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The clinical gaze in the practice of migrant health: Mexican migrants in the United States

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  • Holmes, Seth M.

Abstract

This paper utilizes eighteen months of ethnographic and interview research undertaken in 2003 and 2004 as well as follow-up fieldwork from 2005 to 2007 to explore the sociocultural factors affecting the interactions and barriers between U.S. biomedical professionals and their unauthorized Mexican migrant patients. The participants include unauthorized indigenous Triqui migrants along a transnational circuit from the mountains of Oaxaca, Mexico, to central California, to northwest Washington State and the physicians and nurses staffing the clinics serving Triqui people in these locations. The data show that social and economic structures in health care and subtle cultural factors in biomedicine keep medical professionals from seeing the social determinants of suffering of their unauthorized migrant patients. These barriers lead clinicians inadvertently to blame their patients – specifically their biology or behavior – for their suffering. This paper challenges the focus of mainstream cultural competency training by showing that it is not the culture of the patient, but rather the structure and culture of biomedicine that form the primary barriers to effective multicultural health care.

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  • Holmes, Seth M., 2012. "The clinical gaze in the practice of migrant health: Mexican migrants in the United States," Social Science & Medicine, Elsevier, vol. 74(6), pages 873-881.
    • Handle: RePEc:eee:socmed:v:74:y:2012:i:6:p:873-881
    DOI: 10.1016/j.socscimed.2011.06.067
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    1. Rust, G.S., 1990. "Health status of migrant farmworkers: A literature review and commentary," American Journal of Public Health, American Public Health Association, vol. 80(10), pages 1213-1217.
    2. Seth M Holmes, 2006. "An Ethnographic Study of the Social Context of Migrant Health in the United States," PLOS Medicine, Public Library of Science, vol. 3(10), pages 1-18, October.
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    7. Qenani, Eivis & MacDougall, Neal & Roy, Soma, 2016. "Vigorous Physical Activity and Obesity? – The Paradox of California Farmworker Population," 2016 Annual Meeting, July 31-August 2, Boston, Massachusetts 235530, Agricultural and Applied Economics Association.
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    12. Gamlin, Jennie B., 2013. "Shame as a barrier to health seeking among indigenous Huichol migrant labourers: An interpretive approach of the “violence continuum” and “authoritative knowledge”," Social Science & Medicine, Elsevier, vol. 97(C), pages 75-81.
    13. Holmes, Seth M., 2013. "“Is it worth risking your life?”: Ethnography, risk and death on the U.S.–Mexico border," Social Science & Medicine, Elsevier, vol. 99(C), pages 153-161.
    14. Whittle, Henry J. & Palar, Kartika & Seligman, Hilary K. & Napoles, Tessa & Frongillo, Edward A. & Weiser, Sheri D., 2016. "How food insecurity contributes to poor HIV health outcomes: Qualitative evidence from the San Francisco Bay Area," Social Science & Medicine, Elsevier, vol. 170(C), pages 228-236.
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    17. Fleming, Mark D. & Shim, Janet K. & Yen, Irene H. & Thompson-Lastad, Ariana & Rubin, Sara & Van Natta, Meredith & Burke, Nancy J., 2017. "Patient engagement at the margins: Health care providers' assessments of engagement and the structural determinants of health in the safety-net," Social Science & Medicine, Elsevier, vol. 183(C), pages 11-18.
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