Healthcare workers mobilising cultural health capital to assist socially marginalised patients

ABSTRACT

Research on cultural capital mobilised in healthcare largely focuses on how patients of low-socioeconomic status or ethnic minority groups struggle in the healthcare field. This study examines how providers, care coordinators, and administrators use their own cultural capital resources to bolster equity in health services, and explores the limitations of such efforts. Thirty-five hours of interviews with Hispanic and non-Hispanic White personnel at U.S. community health centres are used to explore how individuals on the ‘supply-side’ of healthcare may exhibit flexible expectations of patient cultural capital. Participants acknowledge how factors such as immigration status and family roles affect patient ability to exhibit traditionally high-value cultural capital in clinical interactions. Yet, providers’ flexible expectations and cultural knowledge alone cannot deliver comprehensive care to indigent patients of colour. Persistent systemic barriers like high costs and limited public programs require healthcare workers to navigate care outside of interactions with patients. Participants describe the precarious process of drawing favours from professional social networks to coordinate access for patients facing multiple forms of social marginalisation. While acknowledging the importance of cross-cultural skills, this research explains processes impeding professional cultural training interventions in their ability to correct health service inequities on a broad scale.

KEYWORDS:

• Cultural capital
• social capital
• providers
• health service inequity
• cultural competency
• cross-cultural training

Acknowledgments

Thank you to Laura Senier, Cameron Macdonald, Pam Herd, and Jane Collins for their comments on early drafts. The feedback from the anonymous reviewers on the manuscript are also appreciated. Finally, my deepest gratitude for assistance from Rene Cardona, my research assistant, and for general help from Jose, Castillo, Victor, Brenda, Stephanie, Joe, Mark, and Mike during my fieldwork.

Disclosure statement

No potential conflict of interest was reported by the author.

Additional information

Funding

The research for this paper was funded by two sources: The National Science Foundation’s Integrative Graduate Education and Research Traineeship and The University of Wisconsin-Madison department of sociology.