Occasioned membership categorization in a transnational medical consultation: Interaction, marginalization, and health disparities.

The purpose of this paper is the identification of linguistic features that work to co‐construct identities and meaning making processes in a transnational medical consultation. Health scholarship has demonstrated that the medical consultation is essentially an interview that tends to be controlled by the medical provider. However, this paper demonstrates that the epistemic status and stance attributed to the patient and the provider can affect the interaction as can the introduction of a third party and multiple languages. Data analyzed in this paper come from a consultation in a low‐income community clinic in Southern California that involves a monolingual Spanish‐speaking patient, her Spanish–English bilingual daughter, and a Spanish–English bilingual nurse practitioner. Data analysis methodology includes membership categorization analysis (MCA) and interactional sociolinguistics (IS). Findings reveal that occasioned membership categories develop micro‐interactionally, which affect how meaning is negotiated within the interaction and the quality of care that the patient receives. Language choice, prosody, phrase choice, paralinguistic signs, and participation framework contribute to the co‐construction of occasioned membership categories. Implications include the need to attend to how the participation framework and occasioned membership categories may contribute to health disparities for transnational populations. [ABSTRACT FROM AUTHOR]