“We feel uncomfortable in most medical settings”: Perceptions of social Perceptions of social exclusion among Black men and Latinx populations Allentown, Pennsylvania

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Background: A community health needs assessment in the Lehigh Valley highlighted social isolation as a priority factor that affects the health and well-being of residents. To address social isolation and exclusion, it is relevant to first understand what this means for groups who are marginalized. Objective: To identify dimensions of social exclusion among Latinx populations and Black men in center city Allentown, PA. Methods: Using a community based participatory approach, we conducted focus groups with black men (n=10) and with Latinx individuals (n=28). The core team held meetings with stakeholders including community health, civic engagement and social service organizations, for-profit and non-profit hospitals, and churches to identify specific marginalized populations and define core research questions. These groups were brought together and facilitated by the community members - people who themselves belong to marginalized groups. Notes and transcripts were analyzed using an integrated approach to coding that consisted of both inductive and deductive techniques. Results: Three main dimensions of social exclusion were identified: individual feelings of invisibility, negative stereotypes about communities; and lack of access to resources. These themes were common for both the Black and Latinx groups. Participants reported feelings of exclusion in a broad range of settings including schools, work places, and restaurants. But these experiences were pronounced in medical settings such as hospitals and pharmacies where participants feltunwelcome. Conclusion: The medical setting is a space where marginalized populations are even more vulnerable. There is need for sustained determination to dismantle structures and practices that foster exclusion and isolation among Black and Latinx populations in these spaces. Public health implications: It is important for health care organizations to move away from treating marginalized populations and their needs as tasks that have to be done. Viewing these groups as individuals deserving of dignity, who have rights, and providing the support needed to achieve things that matter to them are important steps to reducing social exclusion and ultimately improving health.


Department of Family Medicine, Department of Family Medicine Faculty

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