Beyond addiction: the medicalization of poverty in the treatment of chronic pain
Bibliographic record
Abstract
Our team conducted an Institutional ethnography, including qualitative interviews, observations, and textual analysis of relevant documents, of physicians’ work in managing patients with chronic pain in Ontario Canada. We interviewed over 60 participants, including primary care providers (physicians, nurses, nurse practitioners, and allied health professionals). We applied the theoretical lens of medicalization of poverty to analyze our findings. The concept of medicalization has been used to refer to the process by which problems, experiences or issues become defined as primarily medical in nature, thus requiring the skill and expertise of medicine to correct. The known problems associated with poverty – poor health outcomes, mental health issues and addiction, to name but a few – are now increasingly managed by physicians and more importantly are viewed as being within the purview of physicians to “treat”. This medicalization of poverty is problematic because it is based on a model of individual responsibility for one's health.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.014 | 0.033 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.001 | 0.007 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".