{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:15:01Z","timestamp":1777932901403,"version":"3.51.4"},"reference-count":15,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2014,2,18]],"date-time":"2014-02-18T00:00:00Z","timestamp":1392681600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Qual Health Res"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:p>I examined the experiences of 27 individuals who frequented a homeless shelter in Toronto, Canada. Participants\u2019 personal accounts led to cumulative understandings of the exclusionary practices that are often perpetuated by institutional organizations. Many individuals perceived themselves as \u201cpushed out\u201d or excluded by the structures of health care services that purported to support and serve them. However, individuals were also perceived as active agents in a complex, mutual form of exclusion, referred to as \u201cmutually established exclusion,\u201d in which they chose to drop out or remove themselves from institutional mainstream services. Individuals who had chosen not to seek reissuance of their health cards either implicitly or explicitly self-excluded from participation in services that might be seen to regulate, control, and thereby subordinate their interests to those of the dominant institution. I ask, How are institutional health policies evidenced in the everyday, material lives of people? Are such policies exclusionary?<\/jats:p>","DOI":"10.1177\/1049732314523504","type":"journal-article","created":{"date-parts":[[2014,2,19]],"date-time":"2014-02-19T00:21:49Z","timestamp":1392769309000},"page":"366-374","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Are Institutional Health Policies Exclusionary?"],"prefix":"10.1177","volume":"24","author":[{"given":"Naomi Rebecca","family":"Hughes","sequence":"first","affiliation":[{"name":"University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2014,2,18]]},"reference":[{"key":"bibr1-1049732314523504","volume-title":"The street health report: A study of the health status and barriers to health care of homeless women and men in the city of Toronto","author":"Ambrosio E.","year":"1992"},{"key":"bibr2-1049732314523504","volume-title":"Mapping social relations: A primer in doing institutional ethnography","author":"Campbell M.","year":"2002"},{"key":"bibr3-1049732314523504","unstructured":"Cowan L., Hwang S., Khandor E., Mason K. (2007). The street health report. Toronto, ON, Canada: Street Health. Retrieved from http:\/\/wellesleyinstitute.com\/files\/tohomelessupdatesept2006.pdf"},{"key":"bibr4-1049732314523504","volume-title":"The research act","author":"Denzin N.","year":"1978"},{"key":"bibr5-1049732314523504","volume-title":"Institutional ethnography as practice","author":"DeVault M. L.","year":"2006"},{"key":"bibr6-1049732314523504","volume-title":"Panel conducted at the International Conference of the Human Development and Capacity Association","author":"Drydyk J.","year":"2006"},{"key":"bibr7-1049732314523504","volume-title":"Pedagogy of the oppressed","author":"Freire P.","year":"1970"},{"key":"bibr8-1049732314523504","volume-title":"The interpretation of cultures","author":"Geertz C.","year":"1973"},{"key":"bibr9-1049732314523504","volume-title":"Literacy: Reading the word and the world","author":"Giroux H.","year":"1987"},{"key":"bibr10-1049732314523504","doi-asserted-by":"crossref","unstructured":"Hwang S., Ueng J., Chiu S., Kiss A., Tolomiczenko G., Cowan L.Redelmeier D. (2010). Universal health insurance and health care access for homeless persons. American Journal of Public Health, 100, 1454\u20131461. Retrieved from http:\/\/ajph.aphapublications.org\/cgi\/content\/abstract\/100\/8\/1454","DOI":"10.2105\/AJPH.2009.182022"},{"key":"bibr11-1049732314523504","volume-title":"The methodological dilemma: Creative, critical and collaborative approaches to qualitative research","author":"Ng R.","year":"2008"},{"key":"bibr12-1049732314523504","unstructured":"Ontario Health Insurance Plan. (n.d.). Ontario Health Insurance Program information Web site. Retrieved from www.health.gov.on.ca\/english\/public\/program\/ohip\/ohip_mn.html"},{"key":"bibr13-1049732314523504","first-page":"1412","volume":"154","author":"Shu A.","year":"1996","journal-title":"Canadian Medical Association Journal"},{"key":"bibr14-1049732314523504","volume-title":"Institutional ethnography: A sociology for people","author":"Smith D.","year":"2005"},{"key":"bibr15-1049732314523504","volume-title":"Institutional ethnography as practice","author":"Smith G.","year":"2006"}],"container-title":["Qualitative Health Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1049732314523504","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1049732314523504","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1049732314523504","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T01:33:25Z","timestamp":1777685605000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1049732314523504"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,2,18]]},"references-count":15,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2014,3]]}},"alternative-id":["10.1177\/1049732314523504"],"URL":"https:\/\/doi.org\/10.1177\/1049732314523504","relation":{},"ISSN":["1049-7323","1552-7557"],"issn-type":[{"value":"1049-7323","type":"print"},{"value":"1552-7557","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,2,18]]}}}