Addressing trauma, violence and pain: Research on health services for women at the intersections of history and economics. – Browne, Annette J., Varcoe, Colleen M., & Fridkin, Alycia. (2011).

Browne, Annette J., Varcoe, Colleen M., & Fridkin, Alycia. (2011). Addressing trauma, violence and pain: Research on health services for women at the intersections of history and economics. In O. Hankivsky (Ed.), Health Inequities in Canada: Intersectional Frameworks and Practices (pp. 295-311). Vancouver: UBC Press.

Using an intersectional perspective in health services research, this book chapter is aimed at analyzing and improving health care by drawing attention to the following: how health problems are framed; why particular problems are prioritized, and thus legitimized, over others; how multiple health and social issues such as violence and trauma, chronic pain, addictions, and poverty intersect; and the importance of structuring health services in ways that address the intersecting realities of people’s lives. These areas of analysis are critical to developing strategies for mitigating the ongoing marginalizing and racializing inequities that shape the lives and health of many women in Canada.

Harm reduction, methadone maintenance treatment and the root causes of health and social inequities: An intersectional lens in the Canadian context. – Smye, Victoria L., Browne, Annette J., Varcoe, Colleen M., & Josewski, Viviane. (2011).

Smye, Victoria L., Browne, Annette J., Varcoe, Colleen M., & Josewski, Viviane. (2011). Harm reduction, methadone maintenance treatment and the root causes of health and social inequities: An intersectional lens in the Canadian context. Harm Reduction Journal, 8(1), 17. doi: 10.1186/1477-7517-8-17

Abstract from Authors:

Background:

Using our research findings, we explore Harm Reduction and Methadone Maintenance Treatment (MMT) using an intersectional lens to provide a more complex understanding of Harm Reduction and MMT, particularly how Harm Reduction and MMT are experienced differently by people dependent on how they are positioned. Using the lens of intersectionality, we refine the notion of Harm Reduction by specifying the conditions in which both harm and benefit arise and how experiences of harm are continuous with wider experiences of domination and oppression;

Methods:

A qualitative design that uses ethnographic methods of in-depth individual and focus group interviews and naturalistic observation was conducted in a large city in Canada. Participants included Aboriginal clients accessing mainstream mental health and addictions care and primary health care settings and healthcare providers;

Results:

All client-participants had profound histories of abuse and violence, most often connected to the legacy of colonialism (e.g., residential schooling) and ongoing colonial practices (e.g., stigma & everyday racism). Participants lived with co-occurring illness (e.g., HIV/AIDS, Hepatitis C, PTSD, depression, diabetes and substance use) and most lived in poverty. Many participants expressed mistrust with the healthcare system due to everyday experiences both within and outside the system that further marginalize them. In this paper, we focus on three intersecting issues that impact access to MMT: stigma and prejudice, social and structural constraints influencing enactment of peoples’ agency, and homelessness;

Conclusions:

Harm reduction must move beyond a narrow concern with the harms directly related to drugs and drug use practices to address the harms associated with the determinants of drug use and drug and health policy. An intersectional lens elucidates the need for harm reduction approaches that reflect an understanding of and commitment to addressing the historical, socio-cultural and political forces that shape responses to mental illness/ health, addictions, including harm reduction and methadone maintenance treatment.

Article can be found here.