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| 2. |
- Bradby, Hannah, 1966-, et al.
(författare)
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‘If there were doctors who could understand our problems, I would already be better’ : dissatisfactory health care and marginalisation in superdiverse neighbourhoods
- 2020
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Ingår i: Sociology of Health and Illness. - : Wiley. - 0141-9889 .- 1467-9566. ; 42:4, s. 739-757
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Tidskriftsartikel (refereegranskat)abstract
- How people in community settings describe their experience of disappointing health care, and their responses to such dissatisfaction, sheds light on the role of marginalisation and underlines the need for radically responsive service provision. Making the case for studying unprompted accounts of dissatisfaction with healthcare provision, this is an original analysis of 71 semi‐structured interviews with healthcare users in superdiverse neighbourhoods in four European cities. Healthcare users spontaneously express disappointment with services that dismiss their concerns and fail to attend to their priorities. Analysing characteristics of these healthcare users show that no single aspect of marginalisation shapes the expression of disappointment. In response to disappointing health care, users sought out alternative services and to persuade reluctant service providers, and they withdrew from services, in order to access more suitable health care and to achieve personal vindication. Promoting normative quality standards for diverse and diversifying populations that access care from a range of public and private service providers is in tension with prioritising services that are responsive to individual priorities. Without an effort towards radically responsive service provision, the ideal of universal access on the basis of need gives way to normative service provision.
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| 3. |
- Bradby, Hannah, 1966-, et al.
(författare)
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Making Gendered Healthcare Work Visible : Over-Looked Labour in Four Diverse European Settings
- 2019
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Ingår i: Social Inclusion. - : Cogitatio. - 2183-2803. ; 7:2, s. 33-43
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Tidskriftsartikel (refereegranskat)abstract
- Healthcare has long been a gendered enterprise, with women taking responsibility for maintaining health and engaging with service providers. Universal healthcare provision notwithstanding, women nonetheless undertake a range of health- care work, on their own account and on behalf of others, which remains largely invisible. As part of a multi-method com- parative European study that looked at access to healthcare in diverse neighbourhoods from the point of view of people’s own health priorities, the concept of ‘healthcare bricolage’ describes the process of mobilizing resources and overcoming constraints to meet particular health needs. Bricolage mediates between different kinds of resources to meet particular challenges and describing these processes makes visible that work which has been unseen, over-looked and naturalised, as part of a gendered caring role. Drawing on 160 semi-structured interviews and a survey with 1,755 residents of highly diverse neighbourhoods in Germany, UK, Sweden and Portugal, this article illustrates the gendered nature of healthcare bricolage. The complex variations of women’s bricolage within and beyond the public healthcare system show how gen- dered caring roles intersect with migration status and social class in the context of particular healthcare systems.
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| 4. |
- Bradby, Hannah, 1966-, et al.
(författare)
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Universalism, diversity and norms : gratitude, healthcare and welfare chauvinism
- 2020
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Ingår i: Critical Public Health. - : Taylor & Francis Group. - 0958-1596 .- 1469-3682. ; 30:2, s. 166-178
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Tidskriftsartikel (refereegranskat)abstract
- Access to universal healthcare is a normative expectation of citizens in European welfare states. As part of a comparative study of healthcare in diverse European neighbourhoods, we met women who described failures of the public healthcare system, together with gratitude for that system. Challenges to European welfare states of ageing populations, the retraction of resources available for healthcare, and globalised migration streams have been linked to xenophobic ‘welfarist’ attempts to restrict access to services for new arrivals and those seen as failing to contribute sufficiently. Stories of healthcare systems’ failure to treat symptoms, pain, and suffering in a timely and caring fashion came from eight women of non-European migrant backgrounds as part of a wider interview study in four European cities (Birmingham, Uppsala, Lisbon, Bremen). These accounts suggest that a normative aspect of welfare provision has been reproduced – that is, the expression of gratitude – despite inadequate services. Where welfarist attitudes to migration meet normative aspects of healthcare, suffering may be compounded by an expectation of gratitude. The regrettable unmet healthcare need of the eight women whose cases are presented suggests that other marginalised healthcare users may also be under-served in apparently universal healthcare systems.
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| 5. |
- Humphris, Rachel, et al.
(författare)
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After encounters : revealing patients’ unseen work through their pathways to care
- 2020
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Ingår i: International Journal of Migration, Health and Social Care. - : Emerald. - 1747-9894 .- 2042-8650. ; 16:2, s. 173-187
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Research has long focused on the notion of access and the trajectory towards a healthcare encounter but has neglected what happens to patients after these initial encounters. This paper focuses attention on what happens after an initial healthcare encounter leading to a more nuanced understanding of how patients from a diverse range of backgrounds make sense of medical advice, how they mix this knowledge with other forms of information and how they make decisions about what to do next.Design/methodology/approach: Drawing on 160 in-depth interviews across four European countries the paper problematizes the notion of access; expands the definition of “decision partners”; and reframes the medical encounter as a journey, where one encounter leads to and informs the next.Findings: This approach reveals the significant unseen, unrecognised and unacknowledged work that patients undertake to solve their health concerns.Originality/value: De-centring the professional from the healthcare encounter allows us to understand why patients take particular pathways to care and how resources might be more appropriately leveraged to support both patients and professionals along this journey.
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| 6. |
- Marchi, Mattia, et al.
