title: Health care among street-involved women: the perpetuation of health inequity.
abstract: I present the findings from a study that explored the experiences and decision making of street-involved women navigating the health care system. Data were drawn from a larger qualitative study situated in a western Canadian inner-city neighborhood that examined the health-management strategies of street-involved women with a history of crack cocaine use. Data were collected over a 17-month period and included ethnographic methods of participant observation, group interviews (n = 57), and in-depth interviews (n = 10). Inductive thematic analysis derived two major themes: power and punishment, and organization and delivery of care. The themes illustrate how women's experiences and decision making were located within a nexus of power relations that operated across women's shared social location as downtown eastsiders. Implications of the findings are discussed in relation to supporting women's efforts and improving health outcomes.
authors.affiliation: University of British Columbia School of Nursing, T201-2211 Wesbrook Mall, Vancouver, British Columbia, Canada. vicky.bungay@nursing.ubc.ca
authors.forename: Vicky
authors.initials: V
authors.lastname: Bungay
mesh_terms: D000884:Anthropology, Cultural / Q000379:methods; D001291:Attitude of Health Personnel; D001955:British Columbia; D019970:Cocaine-Related Disorders / Q000191:economics / Q000523:psychology / Q000534:rehabilitation; D003657:Decision Making; D055030:Drug Users / Q000523:psychology*; D005260:Female; D006297:Health Services Accessibility / Q000191:economics; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000191:economics; D006703:Ill-Housed Persons / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D019370:Observation; D011203:Poverty; D011209:Power, Psychological; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012927:Social Control, Informal / Q000379:methods; D014504:Urban Health; D016387:Women's Health
keywords: addiction / substance use; critical methods; decision making; health care disparities; health care, access to; homelessness; interviews; poverty; power / empowerment; relationships, health care; social identity; urban health; vulnerable populations; women’s health