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- Title
Why Self-Care Fails: Implementing Policy at a Low-Income Sickle Cell Clinic.
- Authors
Ragins, Arona I.
- Abstract
This paper addresses health care service delivery-its practice and its meanings-to a low income African-American population. Drawing on fieldwork and interviews at a sickle cell clink, I explain why assumptions in the literature on self-care do not apply to a population historically excluded from access to health services. Self-care, a practice in which the individual assumes primary responsibility for health care, is typically seen as empowering patients and reducing the use of professional health services. While these predictions may apply to white, middle-class populations, they were not borne out in the low-income African-American population I studied. Self-care did not increase client control, nor was it associated with sparing use of health services. In this paper I explain why this was the case. I argue that conditions of poverty and the meanings clients attach to self-care impinge upon the implementation of policy producing results directly contrary to those that are predicted.
- Subjects
MEDICAL care; INCOME; AFRICAN Americans; PATIENTS; POVERTY; SICKLE cell anemia
- Publication
Qualitative Sociology, 1995, Vol 18, Issue 3, p331
- ISSN
0162-0436
- Publication type
Article
- DOI
10.1007/BF02393346