Aboriginal women's experiences seeking help in an urban emergency department

Many Aboriginal women living in inner city areas are affected by structural inequities, racialization and other marginalizing practices, which in turn affect their health and access to health services. It is against this backdrop that some Aboriginal women seek help at emergency departments for health issues that, ostensibly, could be addressed in community-based primary care settings. The purpose of this study was to explore the social and political contexts of access to primary care from the perspective of Aboriginal women who attended an emergency department for health issues triaged as stable and non-urgent. It is anticipated that the findings of this study will be used to inform strategies for improving primary care services, in particular for Aboriginal women living in urban areas. This study involved a secondary analysis of interviews gathered during a larger ethnographic study. It was decided a subset consisting of all 13 Aboriginal women’s interviews from the primary study would be analyzed. In keeping with a critical cultural perspective, cultural safety was used as an analytical lens to examine the social contexts and influences that led Aboriginal women in this study to seek care at an emergency department for health concerns that were triaged as stable and non-urgent. The tensions Aboriginal women experienced in this study while seeking care were also explored. Using the methodology of interpretive description as a guide for analysis, four central themes were discussed. The four themes consisted of: 1) needing a safe place to live, 2) negotiating pain management, 3) seeking help against a backdrop of violence and trauma, and 4) the perception of discrimination and the awareness of how one will be read during health care encounters. These findings have implications for understanding the influences that shape health care experiences, the role of the emergency department in relation to primary health care, minimizing the potential for emotional trauma and structural violence in the emergency department, and fostering greater equity in health services.Applied Science, Faculty ofNursing, School ofGraduat