Dean of the College and Sociology Program Present
Convenient Disasters: Resource Shortages as Exclusion Opportunities in Racialized Hospitals
Monday, November 28, 2022
Olin 102
5:00 pm – 6:30 pm EST/GMT-5
5:00 pm – 6:30 pm EST/GMT-5
Alexandra Brewer, PhD, Assistant Professor of Sociology, Wake Forest University
A broad literature demonstrates profound inequalities by race, ethnicity, and socioeconomic status inhealth outcomes in the U.S. Integrating insights from theories of racialized organizations and
inhabited institutions, I show how hospital-based clinicians legitimate unequal care and thereby
produce inequalities in health. To do this, I leverage the case of pain management and a sudden,
U.S.-wide shortage of intravenous (IV) opioids. Drawing on a 21-month hospital ethnography
conducted both before and during the shortage, I demonstrate that evidence-based medicine existed
in tension with clinicians’ negative emotional and material experiences of providing IV opioids to
their primarily Black and low-income pain patients. These negative work experiences were, in turn,
shaped by financial pressures in healthcare. Rather than interpreting the IV opioid shortage as a
disaster because it challenged their ability to adhere to professional standards around pain
management, clinicians largely embraced it as a convenience because it provided a new, legitimate
framework through which they could exclude “undeserving” pain patients from opioids and other
hospital resources in ways that had previously been seen as desirable, but not justifiable. Through
this case study, I show that clinicians may allocate medical resources unequally because the exclusion
of disadvantaged groups appears to solve problems in their daily work life. I extend this case to
consider the reproduction of inequalities in other workplaces and organizations.
For more information, call 845-758-7662, or e-mail [email protected].
Time: 5:00 pm – 6:30 pm EST/GMT-5
Location: Olin 102