Understanding healthcare practices in superdiverse neighbourhoods and developing the concept of welfare bricolage: Protocol of a cross-national mixed-methods study

BMC International Health and Human Rights

Hajo Zeeb⁴  Simon Pemberton⁵  Sin Yi Cheung⁷  Tilman Brand⁶  Beatriz Padilla⁸  Michi Knecht³  Hannah Bradby¹  Jenny Phillimore² 

[1] Department of Sociology, Uppsala University, Uppsala, Se-751 26, Sweden;Institute for Research into Superdiversity (IRiS), School of Social Policy, University of Birmingham, Edgbaston, Birmingham B15 2TT, Great Britain;Department of Anthropology and Cultural Research, University of Bremen, Enrique-Schmidt-Straße 7, Bremen, 28359, Germany;Health Sciences Bremen, University of Bremen, Bremen, Germany;Keele University, Keele, Staffordshire ST5 5UK, Great Britain;Leibniz Institute for Prevention Research and Epidemiology - BIPS GmbH, Achterstraße 30, Bremen, D-28359, Germany;School of Social Sciences, Cardiff University, King Edward VII Avenue, Cardiff CF10 3W, Great Britain;Interdisciplinary Centre of Social Sciences (CICS.NOVA), University of Minho, Campus de Gualtar, Braga, 4710-057, Portugal

关键词: Bricolage;    Welfare state;    Superdiversity;    Health inequality;    Access to healthcare;   

Others  :  1218618
DOI  :  10.1186/s12914-015-0055-x

 received in 2015-04-28, accepted in 2015-06-25,  发布年份 2015

【 摘 要 】

Background

Diversity in Europe has both increased and become more complex posing challenges to both national and local welfare state regimes. Evidence indicates specific barriers for migrant, faith and minority ethnic groups when accessing healthcare. However, previous studies of health in diverse cities in European countries have mainly adopted an ethno-national focus. Taking into account the new complexity of diversity within cities, a deeper and multi-faceted understanding of everyday health practices in superdiverse contexts is needed to support appropriate healthcare provision.

Methods/Design

This protocol describes a mixed method study investigating how residents in superdiverse neighbourhoods access healthcare. The study will include participant observation and qualitative interviewing as well as a standardised health survey and will be carried out in eight superdiverse neighbourhoods – with varying deprivations levels and trajectories of change – in four European countries (Germany, Portugal, Sweden and UK). In each neighbourhood, trained polylingual community researchers together with university researchers will map formal and informal provision and infrastructures supportive to health and healthcare. In-depth interviews with residents and healthcare providers in each country will investigate local health-supportive practices. Thematic analysis will be used to identify different types of help-seeking behaviours and support structures across neighbourhoods and countries. Using categories identified from analyses of interview material, a health survey will be set up investigating determinants of access to healthcare. Complex models, such as structural equation modelling, will be applied to analyse commonalities and differences between population groups, neighbourhoods and countries.

Discussion

This study offers the potential to contribute to a deeper understanding of how residents in superdiverse neighbourhoods deal with health and healthcare in everyday practices. The findings will inform governmental authorities, formal and informal healthcare providers how to further refine health services and how to achieve equitable access in diverse population groups.

【 授权许可】

   
2015 Phillimore et al.

【 图 表 】

Fig. 1.

