地域医療と健康教育

抽象的な

Racism in a Place of Healthcare: The Qualitative Case of a Rural Australian Hospital

Christina Malatzky, Helen Haines and Kristen Glenister

Objective: This article explores how racism manifests in a rural place of healthcare from the perspectives of patients-both a patient’s experience of racial vilification and patients’ racially-prejudicial views towards healthcare providers. In the analysis, we illuminate the important implications of racism for experiences of health and healthcare in rural Australian places. We argue that critical interrogation of these enduring racial tensions is required to improve the quality of rural healthcare.

Methods: This article analyses two interview data sets, originally collected in a study investigating rurally-living patients’ experiences of chronic obstructive pulmonary disease that exemplify how racism manifests in a rural hospital environment. Each transcript was selectively coded for instances of racism and/or instances pertaining to the phenomena of racism. These codes were then reviewed, developed and refined into themes that were contextualized within broader social discourses and race politics that sustain racism.

Results: Contrasting themes of feeling ‘ unwelcome and unsafe ’ in the hospital and expressions of being ‘privileged and strong’ were identified. These themes were situated within participants’ particular contexts and circumstances, most especially their racialised subject positions. These themes illustrate the profound effects of racism on access and the maintenance of culturally unsafe environments for hospital patients, specifically those identifying as First Nation Australian, and emphasise the critical importance of cultural diversity within the rural health workforce.

Conclusion: The analysis demonstrates how racism impacts upon and affects two central functions accessibility and acceptance in the provision of healthcare in rural places. It is suggested that a range of health actors, including policy makers, health service managers and translational researchers, need to converge on and engage with how racism manifests in contemporary rural healthcare settings to address issues of ‘race’ and racism in contemporary places of rural healthcare from multiple, intersecting subject positions.