UBC Theses and Dissertations
Sadhee sehayth (our health) project : health inequity in Canada’s universal healthcare system through the experiences of the Punjabi Sikh Diaspora living with cardiovascular disease Kang, Harminder Bindy Kaur
The Sadhee Sehayth (Our Health) Project investigates how British Columbia’s health authorities support diversity, anti-racism and equity for patients and their families. I selected Post/Colonial, Critical Race and Feminist Theories to analyze the complex and pervasive ideologies that inform institutional structures. Using a Critical Ethnographic approach, I addressed the following research questions: 1. How are institutional diversity discourses and actions constructed, and how do they shape healthcare experience for racialized communities?; 2. How do institutional diversity discourses and actions shape experiences for one racialized diaspora community, the Punjabi Sikh Diaspora when seeking cardiovascular healthcare, and 3. what does this analysis tell us about how systemic structures are conceptualized and might be improved for healthcare delivery for racialized communities? Phase one examined the diversity commitments of health authorities through an analysis of mission statements, visions and values. The analysis revealed that health equity is not prioritized in the institutional statements for 7 of the 8 health authorities. The absence of these markers reaffirms that anti-racist ideologies are not conceptualized into the institutional identities of British Columbia’s healthcare delivery organizations. Phase 2 concentrated on the diversity practices of 4 health authorities. Diversity workers faced numerous obstacles including organizational resistance to maintaining diversity programming, negligible funding and minimal staffing. The most promising finding was the number of informal diversity workers who volunteered to act as diversity liaisons and educators. To gain a patient perspective, Phase 3 focused on Punjabi Sikh Diaspora patients who had experienced a myocardial infarction and recently discharged from a local hospital. Despite the availability of diversity, spiritual care, interpreter and cardiac rehabilitation programming, these participants were not asked about their cultural or religious needs; not offered spiritual care services; interpreter support was minimal to non-existent; post-surgery treatment and care plans were not adequately communicated; and they were not offered information or referrals to cardiac rehabilitation programs. The dissertation concludes with a list of recommendations to improve health equity for racialized communities.
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