Correspondence: Barbara Starfield firstname.lastname@example.org
International Journal for Equity in Health 2011, 10:15 doi:10.1186/1475-9276-10-15
(2011-06-10 09:45) Universit�� de Sherbrooke
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!
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