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《低收入非裔美国女性感知到的歧视中的医疗保健经历》

"": Healthcare experiences of perceived discrimination among low-income African-American women.

作者信息

Okoro Olihe N, Hillman Lisa A, Cernasev Alina

机构信息

Department of Pharmacy Practice and Pharmaceutical Sciences, College of Pharmacy, University of Minnesota, Duluth, MN, USA.

Department of Pharmaceutical Care and Health Systems, College of Pharmacy, University of Minnesota, Minneapolis, MN, USA.

出版信息

Womens Health (Lond). 2020 Jan-Dec;16:1745506520953348. doi: 10.1177/1745506520953348.

Abstract

BACKGROUND

On account of their racial/ethnic minority status, class, and gender, African-American women of low socioeconomic status are among the least privileged, underserved, and most marginalized groups in the United States. Generally, African Americans continue to experience poorer health outcomes, in which disparities have been attributed to socioeconomic inequities and structural racism. This objective of this study was to explore the lived experiences of low-income African-American women in interacting with the healthcare system and healthcare providers.

METHODS

Twenty-two in-depth one-on-one interviews were conducted with low-income African-American women. The audio-recorded interviews were transcribed verbatim. An inductive content analysis was performed, using an analytical software, Dedoose to enabled hierarchical coding. Codes were grouped into categories which were further analyzed for similarities that led to the emergence of themes.

RESULTS

A key finding was the experience of discriminatory treatment. The three themes that emerged relevant to this category were (1) perceived discrimination based on race/ethnicity, (2) perceived discrimination based on socioeconomic status, and (3) stereotypical assumptions such as drug-seeking and having sexually transmitted diseases.

CONCLUSION AND RECOMMENDATIONS

Low-income African-American women experience less than satisfactory patient care, where participants attribute to their experience of being stereotyped and their perception of discrimination in the healthcare system and from providers. Patients' experiences within the healthcare system have implications for their healthcare-seeking behaviors and treatment outcomes. Healthcare personnel and providers need to be more aware of the potential for implicit bias toward this population. Healthcare workforce training on culturally responsive patient care approaches and more community engagement will help providers better understand the context of patients from this population and more effectively meet their healthcare needs.

摘要

背景

由于其种族/族裔少数群体身份、阶级和性别,社会经济地位较低的非裔美国女性是美国最缺乏特权、服务不足且最边缘化的群体之一。总体而言,非裔美国人的健康状况仍然较差,这种差异归因于社会经济不平等和结构性种族主义。本研究的目的是探讨低收入非裔美国女性在与医疗系统和医疗服务提供者互动中的生活经历。

方法

对低收入非裔美国女性进行了22次深入的一对一访谈。对录音访谈进行逐字转录。使用分析软件Dedoose进行归纳性内容分析,以实现分层编码。代码被分组为类别,进一步分析这些类别的相似性以得出主题。

结果

一个关键发现是歧视性待遇的经历。与该类别相关的三个主题是:(1)基于种族/族裔的感知歧视,(2)基于社会经济地位的感知歧视,以及(3)寻求药物和患有性传播疾病等刻板假设。

结论与建议

低收入非裔美国女性获得的患者护理不尽如人意,参与者将其归因于她们被刻板化的经历以及她们在医疗系统和医疗服务提供者那里感受到的歧视。患者在医疗系统中的经历对其就医行为和治疗结果有影响。医护人员和提供者需要更加意识到对这一人群存在潜在的隐性偏见。针对具有文化响应性的患者护理方法的医护人员培训以及更多的社区参与将有助于提供者更好地理解这一人群患者的背景,并更有效地满足他们的医疗需求。

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