‘It’s a cultural thing’: excuses used by health professionals on providing inclusive care

ABSTRACT

Although health services in Australia have an aim to provide inclusive care for their patients/clients, this study highlights how barriers to care can lie at the centre of patient-provider interactions. Racial microaggression is a subtle form of racism that can occur in health settings, leading to further exclusion for First Nations Australians, immigrants and refugees. This paper is guided by Derrida's approach to deconstructionism by unpacking how language is used by health professionals – as holders of organisational power – and how they construct ‘truths’ or discourses about clients that historically have been marginalised by health services and system. Data comprise 21 interviews with staff from two rural health services. It identified three racial microaggressions were used to justify the challenges of providing care to people from First Nations, immigrant and refugee backgrounds: (1) Participants problematised culture(s) of service users; (2) participants implied cultural superiority in their conceptualisation of ‘other’ cultures; and (3) participants shared stories of inactions, discomfort and relegating of responsibility. The findings identified these discourses as forms of racial microaggression that can potentially lead to further exclusion of people seeking services and support.

KEYWORDS:

• Microaggression
• racism
• communication
• rural health
• culture
• inclusion

Acknowledgements

The authors thank the staff from the two health services who generously gave up their time to participate in this study and shared their experiences openly and honestly. The authors also acknowledge the Australian Research Council for funding this research (DP170101187) and support of the Australian Government Department of Health Rural Health Multidisciplinary Training Programme.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The authors also acknowledge the Australian Research Council for funding this research (DP170101187) and support of the Australian Government Department of Health Rural Health Multidisciplinary Training Programme.