(författare)
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Experience of discrimination during COVID-19 pandemic : the impact of public health measures and psychological distress among refugees and other migrants in Europe
- 2022
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Ingår i: BMC Public Health. - : Springer Nature. - 1471-2458. ; 22
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Tidskriftsartikel (refereegranskat)abstract
- Background: The COVID-19 pandemic has had a disproportionately hard impact on refugees and other migrants who are often exposed to the virus with limited means to protect themselves. We tested the hypothesis that during the COVID-19 pandemic, refugees and other migrants have suffered a negative impact on mental health and have been unjustly discriminated for spreading the disease in Europe (data collection from April to November 2020).Methods: Participants in the ApartTogether Survey (N = 8297, after listwise deletion of missing items final N = 3940) provided data regarding to their difficulties to adhere to preventive recommendations against COVID-19 infection (CARE), self-perceived stigmatization (SS), and psychological distress (PD). Structural Equation Modeling was used to investigate PD as a mediator in the pathway linking CARE to SS, while adjusting for the housing and residence status. To improve confidence in the findings, single hold-out sample cross-validation was performed using a train/test split ratio of 0.8/0.2.Results: In the exploratory set (N = 3159) SS was associated with both CARE (B = 0.200, p < 0.001) and PD (B = 0.455, p < 0.001). Moreover, PD was also associated with CARE (B = 0.094, p = 0.001) and mediated the effect of CARE on SS (proportion mediated = 17.7%, p = 0.001). The results were successfully replicated in the confirmation set (N = 781; total effect = 0.417, p < 0.001; proportion mediated = 29.7%, p < 0.001). Follow-up analyses also found evidence for an opposite effect (i.e., from SS to CARE, B = 0.132; p < 0.001), suggesting that there might be a vicious circle between the self-perceived stigmatization and the access to health care and the use of preventive measures against COVID-19 infection.Conclusions: Refugees and other migrants who had more difficulties in accessing health care and preventive measures against COVID-19 infection experienced worse mental health and increased discrimination. These negative effects appeared to be stronger for those with more insecure housing and residence status, highlighting from one side the specific risk of insecure housing in the impact of COVID-19 upon mental health and infection protection, and for another side the need to proper housing as a strategy to prevent both COVID-19 and mental distress.
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| 8. |
- Pemberton, Simon, et al.
(författare)
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Access to healthcare in superdiverse neighbourhoods
- 2019
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Ingår i: Health and Place. - : Elsevier BV. - 1353-8292 .- 1873-2054. ; 55, s. 128-135
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Tidskriftsartikel (refereegranskat)abstract
- To date little attention has been focused on how the differing features of ‘superdiverse’ neighbourhoods shape residents’ access to healthcare services. Through utilising a cross-national mixed-methods approach, the paper highlights how defining features of superdiverse neighbourhoods - ‘newness’, ‘novelty’ and ‘diversity’ - influence a number of neighbourhood ‘domains’ and ‘rules of access’ that regulate access to healthcare. Issues of uncertainty, affordability, compliance, transna- tionalism and the diversity of community and local sociability are identified as being particularly significant, but which may vary in importance according to the nationality, ethnicity and / or religion of particular individuals.
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| 9. |
- Phillimore, Jenny, et al.
(författare)
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Bricolage as conceptual tool for understanding access to healthcare in superdiverse populations
- 2019
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Ingår i: Social Theory & Health. - : Springer Science and Business Media LLC. - 1477-8211 .- 1477-822X. ; 17:2, s. 231-252
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Tidskriftsartikel (refereegranskat)abstract
- This paper applies, for the first time, the concept of bricolage to understand the experiences of superdiverse urban populations and their practices of improvisation in accessing health services across healthcare ecosystems. By adopting the concept of healthcare bricolage and an ecosystem approach, we render visible the agency of individuals as they creatively mobilise, utilise, and re-use resources in the face of constraints on access to healthcare services. Such resources include multiple knowledges, ideas, materials, and networks. The concept of bricolage is particularly useful given that superdiverse populations are by definition heterogeneous, multilingual and transnational, and frequently in localities characterised as "resource-poor", in which bricolage may be necessary to overcome such constraints, and where mainstream healthcare providers have limited understanding of the challenges that populations experience in accessing services. The "politics of bricolage" as neoliberal strategies of self-empowerment legitimising the withdrawal of the welfare state are critically discussed. Conflicting aspects of bricolage are made explicit in setting out tactics of relevance to researching the practices of bricolage.
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| 10. |
- Phillimore, Jenny, et al.
(författare)
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Exploring Welfare Bricolage in Europe's Superdiverse Neighbourhoods
- 2021
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Migration-driven diversity means European cities are becoming increasingly superdiverse. Some European neighbourhoods have become places where newcomers arrive from across the world, speaking many different languages, from a range of socio-economic backgrounds and with diverse religious beliefs and practices, while living alongside long-established migrant and white European populations. This book focuses on what this increasing population diversity means for how people and local health and welfare service providers seek to address everyday health concerns – from minor and chronic conditions to acute and urgent problems.Using an innovative mixed-method approach crossing multiple disciplines and drawing together rich qualitative and robust quantitative data, this book offers unique insight into the complex and intricate actions, which often vary over space and time, implemented by both residents and care providers from eight superdiverse localities in four European countries, each with different health and welfare traditions. The book introduces the concept of welfare bricolage, using it as a mechanism to explore the structures and rationales underpinning need and actions, and how resources are connected across welfare regimes and borders and within locales. The book illustrates how, in the face of increasingly marketised, cash-strapped, restrictive and institutionally racist welfare states and healthcare regimes, individuals and service providers strive to address need.By focusing on welfare regimes, migration histories, everyday actions and resources within neighbourhoods, Exploring Welfare Bricolage in Europe’s Superdiverse Neighbourhoods offers a unique insight into what people and providers actually do when faced with health concerns. The book highlights the role of structure and agency and moves beyond conventional approaches that focus on specific groups or sectors to research health and welfare by looking at whole populations and entire welfare ecosystems. The book’s theoretical, methodological and empirical contributions will be of use to scholars, practitioners and policymakers interested in welfare, healthcare, diversity and migration.
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