“They [Doctors] Don’t Really Know What We’re Actually Experiencing”: Undoing Racializing Frames of Heart Health in Singapore by Centering Listening as Method

ABSTRACT

The mainstream media and local health campaigns in Singapore racialize heart health disparities. Journalists and campaigners report differences in heart health outcomes from a model of race governance known as the Chinese, Malay, Indian, and Others (CMIO) model. This model is then used to frame heart health inequities as an outcome of poor cultural practices and behaviors tied to race. To (un)do the racializing frames of heart health as outcomes of cultural behaviors and practices, I instead center stories of heart health management by Malay participants from lower-income households, identifying the role information asymmetries play in incomplete heart health information retrieval during interactions with providers (social service providers, healthcare workers, doctors, nurses). Cultural and community resources were discussed as critical resources for alleviating urgent heart health episodes or assisting as guides for preventative heart health information. Health campaigners must delve deeper into these findings for more structurally responsive heart health interventions and move away from racializing health disparities based on the CMIO model.

Acknowledgements

I would like to thank my participants, Munirah Bashir, and Professor Mohan Dutta for their mentorship and guidance throughout this study. I would also like to thank Hazirah Mohamad for generously sharing feedback on earlier versions of this manuscript.

Disclosure statement

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

Notes

1. Mendaki is the primary self-help group for the Malay-Muslim community in Singapore (Moore, 2000).

2. Living in a rental flat is one metric for noting low-income status in Singapore with an approximate income cutoff for aid support and rental housing eligibility of a combined household income of SGD$1900.00 or SGD$650 per capita (Ministry of Social and Family Development, 2017).

3. Void decks refer to open areas below high-rise apartments. In Singapore, these spaces are used for recreational or community purposes.

4. Polyclinics in Singapore are healthcare facilities run by the state that provide primary healthcare services affordably to the general public of all financial backgrounds.

5. Jamu is the “Indonesian and Malay term for traditional pharmaceuticals made from fresh or dried medicinal plants. These remedies have existed for centuries, and are popular among the Malay people living in varying proportions in the states of the whole Malayan archipelago (Malaysia, Singapore, Brunei Darussalam, Indonesia)” (Tuschinsky, 1995, p. 1587).

Additional information

Funding

Singapore Heart Foundation [grant number R-124-000-062-592] and National University of Singapore (NUS) grant number for the Center of Culture-Centered Approach to Research and Evaluation (CARE) [grant number R-124-000-048-133].