I don't even want to go to the doctor when I get sick now: Healthcare experiences and discrimination reported by people who use drugs, Arizona 2019
•40% of people using drugs avoided healthcare due to anticipated mistreatment.•Those seeking healthcare reported mistreatment and abuse by healthcare providers.•Social mistreatment by clinicians included disapproval, embarrassment and shaming.•Medical providers ignored health complaints and provided...
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| Published in: | The International journal of drug policy Vol. 93; p. 103112 |
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| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Netherlands
Elsevier B.V
01-07-2021
Elsevier Science Ltd |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | •40% of people using drugs avoided healthcare due to anticipated mistreatment.•Those seeking healthcare reported mistreatment and abuse by healthcare providers.•Social mistreatment by clinicians included disapproval, embarrassment and shaming.•Medical providers ignored health complaints and provided inappropriate treatment.•Healthcare providers abused patients verbally and physically to convey disapproval.
People who use drugs experience severe health inequities created by structural and social barriers related to healthcare access. This includes stigma.
To characterize the experience of healthcare access among people who use drugs in Maricopa County, Arizona USA.
A 20-item guided survey with quantitative and qualitative items was fielded between October 23-November 5, 2019 among people who use drugs in community locations (public spaces, trap houses, drug copping areas). Surveys were administered face-to-face by community researchers with lived experiences. Survey recruitment included convenience sampling and social referral among respondents. Quantitative items were described and qualitative data were independently coded using an a priori coding scheme including reasons for healthcare seeking and healthcare-related stigma (anticipated, experienced, enacted).
Over one-third (39.5%) of the185 person sample did not seek medical care in the past year. Of this group, 34.2% reported that they did not seek needed healthcare because they were afraid of being treated badly by medical providers for using drugs. The three major experiences reported by those seeking healthcare in the past year included 1) medical mistreatment (not addressing the primary medical complaint, providing wrong or inadequate treatment), 2) social mistreatment (disapproval, embarrassment, shaming) and 3) abusive behavior (verbal and physical) by healthcare providers.
Efforts should create healthcare social and practice environments that assure appropriate and competent medical care and prohibit healthcare provider mistreatment of people who use drugs. Structural incentives such as healthcare finance, hospital accreditation and medical complaint registration should be considered. |
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| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| ISSN: | 0955-3959 1873-4758 |
| DOI: | 10.1016/j.drugpo.2021.103112 |