“Where the type of health care products and services available responds to the needs of a diverse population, progress towards health care equity is possible…” –Shariff et. al (page 125)
Ed: Carol Amarantunga
In the course of these readings I’ve developed an interest in health policy and how theories and research may lead to health care and policy that is sensitive to culture. What I mean by “sensitive to culture” is a type of practical, clinical approach to care at hospitals and family doctors that take into account the potentially different needs of a person from a place like Jamaica, who may prefer a more holistic approach to health care. Or it could mean that a hospital has staff able to translate for non-English or French speakers so that patients are better able to express their concerns and understand their diagnoses. It is a direction in health care policy that I think could and would make a difference in lives of black women living with and at risk of contracting HIV/AIDS.
Based on the reading this week and last week, I’ve chosen my essay topic for this course. Accessibility of health care is especially an issue for new Canadians and is something that affects the quality of life of persons living with AIDS and those at high risk of contracting the disease. Because black women in Canada are often (although not always) immigrants, culturally sensitive health care could play a role in combating the spread of HIV/AIDS in this group or in mitigating the damaging affects of having the disease.
The roles ethnicity and race play in health care, access to health services and policy in Canada directly relate to the issue of HIV/AIDS among black women in Canada, especially when it comes to treatment and care. I don’t have a clear thesis or focus at this point, but these readings have definitely helped me recognize my interests.
The readings this week come from on text on race, ethnicity and women’s health. The chapter I read examines the immigrant experience as it relates to health and health care. I think this was an important topic to address in this course because of the fact that a significant percentage of black women in Canada are immigrants.
I found Wanda Thomas Bernard’s chapter on inclusion especially interesting because it looks at theories based on exclusion and inclusion and addresses them from the practical experiences of immigrant women in Canada.
While the readings are regionally focused and all based on research conducted in the immigrant community in the East, the researchers draw conclusions that add to the larger national discussion of ethnicity and health care. I think they were important for me to read because they gave me a sense of the type of research being conducted around the issues of health care, access, ethnicity and immigration and the questions being asked related to them.
My only concern while reading these chapters was that the research seemed to be there, but there was no evidence that the work actually translated to policy. It’s a question I think I will look into for my own knowledge.
Another important element of this set of readings is the perspective from which the researchers address the issue. The readings this week build on what Bhopal discussed in his text. While Bhopal’s work is based on epidemiology and research affecting policy from the point of view of the researcher, the readings this week approach the issues of race and ethnicity and how they relate to health from the perspective of immigrant or “other” race or ethnicity. They rely on qualitative research conducted in PEI, an admittedly limited pool, to draw conclusions about the female immigrant health experience in Canada.
In these readings the reader gets to hear directly from the people who the research is being conducted based on through quotations and relation of answers in the study. It helped me realize that there is a certain level of validity to this type of qualitative research when it relates to groups that are often marginalized and not given a voice in wider society.
The readings this week felt less personal this week in that I didn’t find myself comparing my experience to those related in the text. But they were just as important as any other I’ve encountered to date because of the broad perspective they offer.
I think your research topic sounds interesting, but I want to caution you about a slippage from race to ethnicity to culture in the discourses that you are using. The discourse on culture is one that is particularly rooted in the liberal multicultural approach to diversity that underpins Canadian society, while useful in its popularity and in its focus on equality through diversity, it fails to account adequately for relations of power - particularly racism. Culture is foregrounded over race, so service providers are focusing on everyone having culture and being culturally sensitive, rather than attending to the more troublesome and problematic aspects of racism. I have a couple references that you might want to consider...
ReplyDeletePon, G. (2009) Cultural Competency as New Racism: An Ontology of Forgetting. Journal of Progressive Human SErvices, 20, 59-71.
Dhamoon, R. (2010) Identity/Difference Politics: How Difference is Produced and Why It Matters. VAncouver: UBC Press.
For more of Wanda Thoma Bernard's work See her new book with Carl James and David Este, entitled, Race and Well-Being.
These are background pieces, but definitely read Gordon Pon's article.
If you are looking at access to health and health care policy make sure you look at some of the collections written by Pat and Hugh Armstrong as well as collections by Dennis Raphael on the social determinants of health.
I hope this helps.