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Intersectional bias in healthcare - the inequity borne by the patients: a qualitative study
Umeå University, Faculty of Medicine, Department of Odontology. Department of Odontology, Orofacial Pain and Jaw Function Faculty of Medicine Umeå Sweden.ORCID iD: 0000-0002-1932-9610
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.ORCID iD: 0000-0002-3334-1376
Umeå University, Faculty of Medicine, Department of Odontology. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Department of Odontology, Orofacial Pain and Jaw Function Faculty of Medicine Umeå Sweden;Department of Community Medicine and Rehabilitation Umeå University Umeå Sweden.ORCID iD: 0000-0002-4556-2846
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.ORCID iD: 0000-0002-2916-0628
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2026 (English)In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 53, no 2, p. 328-336Article in journal (Refereed) Published
Abstract [en]

Background: Care should be neutral and equal, but normative beliefs may impact the interaction between patients and healthcare professionals in pain management.

Objectives: To explore how patients with jaw and neck pain perceive pain management and the interaction with healthcare professionals in relation to intersectionality, with a specific focus on gender.

Methods: Recruitment was performed at a specialist dentistry clinic in Sweden. Inclusion criteria were patients aged 18-70 years, reporting jaw and neck pain and understanding the Swedish language. Exclusion criteria were rheumatic disease, temporomandibular joint arthralgia or arthritis. Using purposive sampling, 16 patients (11 women) aged 19-56 were interviewed using individual semi-structured interviews. The analysis was performed using thematic analysis.

Results: The analysis resulted in the theme: 'Intersectional bias in healthcare - the inequity borne by the patients', with five subthemes that entailed different types of bias related to the participants' personal characteristics and their interaction with healthcare professionals. Health-related stigmata was one subtheme described among participants, resulting in labelling and burden in the encounter. Other subthemes also described bias in relation to biological differences among pain patients and patients not being taken seriously due to, for example, female gender and younger age. Two subthemes also described bias in relation to the healthcare professionals' gender and age.

Conclusion: Normative beliefs have a negative impact on the interaction between patients and healthcare professionals in pain management. Since patient-provider interaction should be neutral and equal, intersectional bias should be acknowledged to prevent health and care inequalities.Keywords: gender differences; healthcare disparities; intersectionality; neck pain; temporomandibular joint disorders.

Place, publisher, year, edition, pages
John Wiley & Sons, 2026. Vol. 53, no 2, p. 328-336
Keywords [en]
gender differences, healthcare disparities, intersectionality, neck pain, temporomandibular joint disorders
National Category
Rehabilitation Medicine Odontology
Research subject
Odontology
Identifiers
URN: urn:nbn:se:umu:diva-245651DOI: 10.1111/joor.70088ISI: 001594702700001PubMedID: 41099478Scopus ID: 2-s2.0-105019255564OAI: oai:DiVA.org:umu-245651DiVA, id: diva2:2006976
Funder
Region Västerbotten, RV‐909851Region Västerbotten, RV‐990480Swedish Dental AssociationAvailable from: 2025-10-16 Created: 2025-10-16 Last updated: 2026-03-23Bibliographically approved

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Böthun, AliciaFjellman-Wiklund, AnncristineHellström, FredrikStålnacke, Britt-MarieHäggman-Henrikson, BirgittaLövgren, Anna

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Böthun, AliciaFjellman-Wiklund, AnncristineHellström, FredrikStålnacke, Britt-MarieHäggman-Henrikson, BirgittaDurham, JustinLövgren, Anna
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Department of OdontologySection of PhysiotherapyDepartment of Community Medicine and RehabilitationRehabilitation Medicine
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