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Othering and Being Othered in the Context of Health Care Services

Taylor & Francis
Health Communication
Authors:
Joy L Johnson
Joy L Johnson
Joy L Johnson
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Joan L. Bottorff at University of British Columbia - Okanagan
Joan L. Bottorff
Annette J Browne at University of British Columbia
Annette J Browne
Suki Grewal at Langara College
Suki Grewal
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Abstract

Othering is a process that identifies those that are thought to be different from oneself or the mainstream, and it can reinforce and reproduce positions of domination and subordination. Although there are theoretical and conceptual treatments of othering in the literature, researchers lack sufficient examples of othering practices that influence the interactions between patients and health care providers. The purpose of this study was to explore the interactions between health care providers and South Asian immigrant women to describe othering practices and their effects. Ethnographic methods were used involving in-depth interviews and focus group discussions. The analysis entailed identifying uses of othering and exploring the dynamics through which this process took place. Women shared stories of how discriminatory treatment was experienced. The interviews with health care professionals provided examples of how views of South Asian women shaped the way health care services were provided. Three forms of othering were found in informants' descriptions of their problematic health care encounters: essentializing explanations, culturalist explanations, and racializing explanations. Women's stories illustrated ways of coping and managing othering experiences. The analysis also revealed how individual interactions are influenced by the social and institutional contexts that create conditions for othering practices. To foster safe and effective health care interactions, those in power must continue to unmask othering practices and transform health care environments to support truly equitable health care.
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Othering and being othered in the context of health care ser.
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... According to Brotman (194), the strength of filial piety is often referenced by healthcare providers as a way to shift the responsibility of care onto family members, which can have detrimental effects on both caregivers and older adults. Othering is a pattern of differentiation and marginalisation based on identities that depart from the norm, impacting how individuals perceive and treat those who are viewed as belonging to the "in-group" as opposed to those who are viewed as belonging to the "out-group" (194)(195)(196). In our study, participants specifically detailed the occurrences of othering they experienced, which involved the dismissal of healing practices from their cultural heritage, such as Ayurveda. ...
... Health researchers, practitioners, and decision-makers in Canada should not shy away from addressing the complexities of racism in combination with other "isms" (220,221). To cater to the needs of racialized immigrant older adults, it is crucial to offer a diverse array of healthcare options, including "non-Western" systems that have been and continue being "othered" (196,222). Embracing diversity and finding innovative solutions to longstanding healthcare challenges requires challenging the prevailing dominance of the biomedical model of health and research (223,224). It is also important to move beyond an exclusive emphasis on assimilation theories, since they center around whiteness and focus on how immigrants of color become more similar or distant from the dominant group, middle-class white people, over time (225)(226)(227)(228)(229)(230). ...
“When in Rome…”: structural determinants impacting healthcare access, health outcomes, and well-being of South Asian older adults in Ontario using a multilingual qualitative approach
Article
Full-text available
  • Dec 2024
With the increase in international migration, the need for an equitable healthcare system in Canada is increasing. The current biomedical model of healthcare is constructed largely in the Eurocentric tradition of medicine, which often disregards the diverse health perspectives of Canada’s racialized immigrant older adults. As a result, current healthcare approaches (adopted in the US and Canada) fall short in addressing the health needs of a considerable segment of the population, impeding their ability to access healthcare services. This study aimed to identify and understand the structural and systemic factors that influence healthcare experiences and well-being among South Asian older adults in Ontario, addressing a significant gap in empirical and theoretical knowledge in the Canadian context. We conducted in-depth individual and dyadic interviews (n = 28) utilizing a descriptive multilingual cross-cultural qualitative approach. Through this research, participants expressed that their understanding of well-being does not align with that of their healthcare providers, resulting in unmet health needs. Our study uses an intersectional lens to demonstrate participants’ perceptions of virtual access to care and systemic factors, such as mandatory assimilation and whiteness as a taken-for-granted norm impacting the health and well-being of South Asian older adults. The findings of this research can offer valuable insights to healthcare providers and policymakers in developing culturally competent practices, guidelines, and training policies that effectively address the healthcare needs of the South Asian population in Canada.
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... This is advanced through Foucault's concept of Biopower, whereby the state or authority uses ideas around the body to assert what is healthy or normal for it to do, through this it creates a division between those considered normal and right, and those who are other and strange (Foucault, 1978). This concept can be tied back to the othering of women and racialised peoples as state institutions like medical practices historically have treated the white man as the standard and other bodies have suffered at their secondary class within medical practices (Johnson et al, 2004). These frameworks are important to acknowledge when discussing marginalised peoples' experience today on social media as the harassment and hate speech that is targeted towards them has not come out of a vacuum. ...
“I Ran to the Comments”: Social Media Culture, Hate-Speech, and Hyperreality
Article
Full-text available
  • Feb 2025
While social media has allowed our world to become more interconnected and informed on global issues than ever. It has also aroused much criticism in the way it facilitates unrestricted hate-speech and violent rhetoric, especially towards historically oppressed groups. While the abundance of hate-speech online may be credited to the facelessness facilitated by internet profiles that negates accountability, this essay argues that there is a more cognitive and deeper explanation for how people are able to engage so violently with one another online. It will explain this through the framework of Baudrillard’s “Simulacra and Simulation”, elaborating that this discourse on social media exists within a hyperreality in which people are trained to jump to comment in a discriminatory way as soon as they witness the existence of a represents historical traits of otherness. The essay situates this idea of otherness in literature concerning the social architecture of gender, race and sexuality. Due to this process of reproduction of information, people are able to comment so aggressively as they are not witnessing another human being but instead, through the hyperreality they are only witnessing an image of a historically category of other, and thus they do not authentically engage with what they see but instead play into the simulation.
