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Health care is a basic social necessity that is critical for people to acquire good health status despite their difference in social, political, and economic levels. The health care system in Canada has made significant steps in ensuring that Canadians receive health care services without undue discrimination.
Accessibility, universality, portability, comprehensiveness, and public administration are five principles that guide the health care system of Canada in delivering quality health care services. However, due to societal differences in social, economic, racial, and political backgrounds, discrimination does arise in delivery of health care services.
In Canada, Aboriginal people experience discrimination in health care by virtue of their race since they do not receive equal treatment. According to United Nations Human Development Index, health care of Canada ranks among the top nations, but health care of Aboriginal people ranks 68th in rural reserves and 36th in other parts (Tang, & Bowne, 2008, p.110).
Hence, racism among others factors such as social exclusion, poverty, and discrimination have contributed to inequitable access to health care by the Aboriginal people. Therefore, this critique examines how “race” and racialization process perpetuate inequality in health care system.
The ethnographic study focuses on factors that influence decisions of Aboriginal patients when seeking health care services from Emergency Department in urban hospitals. The study hypothesizes that racialization affects how doctors and nurses deliver their services to Aboriginal people.
To collect robust data from interview and participant observation, the study sampled 82 participants; 38 were staff, which consisted of physicians, nurses and social workers, and 44 patients from Fast Track, a division of Emergency Department. Out of the 44 patients, 10 were Euro-Canadian patients and 34 were Aboriginal patients.
Tang and Browne (2008) point out that theoretical sample was necessary to expound racialization of “Aboriginality” among Aboriginal patients (p.112). Diversity of samples provided for comparative analysis of results with respect to racialization and accessibility of health care by Aboriginals people.
Ethnographic researchers interviewed and observed Aboriginal patients for about 30 to 60 minutes at the Fast Track division in the Emergency Department. To collect reliable data, the researchers interviewed and observed Aboriginals patients in private places such as clinical examination rooms and meeting rooms.
Interviews and observations of physicians, nurses, and social workers also took places in the same place and did last for about 15 to 30 minutes. Tang and Browne (2008) assert that the study aimed at analyzing process of racialization in a health care environment (p.113). Process of racialization is so complex because it has many confounding factors such as economic, social, and cultural factors.
Effective analysis of racialization process involved the researchers, Emergency Department staff, and collaborators who confirmed that the data collected resonated with daily experiences that they constantly encounter.
Racialization has a significant impact in perception of images attributed to certain people. Ideally, racialization involves conceptualization of “race” as a basic and natural way of categorizing people according to their racial attributes.
Dominant race has racialized perception of Aboriginal people because of their cultural, historical, social, and economic backgrounds, thus negatively affect their accessibility to health care. Tang and Browne (2008) argue that notions of “Aboriginality” emanate historical power relations between non-Aboriginal and Aboriginal populations, thus creating racialized images that negatively depict Aboriginals (p.114).
Hence, perception of Aboriginal people based on racialized Aboriginality explains tough experiences that they encounter as they struggle to access health care. Racialized Aboriginality is a concept that has historical origin, and plays a considerable role in shaping political discourses regarding racialization of Aboriginal people, in the context of health care.
Ethnographic study revealed that most Aboriginal people experience discrimination in health care system due to racialized images that depict them negatively. A case scenario describes how Aboriginal patient went to two different Emergency Departments in search of treatment of his chronic headache.
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In the first, the physician assumed him as drunk, hence did not diagnose any medical condition after brain scan. Since the physician gave him pills, but the pain did not relieve, the patient went to second Emergency Department where they did brain scan and realized that the patient requires urgent operation. Such a case scenario of the Aboriginal patient portrays experiences that Aboriginal patients undergo when they seek medical attention from health care system.
In the first Emergency Department, the physician based his diagnosis of severe headache on racialized perception that Aboriginals people are drunkards. Tang and Browne (2008) assert that, racialized images of Aboriginal people have negatively influenced how they obtain medical services from health care system (p.115). Therefore, this confirms that health care providers perceive Aboriginal people based on racialized assumptions that depict them as drunkards, poor, and abusers of substances.
Although the health care system of Canada upholds egalitarian principle, which supports equal treatment of everyone, racialization hinders Aboriginal people from accessing health care services. Egalitarianism has its basis in ethical principles, which ensure that everyone receives equal treatment in spite of differences in social categories that society attaches to people.
According to Tang and Browne (2008), application of egalitarianism in health care assumes that health care providers are sensitive and rational when exercising their roles lest they succumb to racialized perceptions of patients (p.117). Mere rhetoric of “treating everyone equally” does not reflect how Aboriginal people experience discrimination due to racialization.
Therefore, health care providers should avoid racialization of Aboriginal people by upholding ethical principles that guarantee just and fair treatment of everyone, and prevent discrimination in health care practice.
Racial profiling indicates that racialization is a hidden process that Aboriginal people encounter in health care system when they seek medical services. Although racialization is real, non-Aboriginal people always tend to deny it because they assume that everyone accesses health care equally.
Most people presume that social issues of race and racism no longer exist in society because they seem obsolete, thus; they overlook the fact that there is racialization of Aboriginal people in health care system.
Tang and Browne (2008) explain that, racial profiling is a discourse that government and media articulate to rationalize racializing practices among diverse communities (p.118). Hence, racial profiling of Aboriginal people indicates that they experience enormous challenges in their lives as they struggle to reclaim their racialized images that contribute to discrimination in health care system.
The health care system of Canada is advanced because it advocates for egalitarianism, an ideology which ensures that everyone receive equal treatment in health care. However, racialization of Aboriginal people has hindered them from accessing health care services as their counterparts from other communities.
Ethnographic study revealed that racialization is a form of discrimination that relegates Aboriginal people by depicting them as drunkards, poor, and substance abusers. Assumptions and stereotypes that health care providers have relating to Aboriginal people determine the nature of treatment that they receive from health care system. Thus, race and racialization are factors that contribute to discrimination of Aboriginal people by health care providers.
Tang, S. Y., & Browne, A. J. (2008). ‘Race’ matters: Racialization and Egalitarian
Discourses Involving Aboriginal People in the Canadian Health Care Context. Ethnicity & Health, 13(2), 109-127. doi:10.1080/13557850701830307