Karen Lottis

Engaging the Liminal: Indigenous Perceptions of the Healthcare System Karen Lottis

It is well documented that there is decreased access and utilization of healthcare services by minority populations. This study explored experiences with the healthcare system among remotely situated First Nations people of coastal British Columbia, to shed light on elements considered crucial to healthcare delivery. The study was conducted as a critical ethnography with an underlying framework of phenomenology and critical social theory. Findings revealed individuals who had developed relationships of trust with providers, or whose family members acted as advocates in healthcare encounters were content overall with the care received. However, many voiced perceptions of prejudice and stigmatization, believing care to be of a lower quality than that received by non-Aboriginal BC residents. These findings were deeply embedded contextually and were framed by the legacy of a colonial past, ongoing 'civilized oppression,' and the socioeconomics of isolation, which undermined healthcare at every level. Recognition that social justice has been obscured beneath the labels of chronic disease demands re-evaluation of mainstream approaches to marginalized communities.