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... 9 This may reflect 'othering', which singles out individuals who differ from the norm. 10 Despite WRES setting out quality improvement indicators, significant inequalities still exist. 6 The RCPsych has highlighted the negative experiences of BAME doctors. ...
Black psychiatrists' experience of discrimination and related behaviours in the workplace: UK survey
Article
Full-text available
  • Feb 2025
Aims and methodIn the UK, Black doctors experience higher levels of discrimination, bullying and harassment compared with other doctors. This study aims to explore the impact of this on perceived well-being and mental health. A UK survey of 109 Black psychiatrists asked about racism, othering, microaggressions, bullying and harassment, plus any links to career progression or mental well-being. ResultsSixty-three survey participants (57.8%) had faced workplace microaggressions, 44 (40.4%) had experienced workplace bullying and 41 (37.6%) had faced workplace harassment. Forty-seven (43.1%) participants reported a detrimental impact on their mental health, with 35 (32.1%) considering quitting and 24 (22%) reporting a poorer work performance. Clinical implicationsThese experiences are unacceptable and can be traumatic. The impact of racism and discrimination can also undermine effective service delivery. Barriers to reporting can prolong mistreatment and deter professional aspirations among Black psychiatrists. Collective action is needed to drastically improve the workplace environment, including the widespread institutional adoption of an anti-discriminatory stance.
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... At its most destructive, othering is part of the zero-sum process of individual and collective self-realization and identity formation by the 'in-group' achieved through genocide (Holslag, 2015). Othering also appears in contemporary healthcare directed at specific and often intersecting patient cohorts, such as people experiencing poverty, gender, age, and race-related discrimination in ways that can adversely -and sometimes lethally -impact the quality of care they receive (Akbulut & Razum, 2022;Browne et al., 2022;Chochinov, 2022;Gallagher et al., 2020;Johnson et al., 2004;Peña-Guzmán & Reynolds, 2019). It features in the ableism that leads healthcare professionals to perceive the lives of people with disabilitiesincluding the elderly, terminally or chronically ill -to be of lower quality or value (Atkins, 2023;Chochinov, 2022;Janz, 2023;Kothari, 2004;van Dyk, 2016;Walton & Lazzaro-Salazar, 2016). ...
Human misconnection? A response to Beuthin and Bruce on medical assistance in dying providers' lived experience
Article
Full-text available
Beuthin and Bruce's study 'MAiD as human connection: Stories and metaphors of physician providers existential lived experience' in this journal describes the affective experiences of Canadian Medical Assistance in Dying (MAiD) providers. A critical response to this work shows it is based on flawed premises and interpretations of its data, which centers on praising its participants in lethal injection for their very positive emotions. Their study also seems to unproblematically construct people dying by MAiD as "the other, " a term that usually describes members of groups subject to individual and systemic oppression. Contextualized, their paper can be read to show how some MAiD providers may affectively and financially benefit from providing death to, and at the expense of, their suffering patients and grieving and possibly traumatized family members and witnesses. Beuthin and Bruce's study sheds new light on the provider side of MAiD and assists the case for vetting and setting suitability criteria for MAID clinicians.
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Migration and Women's Health Research (2000−2023): A bibliometric analysis of trends and gaps
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  • Mar 2025
This bibliometric study examines the scholarly landscape of migration and women’s health, analyzing 1314 Scopus-indexed articles from 462 journals published between 2000 and 2023. Findings indicate a consistent increase in research output, reflecting growing global interest in this interdisciplinary field. Geographically, high-income countries (HICs), including the United States, Canada, the United Kingdom, and Australia, dominate contributions, while low- and middle-income countries (LMICs) remain underrepresented despite hosting significant migrant populations. International collaborations play a crucial role, with key institutions such as the University of California and the London School of Hygiene and Tropical Medicine shaping research efforts. The keyword co-occurrence analysis highlights migration, gender dynamics, mental health, and reproductive health as dominant themes. Persistent gaps in mental and reproductive healthcare access for migrant women emphasize the need for trauma-informed care (TIC), mobile bilingual healthcare services, and inclusive health policies. Disparities in research funding further exacerbate global health inequities, underscoring the necessity of equitable redistribution of resources, including redirecting at least 10 % of HIC research grants to LMIC-led studies. The COVID-19 pandemic magnified pre-existing vulnerabilities, stressing the importance of multilateral collaborations and sustainable policy interventions to enhance migrant healthcare access. This study provides valuable insights into research trends, collaboration networks, and thematic focus areas, offering a foundation for future interdisciplinary research and evidence-based policymaking aimed at promoting health equity for migrant women globally.
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This report of a study of 47 South Asian women who were recent immigrants to Canada reveals that these women face many challenges in settling in the new country and barriers to the receipt of social services. The findings emphasize the need to understand these women's experiences within the framework of the intersecting diver sities of race, gender, and class and to develop culturally and linguis tically sensitive social work policies and practice.
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This paper is concerned with the way in which discussions of the health status of people from minority ethnic groups and the delivery of health care to such groups has been constructed, in the nursing literature in particular, within a culturalist framework which has many serious drawbacks The paper reviews the argument for a ‘multicultural’ approach to health care and also discusses some of the main implications of this analysis for the education of health professionals It suggests that health workers and those responsible for the education of such workers, need to reassess learning needs in the light of a critique of the effects of an analysis based on ‘cultural pluralism’ and ‘ethnic sensitivity’ The paper suggests ways in which the nursing curriculum must be broadened to take into account the limitations of a culturalist approach and to debate the interplay of racism and other structures of inequality and their influence on health and on service delivery
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