【 参考文献 】

• [1]Tudor-Hart J. The inverse care law. Lancet. 1971; 1(7696):405-412.
• [2]Watt G. The inverse care law today. Lancet. 2002; 360(9328):252-254.
• [3]Goddard M, Smith P. Equity of access to health care services: theory and evidence from the UK. Soc Sci Med. 2001; 53(9):1149-1162.
• [4]Bambra C, Garthwaite K, Hunter D. All things being equal: does it matter for equity how you organize and pay for health care? A review of the international evidence. Int J Health Serv. 2014; 44(3):457-477.
• [5]Uiters E, Deville W, Foets M, Spreeuwenberg P, Groenewegen PP. Differences between immigrant and non-immigrant groups in the use of primary medical care; a systematic review. BMC Health Serv Res. 2009; 9:76. BioMed Central Full Text
• [6]Norredam M, Nielsen SS, Krasnik A. Migrants’ utilization of somatic healthcare services in Europe--a systematic review. Eur J Public Health. 2010; 20(5):555-563.
• [7]Urry J. Mobilities. Polity Press, Cambridge; 2007.
• [8]Vertovec S. Super-diversity and its implications. Ethnic Racial Stud. 2007; 30(6):1024-1054.
• [9]Routledge international handbook of diversity studies. Routledge, London and New York; 2015.
• [10]Hollinger D. Postethnic America: beyond multiculturalism. Basic Books, New York; 1995.
• [11]Bradby H. Describing ethnicity in health research. Ethn Health. 2003; 8(1):5-13.
• [12]Bhopal RS. Research agenda for tackling inequalities related to migration and ethnicity in Europe. J Public Health (Oxf). 2012; 34(2):167-173.
• [13]Robinson D, Reeve K, Casey R. The housing pathways of new migrants. Joseph Rowntree Foundation, York; 2007.
• [14]Boschmann S. Residential segregation and interethnic contact in the Netherlands. Urban Stud. 2012; 34(2):353-367.
• [15]Laurence J. “Hunkering down or hunkering away?” The effect of community ethnic diversity on residents’ social networks. J Elect Public Opin Parties. 2013; 23(3):255-278.
• [16]Mielck A, Kiess R, von dem Knesebeck O, Stirbu I, Kunst AE. Association between forgone care and household income among the elderly in five Western European countries - analyses based on survey data from the SHARE-study. BMC Health Serv Res. 2009; 9:52. BioMed Central Full Text
• [17]Eikemo TA, Hoffmann R, Kulik MC, Kulhanova I, Toch-Marquardt M, Menvielle G, Looman C, Jasilionis D, Martikainen P, Lundberg O et al.. How can inequalities in mortality be reduced? A quantitative analysis of 6 risk factors in 21 European populations. PLoS One. 2014; 9(11):e110952.
• [18]Bambra C. Health inequalities and welfare state regimes: theoretical insights on a public health ‘puzzle’. J Epidemiol Community Health. 2011; 65(9):740-745.
• [19]Bambra C, Eikemo TA. Welfare state regimes, unemployment and health: a comparative study of the relationship between unemployment and self-reported health in 23 European countries. J Epidemiol Community Health. 2009; 63(2):92-98.
• [20]Eikemo TA, Huisman M, Bambra C, Kunst AE. Health inequalities according to educational level in different welfare regimes: a comparison of 23 European countries. Sociol Health Illn. 2008; 30(4):565-582.
• [21]Esping-Anderson G. The three worlds of welfare capitalism. Princeton University Press, Princeton, NJ; 1990.
• [22]Ferrera M. The ‘southern model’ of welfare in social Europe. J European Soc Policy. 1996; 6(1):17-37.
• [23]Andreotti A, Mingione E, Polizzi E. Local welfare systems: a challenge for social cohesion. Urban Stud. 2012; 49(9):1925-1940.
• [24]Sainbury D. Immigrants’ social right rights in comparative perspective: welfare regimes, forms of immigration and immigration policy regimes. J European Soc Policy. 2006; 16(3):229-244.
• [25]Lundberg O. Commentary: Politics and public health--some conceptual considerations concerning welfare state characteristics and public health outcomes. Int J Epidemiol. 2008; 37(5):1105-1108.
• [26]van der Waal J, De Koster W, van Oorschot W. Three worlds of welfare chauvinism? How welfare regimes affect support for distributing welfare to immigrants in Europe. J Comp Soc Policy. 2013; 15(2):164-181.
• [27]Green G, Davison C, Bradby H, Krause K, Mejias FM, Alex G. Pathways to care: how superdiversity shapes the need for navigational assistance. Sociol Health Illn. 2014; 36(8):1205-1219.
• [28]Morton RL, Schlackow I, Mihaylova B, Staplin ND, Gray A, Cass A. The impact of social disadvantage in moderate-to-severe chronic kidney disease: an equity-focused systematic review. Nephrol Dial Transplant. 2015. pii: gfu394. [Epub ahead of print].
• [29]White BM, Newman SD. Access to primary care services among the homeless: a synthesis of the literature using the equity of access to medical care framework. J Prim Care Community Health. 2015;6(2):77-87. doi:. 10. 1177/2150131914556122 webcite
• [30]White J, Gutacker N, Jacobs R, Mason A. Hospital admissions for severe mental illness in England: changes in equity of utilisation at the small area level between 2006 and 2010. Soc Sci Med. 2014; 120:243-251.
• [31]Massey DE. Spatial division of labor: social structures and the geography of production. Routledge, New York; 1995.
• [32]De Certeau M. The practice of everyday day life. University of California Press, Berkeley, CA; 2011.
• [33]Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference. World Health Organization, New York; 1946.
• [34]Rice D. Beyond welfare regimes: from empirical typology to conceptual ideal types. Soc Policy Adm. 2013; 47(1):93-110.
• [35]Soteri-Proctor A. Little big societies: micro mapping of organisations operating below the radar. In: Third Sector Research Centre Working Paper, No 71. Birmingham, UK: Third Sector Research Centre, University of Birmingham; 2011.
• [36]Goodson L, Phillimore J. Community research for participation. Policy Press, Bristol; 2012.
• [37]Dekker R, Engbersen G. How social media transform migrant networks and facilitate migration. In: IMI Working Papers Series, No 64. Oxford, UK: International Migration Institute, University of Oxford; 2012.
• [38]Patton M. Qualitative research and evaluation methods. Sage, Thousand Oaks, CA; 2001.
• [39]Guest G, MacQueen KM, Namey EE. Applied thematic analysis. Sage, Los Angeles; 2012.
• [40]Winkler V, Leitzmann M, Obi N, Ahrens W, Edinger T, Giani G, Linseisen J, Loffler M, Michels K, Nothlings U et al.. Response in individuals with and without foreign background and application to the National Cohort in Germany: which factors have an effect? Int J Public Health. 2014; 59(3):555-563.
• [41]Reiss K, Dragano N, Ellert U, Fricke J, Greiser KH, Keil T, Krist L, Moebus S, Pundt N, Schlaud M et al.. Comparing sampling strategies to recruit migrants for an epidemiological study. Results from a German feasibility study. Eur J Public Health. 2014; 24(5):721-726.