Email updates

Keep up to date with the latest news and content from IJEqH and BioMed Central.

Open Access Highly Accessed Open Badges Editorial

The hidden inequity in health care

Barbara Starfield

International Journal for Equity in Health 2011, 10:15  doi:10.1186/1475-9276-10-15

PubMed Commons is an experimental system of commenting on PubMed abstracts, introduced in October 2013. Comments are displayed on the abstract page, but during the initial closed pilot, only registered users can read or post comments. Any researcher who is listed as an author of an article indexed by PubMed is entitled to participate in the pilot. If you would like to participate and need an invitation, please email, giving the PubMed ID of an article on which you are an author. For more information, see the PubMed Commons FAQ.

Equity and the problem of legitimacy

Christine Loignon   (2011-06-10 09:45)  Universit�� de Sherbrooke email

I really appreciated reading the Starfield's editorial entitled "The hidden inequity in health care". As a sociologist, my scientific research in primary care leads me to consider the importance of the user point of view regarding the problem of legitimacy. Underserved patients I've met who experience both multiple chronic conditions and poverty encountered the problem of legitimacy toward the health care system. The problem of legitimacy could be defined as the perception of not having a legitimated place in the health care system. It comes with the humiliation that goes with poverty experience and with being perceived as ��bad patient�� through social experience of the health care system. Negative past experience of care, stigma, economics and social barriers of access to care and discouragement all play a central role in the occurrence of the problem of legitimacy. Relational accessibility through positive, inclusive and repetitive contacts with the primary health care system (both at the GP level and care organization level) is a core component of the effective social legitimacy. The capability of the primary health care system to take into account the roots of the social inequities and the problem of legitimacy experienced by patients is in my sense one avenue of solution for enhancing equity!

Competing interests

No competing interests.


Post a comment