Culture, Styles of Institutional Interactions, and Inequalities in Healthcare Experiences

J Health Soc Behav. 2017 Jun;58(2):147-165. doi: 10.1177/0022146517693051. Epub 2017 Feb 1.

Abstract

In this study, I examine how parents' cultural knowledge shapes experiences navigating the healthcare system after a child is diagnosed with cancer and the extent to which differential styles of health-related advocacy contribute to inequalities in healthcare experiences. I combine data from parents' perspectives, physicians' perspectives, and direct observation of clinical interactions and find three overarching styles of health-related advocacy. Findings show that cultural dispositions and competencies shape parents' abilities to effectively navigate the healthcare system, and physicians differentially reward each style of health-related advocacy. Parents' styles of advocacy shape relationships with clinicians, physicians' perceptions of families, and physicians' strategies for interacting with families. These findings refine understanding of the mechanisms through which social class manifests in clinical interactions, shapes patient-physician relationships, and contributes to unequal healthcare experiences.

Keywords: cancer; culture; health disparities; patient–provider interactions; social class.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Bromisovalum
  • Catechols
  • Child
  • Child, Preschool
  • Culture*
  • Drug Combinations
  • Female
  • Health Services Accessibility*
  • Health Status Disparities*
  • Humans
  • Inositol
  • Male
  • Professional-Family Relations*
  • Professional-Patient Relations*
  • Social Class
  • Socioeconomic Factors
  • Surveys and Questionnaires

Substances

  • Cancell
  • Catechols
  • Drug Combinations
  • Bromisovalum
  • Inositol
  • Dolestan