Mobilizing Interference as Methodology and Metaphor in Disability Arts Inquiry

This article interrogates the limits and possibilities of interference as methodology and metaphor in video-based research aiming to disrupt ableist understandings of disability that create barriers to health care. We explore the overlapping terrain of diffractive and interference methodologies, teasing apart the metaphorical-material uses and implications of interference for video-makers in our project. Using the digital/multimedia stories created and an interview as research artifacts, we illuminate how interference manifested in disabled makers’ lives, how interference operated through the research apparatus, and how the videos continue to hold agency through their durability in the virtual realm. Drawing on feminist post-philosophies of matter (Barad) and use (Ahmed), we argue that the videos disrupt the gaze that fetishizes disabled bodies, thereby interfering with cultural-clinical processes that abnormalize disability. The research apparatus interfered with makers’ subjectivities yet also brought people together to generate something new—a community that creates culture and contests its positioning as marginal.

State-Level Sexism and Women’s Health Care Access in the United States: Differences by Race/Ethnicity, 2014–2019

Objectives. To quantify racial/ethnic differences in the relationship between state-level sexism and barriers to health care access among non-Hispanic White, non-Hispanic Black, and Hispanic women in the United States. Methods. We merged a multidimensional state-level sexism index compiled from administrative data with the national Consumer Survey of Health Care Access (2014–2019; n = 10 898) to test associations between exposure to state-level sexism and barriers to access, availability, and affordability of health care. Results. Greater exposure to state-level sexism was associated with more barriers to health care access among non-Hispanic Black and Hispanic women, but not non-Hispanic White women. Affordability barriers (cost of medical bills, health insurance, prescriptions, and tests) appeared to drive these associations. More frequent need for care exacerbated the relationship between state-level sexism and barriers to care for Hispanic women. Conclusions. The relationship between state-level sexism and women’s barriers to health care access differs by race/ethnicity and frequency of needing care. Public Health Implications. State-level policies may be used strategically to promote health care equity at the intersection of gender and race/ethnicity. (Am J Public Health. Published online ahead of print September 2, 2021: e1–e10. https://doi.org/10.2105/AJPH.2021.306455 )

Factors associated with access to health care among foreign residents living in Aichi Prefecture, Japan: secondary data analysis

Background In Japan, foreign residents, and particularly new arrivals in the country, experience barriers to health care and show poorer health outcomes when compared to Japanese nationals. The health-care-related situation for foreign residents in Japan has been characterized by drastic changes over time; thus, there is difficulty identifying individuals who are “left behind” by the system. In this study, we aimed to identify, among foreign residents who attended informal free medical consultations, factors associated with “being advised to visit a medical facility” and “being referred to a medical facility,” which represented hypothetical proxy indicators of barriers to health care. Methods Secondary data analyses were conducted using the activity records of a non-governmental organization that provides free consultations targeting foreign residents in various locations in Aichi Prefecture, Japan. Participant characteristics, including insurance coverage, were determined. Bivariate and multi-variate analyses were performed to identify factors associated with having barriers to health care. Results Among 608 extracted cases, 164 (27.5%) cases were advised to visit a medical facility, and 72 (11.8%) were referred to a medical facility during the consultations. Those who were not covered by public insurance showed a 1.56-time (95% confidence interval [CI]: 1.19–2.05) higher prevalence of being advised to visit a medical facility when compared to those who were covered by public insurance. Unemployed people and students were more likely to be referred to a medical facility than were professional workers; the prevalence ratios were 3.28 (95% CI: 1.64–6.57) and 2.77 (95% CI: 1.18–6.46), respectively. Conclusions Although the majority were insured, almost 30% were advised to visit a medical facility, which implied that they had had limited access to the formal health-care system before availing of the free consultations. The findings highlight those uninsured, unemployed people and students, who are considered vulnerable to access to health care. It is vital to provide those who are vulnerable with the necessary support while updatinge evidence, so that no one is “left behind.”

Associated factors of access to health care among foreign residents living in Aichi Prefecture, Japan: Secondary data analysis of informal free consultations organized by a non-governmental organization

Background In Japan, foreign residents, and particularly new arrivals in the country, experience barriers to health care and show poorer health outcomes when compared to Japanese nationals. The health-care-related situation for foreign residents in Japan has been characterized by drastic changes over time; thus, there is difficulty identifying individuals who are “left behind” by the system. In this study, we aimed to identify, among foreign residents who attended informal free medical consultations, factors associated with “being advised to visit a medical facility” and “being referred to a medical facility,” which represented hypothetical proxy indicators of barriers to health care. Methods Secondary data analyses were conducted using the activity records of a non-governmental organization that provides free consultations targeting foreign residents in various locations in Aichi Prefecture, Japan. Participant characteristics, including insurance coverage, were determined. Bivariable and multi-variable analyses were performed to identify factors associated with having barriers to health care. Results Among 608 extracted cases, 81.7% were covered by Japanese public insurance, and insurance coverage was associated with sex and region of origin. During the consultations, 164 (27.5%) cases were advised to visit a medical facility, and 72 (11.8%) were referred to a medical facility. Those who were not covered by public insurance showed a 1.56-times (95% confidence interval [CI]: 1.19–2.05) higher prevalence of being advised to visit a medical facility when compared to those who were covered by public insurance. Unemployed people and students were more likely to be referred to a medical facility than were professional workers; the prevalence ratios were 3.28 (95% CI: 1.64–6.57) and 2.77 (95% CI: 1.18–6.46), respectively. Conclusions Information from the non-governmental organization revealed the diversity of foreign residents who require informal health-care-related consultations. Although the majority were insured, almost 30% were advised to visit a medical facility, which implied that they had had limited access to the formal health-care system before availing of the free consultations. The findings highlight specific groups who may be vulnerable, and it is important to provide these groups with the necessary support, based on updated evidence, to ensure that no one is “left behind.”