Madden Erin Fanning
University of New Mexico, Department of Family and Community Medicine, Public Health Program, MSC09 5060, 1 University of New Mexico, Albuquerque, NM 87131-0001, USA.
Soc Sci Med. 2015 May;133:145-52. doi: 10.1016/j.socscimed.2015.04.006. Epub 2015 Apr 3.
Communities struggling with access to healthcare in the U.S. are often considered to be disadvantaged and lacking in resources. Yet, these communities develop and nurture valuable strategies for healthcare access that are underrecognized by health scholars. Combining medical sociology and critical race theory perspectives on cultural capital, this paper examines the health-relevant cultural resources, or Cultural Health Capital, in South Texas Mexican American border communities. Ethnographic data collected during 2011-2013 in Cameron and Hidalgo counties on the U.S.-Mexico border provide empirical evidence for expanding existing notions of health-relevant cultural capital. These Mexican American communities use a range of cultural resources to manage healthcare exclusion and negotiate care in alternative healthcare spaces like community clinics, flea markets and Mexican pharmacies. Navigational, social, familial, and linguistic skills and knowledge are used to access doctors and prescription drugs in these spaces despite social barriers to mainstream healthcare (e.g. cost, English language skills, etc.). Cultural capital used in marginalized communities to navigate limited healthcare options may not always fully counteract healthcare exclusion. Nevertheless, recognizing the cultural resources used in Mexican American communities to facilitate healthcare challenges deficit views and yields important findings for policymakers, healthcare providers, and advocates seeking to capitalize on community resources to improve healthcare access.
在美国，难以获得医疗保健服务的社区通常被视为弱势群体且资源匮乏。然而，这些社区发展并培育了一些宝贵的获取医疗保健服务的策略，而这些策略却未得到健康学者的充分认可。本文结合医学社会学和批判种族理论中关于文化资本的观点，考察了南德克萨斯州墨西哥裔美国边境社区中与健康相关的文化资源，即文化健康资本。2011年至2013年期间在美国 - 墨西哥边境的卡梅伦县和伊达尔戈县收集的人种志数据，为扩展现有的与健康相关的文化资本概念提供了实证依据。这些墨西哥裔美国社区利用一系列文化资源来应对医疗保健方面的排斥，并在社区诊所、跳蚤市场和墨西哥药店等替代医疗保健场所协商医疗服务。尽管存在进入主流医疗保健的社会障碍（如费用、英语语言能力等），但人们利用导航、社交、家庭和语言技能及知识在这些场所看医生和获取处方药。在边缘化社区用于应对有限医疗保健选择的文化资本可能并不总能完全消除医疗保健方面的排斥。然而，认识到墨西哥裔美国社区用于促进医疗保健的文化资源，对那些认为存在不足的观点提出了挑战，并为政策制定者、医疗保健提供者以及寻求利用社区资源改善医疗保健可及性的倡导者带来了重要发现。
