Sociology of Health and Health Care

Past research yields mixed evidence regarding whether ethnoracial minorities trust physicians less than Whites. Using the 2002 and 2006 General Social Surveys, variegated ethnoracial differences in trust in physicians are identified by disaggregating a multidimensional physician trust scale. Compared to Whites, Blacks are less likely to trust the technical judgment and interpersonal competence of doctors. Latinos are less likely than Whites to trust the fiduciary ethic, technical judgment, and interpersonal competence of doctors. Black-Latino differences in physician trust are a function of ethnoracial differences in parental nativity. The ways ethnoracial hierarchies are inscribed into power-imbalanced clinical exchanges are discussed.

Among Indigenous (Native American) people, the mortality rate from COVID-19 has been as high as three and a half times higher than the US national average. The pandemic has highlighted existing disparities in the health care services available to both rural and urban Indigenous/Native American peoples in the US federally recognized “Indian Tribes” (Tribal Nations). “Constructive Indigenization” reveals areas where Indigenous/Native American ways of knowing and being apply uniquely Indigenous/Native American cultural values, world views, and perspectives to transcend systemic, economic, and social barriers. This study proposes the concept of Constructive Indigenization as a mechanism for observing and considering the contextual reality that exists in, around, and through the interactions between tribal sovereignty, nation-building, and decolonization, collectively. Using analysis from two case studies of the Navajo and Choctaw Nations, the authors consider Constructive Indigenization through a variety of Tribal responses to the COVID-19 crisis in “Indian Country” while also incorporating a social determinants of health (SDoH) framework to situate healthcare disparities of marginalized people and the responses of Indigenous/Native American Nations to the crisis.
Keywords: Indigenous, Native American, Social Determinants of Health, Healthcare, Sociology of Health Care, COVID-19, Indigenization.

Fondé sur une enquête ethnographique menée par entretiens et observation dans deux établissements d’hébergement pour personnes âgées dépendantes (EHPAD), cet article montre comment les aides-soignants, en dépit de conditions de travail difficiles, « s’arrangent » avec les règles et les contraintes qui leurs sont imposées pour rendre leurs tâches quotidiennes faisables et supportables. Ces aides-soignants, portés par un idéal fort de réalisation de leur travail, produisent des normes informelles partagées malgré la diversité de leurs formations initiales et de leur statut d’emploi. Cette recherche de compromis entre la volonté de « bien faire leur travail » et le sentiment de ne pas recevoir les moyens pour y parvenir constitue pour eux une véritable « épreuve de professionnalité ». Plus généralement, celle-ci revoie aux épreuves que rencontrent les professionnels financés par l’argent public en France, spécialement dans le contexte actuel de restrictions budgétaires et de crise de l’État-providence.