16
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Deservingness: migration and health in social context

      review-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          This article brings the social science concept of ‘deservingness’ to bear on clinical cases of transnational migrant patients. Based on the authors’ medical social science research, health delivery practice and clinical work from multiple locations in Africa. Europe and the Americas, the article describes three clinical cases in which assumptions of deservingness have significant implications for the morbidity and mortality of migrant patients. The concept of deservingness allows us to maintain a critical awareness of the often unspoken presumptions of which categories of patients are more or less deserving of access to and quality of care, regardless of their formal legal eligibility. Many transnational migrants with ambiguous legal status who rely on public healthcare experience exclusion from care or poor treatment based on notions of deservingness held by health clinic staff, clinicians and health system planners. The article proposes several implications for clinicians, health professional education, policymaking and advocacy. A critical lens on deservingness can help global health professionals, systems and policymakers confront and change entrenched patterns of unequal access to and differential quality of care for migrant patients. In this way, health professionals can work more effectively for global health equity.

          Related collections

          Most cited references33

          • Record: found
          • Abstract: found
          • Article: found
          Is Open Access

          Structural competency: Theorizing a new medical engagement with stigma and inequality

          This paper describes a shift in medical education away from pedagogic approaches to stigma and inequalities that emphasize cross-cultural understandings of individual patients, toward attention to forces that influence health outcomes at levels above individual interactions. It reviews existing structural approaches to stigma and health inequalities developed outside of medicine, and proposes changes to U.S. medical education that will infuse clinical training with a structural focus. The approach, termed “structural competency,” consists of training in five core competencies: 1) recognizing the structures that shape clinical interactions; 2) developing an extra-clinical language of structure; 3) rearticulating “cultural” formulations in structural terms; 4) observing and imagining structural interventions; and 5) developing structural humility. Examples are provided of structural health scholarship that should be adopted into medical didactic curricula, and of structural interventions that can provide participant-observation opportunities for clinical trainees. The paper ultimately argues that increasing recognition of the ways in which social and economic forces produce symptoms or methylate genes then needs to be better coupled with medical models for structural change.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Cultural humility versus cultural competence: a critical distinction in defining physician training outcomes in multicultural education.

            Researchers and program developers in medical education presently face the challenge of implementing and evaluating curricula that teach medical students and house staff how to effectively and respectfully deliver health care to the increasingly diverse populations of the United States. Inherent in this challenge is clearly defining educational and training outcomes consistent with this imperative. The traditional notion of competence in clinical training as a detached mastery of a theoretically finite body of knowledge may not be appropriate for this area of physician education. Cultural humility is proposed as a more suitable goal in multicultural medical education. Cultural humility incorporates a lifelong commitment to self-evaluation and self-critique, to redressing the power imbalances in the patient-physician dynamic, and to developing mutually beneficial and nonpaternalistic clinical and advocacy partnerships with communities on behalf of individuals and defined populations.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: found

              The UCL–Lancet Commission on Migration and Health: the health of a world on the move

                Bookmark

                Author and article information

                Journal
                BMJ Glob Health
                BMJ Glob Health
                bmjgh
                bmjgh
                BMJ Global Health
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2059-7908
                2021
                7 April 2021
                : 6
                : Suppl 1
                : e005107
                Affiliations
                [1 ] departmentSociety and Environment, Medical Anthropology, and Public Health , University of California Berkeley , Berkeley, California, USA
                [2 ] departmentHumanities and Social Sciences , University of California San Francisco School of Medicine , San Francisco, California, USA
                [3 ] departmentPaoli Calmettes Chair , IMéRA Mediterranean Institute for Advanced Study , Marseille, France
                [4 ] departmentSociology , American University , Washington, DC, USA
                [5 ] departmentEuropean Ethnology , Humboldt University of Berlin , Berlin, Germany
                [6 ] departmentAnthropology , University of South Florida , Tampa, Florida, USA
                [7 ] departmentInstitute for Social and Cultural Anthropology , Free University of Berlin , Berlin, Germany
                [8 ] departmentAnthropology , University of Connecticut , Storrs, Connecticut, USA
                [9 ] Partners in Health , Freetown, Sierra Leone
                [10 ] departmentSchool of Medicine , University of California San Francisco , San Francisco, California, USA
                [11 ] departmentMedical Anthropology , University of California Berkeley , Berkeley, California, USA
                [12 ] departmentInstitute of Health and Society , University of Oslo , Oslo, Norway
                Author notes
                [Correspondence to ] Dr Seth M Holmes; sethmholmes@ 123456berkeley.edu

                Guest Chief Editor: Emily Mendenhall and Seth M. Holmes.

                Author information
                http://orcid.org/0000-0002-2244-2868
                http://orcid.org/0000-0002-6445-1949
                http://orcid.org/0000-0002-0827-0510
                http://orcid.org/0000-0003-0182-9155
                Article
                bmjgh-2021-005107
                10.1136/bmjgh-2021-005107
                8031028
                33827795
                a0cf9138-df34-4c1f-bc78-e4ffb3d42be6
                © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 25 January 2021
                : 30 January 2021
                Funding
                Funded by: Deutscher Akademischer Austauschdienst (DAAD);
                Funded by: Peder Sather Center for Advanced Study;
                Funded by: Paoli Calmettes Chair IMéRA Mediterranean Institute for Advanced Study;
                Funded by: Global Futures Initiative, Georgetown University;
                Funded by: Berkeley Center for Social Medicine;
                Categories
                Analysis
                1506
                Custom metadata
                unlocked

                public health,health policies and all other topics,health systems,treatment,qualitative study

                Comments

                Comment on this article