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Uncovering social structures and informational prejudices to reduce inequity in delivery and uptake of new molecular technologies
  1. Sara Filoche1,
  2. Peter Stone2,
  3. Fiona Cram3,
  4. Sondra Bacharach4,
  5. Anthony Dowell5,
  6. Dianne Sika-Paotonu6,
  7. Angela Beard7,
  8. Judy Ormandy8,
  9. Christina Buchanan9,
  10. Michelle Thunders6,
  11. Kevin Dew10
  1. 1 Department of Obstetrics, Gynaecology and Women’s Health and Department of Pathology and Molecular Medicine, University of Otago, Wellington, New Zealand
  2. 2 Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand
  3. 3 Katoa Ltd, Auckland, New Zealand
  4. 4 School of History, Philosophy, Political Science and International Relations, Victoria University, Wellington, New Zealand
  5. 5 Department of Primary Health Care and General Practice, University of Otago Wellington, Wellington, New Zealand
  6. 6 Department of Pathology and Molecular Medicine, University of Otago, Wellington, New Zealand
  7. 7 Christchurch Obstetric Associates, Christchurch, New Zealand
  8. 8 Department of Obstetrics and Gynaecology, University of Otago, Christchurch, New Zealand
  9. 9 Faculty of Medical and Health Sciences, The University of Auckland, New Zealand
  10. 10 School of Social and Cultural Studies, Victoria University, Wellington, New Zealand
  1. Correspondence to Dr Sara Filoche, University of Otago, Wellington 6242, New Zealand; sara.filoche{at}otago.ac.nz

Abstract

Advances in molecular technologies have the potential to help remedy health inequities through earlier detection and prevention; if, however, their delivery and uptake (and therefore any benefits associated with such testing) are not more carefully considered, there is a very real risk that existing inequities in access and use will be further exacerbated. We argue this risk relates to the way that information and knowledge about the technology is both acquired and shared, or not, between health practitioners and their patients.

A healthcare system can be viewed as a complex social network comprising individuals with different worldviews, hierarchies, professional cultures and subcultures and personal beliefs, both for those giving and receiving care. When healthcare practitioners are not perceived as knowledge equals, they would experience informational prejudices, and the result is that knowledge dissemination across and between them would be impeded. The uptake and delivery of a new technology may be inequitable as a result. Patients would also experience informational prejudice when they are viewed as not being able to understand the information that is presented to them, and information may be withheld.

Informational prejudices driven by social relations and structures have thus far been underexplored in considering (in)equitable implementation and uptake of new molecular technologies. Every healthcare interaction represents an opportunity for experiencing informational prejudice, and with it the risk of being inappropriately informed for undertaking (or offering) such screening or testing. Making knowledge acquisition and information dissemination, and experiences of informational prejudice, explicit through sociologically framed investigations would extend our understandings of (in)equity, and offer ways to affect network relationships and structures that support equity in delivery and uptake.

  • genetic information
  • informed consent
  • Professional - professional relationship
  • quality of health care
  • sociology
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Footnotes

  • Contributors SF conceived the idea and led the writing. PS contributed to the development of the methods and writing. FC contributed to the development of the methods and writing. SB contributed to the development of the methods and writing. AD contributed to the development of the methods and writing. DS-P contributed to the development of the methods and writing. AB critically reviewed the drafts. JO critically reviewed the drafts. CB contributed to the development of the methods and writing. MT contributed to the development of the methods and writing. KD contributed to the development of the methods and writing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The work discussed in this paper is theoretical, and not derived from any study that has involved practitioner or patient recruitment, nor any patient health information. This paper is intended to promote discussion for such work to be undertaken. Neither is there any contestable funding associated with this paper, as such we did not seek ethical approval.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement There are no data in this work

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