Ethnicity and illness experience: ideological structures and the health care delivery system

This paper analyses the experiences of Anglo-Canadian and immigrant Chinese families with a chronically ill child by using the idea that the social organization and ideology of health care services generate particular illness experiences. Immigrant families find the ideology dissonant with their customs for managing illness. The disjuncture between practices often leads to non-compliance and ineffective treatment. Health professionals explain non-compliance by the obvious facts of cultural differences, but I argue that it should be understood by institutional practices that exclude families from participating in caretaking. I maintain that patients and families should be included in decisions that affect their lives. Pressures from government to economize by increasing home care services, and the increasing number of immigrants may force practitioners to negotiate culturally acceptable care with them.