian healthcare settings. These experiences may add to the knowledge required to improve treatment engagement.

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“…Stigmatisation, prejudices, inequalities continue to pervade clinical communications (Bradby et al . 2020, Hamed et al, 2020) and are often elusive. Narrative elicitation has the potential to redress them in clinical communication.…”

Section: Discussion: Narrative Elicitation As Empowerment and Refleximentioning

confidence: 99%

Epistemic injustices in clinical communication: the example of narrative elicitation in person‐centred care

Naldemirci

Britten

Lloyd

et al. 2020

Sociology Health & Illness

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The increasing popularity of the term ‘person‐centred’ in the healthcare literature and a wide range of ideals and practices it implies point to the need for a more inclusive and holistic healthcare provision. A framework developed in a Swedish context suggested narrative elicitation as a key practice in transition to person‐centred care. Initiating clinical communication by inviting people to tell their stories makes persistent yet often subtle problems in clinical communication visible. By drawing upon an observational study on narrative elicitation and vignette‐based focus group interviews with nurses, our aim is to trace ‘credibility deficits’ (Fricker 2007. Epistemic Injustice. Power and the Ethics of Knowing. Oxford: Oxford University Press) and ‘credibility excesses’ (Medina 2011, Social Epistemology, 25, 1, 15–35, 2013, The Epistemology of Resistance: Gender and Racial Oppression, Epistemic Injustice, and the Social Imagination. Oxford: Oxford University Press) in narrative elicitation. We argue that narrative elicitation may be one way to tackle epistemic injustices by giving voice to previously silenced groups, yet it is not enough to erase the effects of ‘credibility deficits’ in clinical communication. Rather than judging individual professionals’ success or failure in eliciting narratives, we underline some extrinsic problems of narrative elicitation, namely structural and positional inequalities reflecting on narrative elicitation and the credibility of patients. ‘Credibility excesses’ can be useful and indicative to better understand where they are missing.

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Racism in European Health Care: Structural Violence and Beyond

Cited by 60 publications

References 45 publications

Social Representations of Immigrant Patients: Physicians’ Discourse

Social Representations of Immigrant Patients: Physicians’ Discourse

Treatment Experiences with Norwegian Health Care among Immigrant Men Living with Co-Occurring Substance Use- and Mental Health Disorders

Epistemic injustices in clinical communication: the example of narrative elicitation in person‐centred care

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