Towards health equity for people experiencing chronic pain and social marginalization

International Journal for Equity in Health

Kenneth D. Craig¹  Gregg Moor²  Maria Hudspith²  Colleen Varcoe³  Cindy Holmes⁴  Mehmoona Moosa-Mitha⁴  Bruce Wallace⁵ 

[1] Department of Psychology, University of British Columbia, 2136 West Mall, V6T 1Z4, Vancouver, BC, Canada;Pain BC, 1508 W Broadway, BC, Vancouver, V6J 1W8, Canada;School of Nursing, University of British Columbia, T153-2211 Wesbrook Mall, V6T 2B5, Vancouver, BC, Canada;School of Social Work, University of Victoria, PO Box 1700, STN CSC, Victoria, BC, Canada;School of Social Work, University of Victoria, PO Box 1700, STN CSC, Victoria, BC, Canada;Canadian Institute for Substance Use Research (CISUR), P.O. Box 1700, STN CSC, V8W 2Y2, Victoria, BC, Canada;

关键词: Chronic pain;    Health equity;    Social marginalization;    Structural violence;    Community‐based participatory research (CBPR);    Indigenous;    LGBTQ2S;    Refugee;   

DOI  :  10.1186/s12939-021-01394-6

来源: Springer

【 摘 要 】

ObjectiveFor people who experience social inequities and structural violence, pain and related care are inexorably linked to experiences of injustice and stigma. The purpose of this study was to examine in greater depth the experiences of pain and discrimination and stigma across diverse marginalized communities in order to recommend equity-oriented healthcare approaches.MethodsThis community-based qualitative study reports on four focus groups that included 36 people living with pain. All participants identified with one of three groups known to experience high levels of inequities and structural violence including an Indigenous group, a LGBTQ2S group, and two newcomer and refugee groups.ResultsPain was entangled with and shaped by: social locations and identities, experiences of violence, trauma and related mental health issues, experiences of discrimination, stigma and dismissal, experiences of inadequate and ineffective health care, and the impacts of these intersecting experiences.ConclusionsEquity-oriented responses to chronic pain would recognize pain not only as a biomedical issue but as a social justice issue. The EQUIP Framework is an approach to integrating trauma- and violence-informed care; culturally-safe care; and harm reduction in health care that may hold promise for being tailored to people experiencing pain and social marginalization.

【 授权许可】

CC BY