Hospitals, clinics, and palliative care units: Place-based experiences of formal healthcare settings by people experiencing structural vulnerability at the end-of-life. (September 2018)

• Record Type: Journal Article
• Authors: Giesbrecht, Melissa; Stajduhar, Kelli I.; Mollison, Ashley; Pauly, Bernie; Reimer-Kirkham, Sheryl; McNeil, Ryan; Wallace, Bruce; Dosani, Naheed; Rose, Caelin
• Is Part Of: Health & place. Volume 53(2018:Sep.)
• Page Start: 43
• Page End: 51
• Publication Date: 2018-09
• Subjects: Structural vulnerability -- Palliative care -- Access to care -- Intersectionality -- Therapeutic landscapes -- Canada; Health -- Social aspects -- Periodicals; Health services accessibility -- Periodicals; Public health -- Periodicals; Political planning -- Periodicals; Social medicine -- Periodicals; Epidemiology -- Periodicals; Health Policy -- Periodicals; Health Services Accessibility -- Periodicals; Public Health -- Periodicals; Public Policy -- Periodicals; Sociology, Medical -- Periodicals; Épidémiologie -- Périodiques; Politique sanitaire -- Périodiques; Santé, Services de -- Accessibilité -- Périodiques; Health services accessibility; Health -- Social aspects; Political planning; Public health; Social medicine; Periodicals; 613
• DOI: 10.1016/j.healthplace.2018.06.005
• Languages: English
• ISSNs: 1353-8292

Abstract

Abstract: The process of dying pronounces inequities, particularly for structurally vulnerable populations. Extending recent health geography research, we critically explore how the 'places' of formal healthcare settings shape experiences of, and access to, palliative care for the structurally vulnerable (e.g., homeless, substance users). Drawing on 30 months of ethnographic data, thematic findings reveal how symbolic, aesthetic, and physical elements of formal healthcare 'places' intersect with social relations of power to produce, reinforce, and amplify structural vulnerability and thus, inequities in access to care. Such knowledge may inform decision-makers on ways to enhance equitable access to palliative care for some of societies' most vulnerable population groups. Highlights: Contributes insights on the significance of place and access to palliative care. Contributes a critically-informed understanding on healthcare settings. Provides experiential perspectives of those experiencing structural vulnerability. Offers suggestions to inform policy and improve equitable access to palliative care. Offers a new lens for examining the intersections of power, place, and diversity.