Bruce Wallace1,2, Colleen Varcoe3, Cindy Holmes4, Mehmoona Moosa-Mitha4, Gregg Moor5, Maria Hudspith5, Kenneth D Craig6. 1. School of Social Work, University of Victoria, PO Box 1700, STN CSC, BC, Victoria, Canada. barclay@uvic.ca. 2. Canadian Institute for Substance Use Research (CISUR), P.O. Box 1700, STN CSC, BC, V8W 2Y2, Victoria, Canada. barclay@uvic.ca. 3. School of Nursing, University of British Columbia, T153-2211 Wesbrook Mall, BC, V6T 2B5, Vancouver, Canada. 4. School of Social Work, University of Victoria, PO Box 1700, STN CSC, BC, Victoria, Canada. 5. Pain BC, 1508 W Broadway, V6J 1W8, BC , Vancouver, Canada. 6. Department of Psychology, University of British Columbia, 2136 West Mall, BC, V6T 1Z4, Vancouver, Canada.
Abstract
OBJECTIVE: For 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. METHODS: This 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. RESULTS: Pain 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. CONCLUSIONS: Equity-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.
OBJECTIVE: For 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. METHODS: This 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. RESULTS:Pain 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. CONCLUSIONS: Equity-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.
Entities:
Keywords:
Chronic pain; Community‐based participatory research (CBPR); Health equity; Indigenous; LGBTQ2S; Refugee; Social marginalization; Structural violence
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