Experiences and Perceptions of Medical Discrimination Among a Multiethnic Sample of Breast Cancer Patients in the Greater San Francisco Bay Area, California

Autor:	Pagan Morris, Sarah J. Shema, June K. Winters, Scarlett Lin Gomez, Amani Nuru-Jeter, Thu Quach, Laura Allen, Gem M. Le
Rok vydání:	2012
Předmět:	Adult Gerontology media_common.quotation_subject education Immigration Population Ethnic group Breast Neoplasms Interviews as Topic Social support Breast cancer Adaptation Psychological Humans Medicine Healthcare Disparities Qualitative Research Aged Language media_common education.field_of_study business.industry Communication Public Health Environmental and Occupational Health Social Support Professional-Patient Relations Middle Aged medicine.disease Focus group Socioeconomic Factors The Science of Research on Racial/Ethnic Discrimination and Health Female San Francisco Patient Care Personal experience business Prejudice Stress Psychological Qualitative research
Zdroj:	American Journal of Public Health. 102:1027-1034
ISSN:	1541-0048 0090-0036
DOI:	10.2105/ajph.2011.300554
Popis:	Objectives. We conducted qualitative interviews with breast cancer survivors to identify themes related to institutional, personally mediated, and internalized discrimination in the medical setting. Methods. We conducted 7 focus groups and 23 one-on-one interviews with a multiethnic sample of breast cancer survivors randomly selected from a population-based registry covering the Greater San Francisco Bay Area, California. Results. Participants reported experiencing different forms of medical discrimination related to class, race, and language. Among African Americans, participants reported experiencing internalized discrimination and personal or group discrimination discrepancy—perceiving discrimination against them as a racial/ethnic group, yet not perceiving or discussing personal experiences of discrimination. Among Asian immigrants, participants reported experiencing institutional and personally mediated overt types of discrimination, including lack of access to quality and readily available translation services. Our results also indicated well-established coping mechanisms in response to discrimination experiences in both groups. Conclusions. Participants reported experiencing medical discrimination at all 3 levels, which may have deleterious health effects through the biopsychosocial stress pathway and through active coping mechanisms that could lead to delayed- or underutilization of the health care system to avoid discrimination.
Databáze:	OpenAIRE
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