Understanding social inequalities in cardiac treatment through the lens of cultural health capital: a study of Danish socially disadvantaged ischemic heart patients’ lived experiences of healthcare interactions

Socially disadvantaged ischemic heart patients are more likely to report poor patient satisfaction and problematic patient-provider communication than patients without social disadvantages. These inequalities are often understood with the use of concepts emphasising the individual’s cognitive abilities, such as health literacy. This study aims to explore Danish socially disadvantaged ischemic heart patients’ lived experiences of healthcare interactions through the lens of cultural health capital, and thereby further our understanding of more underlying structural, social and interpersonal factors shaping social inequalities in cardiac treatment. The study was carried out as a nationwide critical hermeneutic study in Denmark between October 2018 and August 2019. Data consist of qualitative interviews with 30 participants and supplementary observations. The findings showed that the healthcare interactions were characterised by unequal power balances. The healthcare professionals dominated the norms of the clinical encounter and thereby what kind of cultural health capital that held the highest exchange value. Furthermore, the participants felt inferior compared to patients with a higher social status who managed to display valued parts of the cultural health capital, and thereby receive more attentive treatment. The findings indicate that treatment of this group of patients should acknowledge the patients’ habitus and life circumstances.