title: "They treated me like crap and I know it was because I was Native": The healthcare experiences of Aboriginal peoples living in Vancouver's inner city.
abstract: There is growing evidence that Aboriginal peoples often experience healthcare inequalities due to racism. However, research exploring the healthcare experiences of Aboriginal peoples who use illicit substances is limited, and research rarely accounts for how multiple accounts of stigma intersect and contribute to the experiences of marginalized populations. Our research aimed to explore the healthcare experiences of Aboriginal peoples who use illicit drugs and or illicit alcohol (APWUID/A) living in Vancouver's inner city. Using Indigenous methodologies, a community research team comprised of APWUID/A led the study design, data collection and analysis. Peer-facilitated talking circles explored community members' experiences accessing healthcare services and patient-provider encounters. Using an intersectionality framework, our research demonstrated how healthcare inequalities among Aboriginal peoples are perpetuated by systemic racism and discrimination. Stigmatizing racial stereotypes were perceived to negatively influence individual attitudes and clinical practice. Participants' experiences of medical dismissal often resulted in disengagement from care or delay in care. The findings suggest healthcare providers must understand the structural and historical forces that influence racial disparities in healthcare and personal attitudes in clinical practice. Adequate clinical protocols for pain management within the context of illicit substance use are urgently needed. The valuation of Aboriginal peoples and cultures within healthcare is paramount to addressing the health gap between Aboriginal and non-Aboriginal Canadians.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.
authors.forename: Ashley
authors.initials: A
authors.lastname: Goodman
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.
authors.forename: Kim
authors.initials: K
authors.lastname: Fleming
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.
authors.forename: Nicole
authors.initials: N
authors.lastname: Markwick
authors.affiliation: Western Aboriginal Harm Reduction Society, Vancouver, British Columbia, Canada.
authors.forename: Tracey
authors.initials: T
authors.lastname: Morrison
authors.affiliation: Western Aboriginal Harm Reduction Society, Vancouver, British Columbia, Canada.
authors.forename: Louise
authors.initials: L
authors.lastname: Lagimodiere
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada; Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: uhri-tk@cfenet.ubc.ca.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
mesh_terms: D000328:Adult; D000368:Aged; D001955:British Columbia / Q000208:ethnology; D005260:Female; D017144:Focus Groups; D006303:Health Services, Indigenous / Q000592:standards*; D054625:Healthcare Disparities / Q000208:ethnology; D006801:Humans; D007198:Indians, North American / Q000208:ethnology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000208:ethnology*; D036301:Qualitative Research; D063505:Racism / Q000208:ethnology / Q000523:psychology*; D035862:Vulnerable Populations / Q000208:ethnology / Q000523:psychology
keywords: Aboriginal peoples; Canada; Drug users; Health inequalities; Healthcare; Indigenous peoples; Marginalized populations; Racism