Pathways to care: how superdiversity shapes the need for navigational assistance

Abstract

Pathways to care: how superdiversity shapes the need for navigational assistance. Health and Illness, 36(8) Sociology of ABSTRACTThe recently developed sociological concept of superdiversity provides a potentially interesting and useful way of developing an understanding of life in contemporary Europe. Here we report on research based on individual narratives about access to healthcare, as described by a range of people from very different socio-cultural backgrounds in four European countries. This paper notes the frequent appearance in first person narratives of the need for navigational assistance in the form of knowledge, cultural completence and orientation that facilitate the identification and use of pathways to healthcare. Our dataset of 24 semi-structured interviews suggests that, in the context of needing healthcare, the feeling of being a 'stranger in a strange land' is common across a wide range of backgrounds. In social settings characterised by transnationalism and cultural heterogeneity, understanding the need for navigational assistance, particularly at times of uncertainty, has potential importance for the design and delivery of health services. The relationship between the inhabitants of contemporary Europe and the healthcare systems available in the places they live is dominated by both complexity and contingency -and this is the cultural field in which navigation operates. (187 words)

‘If there were doctors who could understand our problems, I would already be better’: dissatisfactory health care and marginalisation in superdiverse neighbourhoods.

“…For some people, the experience of disappointing health care involved aspects of marginalisation, including the inability to pay for private services, and/or the inability to speak the local language and/or to navigate the healthcare system (Green et al . ). But we also heard from disappointed healthcare users who spoke the local language fluently and could afford to pay for additional services.…”

Is Superdiversity a Useful Concept in European Medical Sociology?

“…Across our diversity sample in all four country settings, we found evidence of the need to accommodate "the views and perceptions of others (including institutionalised norms and restrictions)" in gaining access to suitable healthcare gave rise to "the need for navigational assistance" (Green et al, 2014(Green et al, , p. 1205.…”

“…This need for navigational assistance manifested as an expressed desire for: advice on a range of symptoms, ailments, therapies, and treatment locations; facilitation with access to care (including making contact with services, companionship, and transport); financial or material help; linguistic and conceptual assistance to access and engage with healthcare at critical moments (Green et al, 2014(Green et al, , p. 1209). …”

“…The idea of superdiversity has been picked up across a range of scholarly disciplines (Blommaert, 2013;De Bock, 2015), public policy (Fanshawe and Sriskandarajah, 2010;Phillimore, 2011;Aspinall, 2012), and political discourse (Muir, 2015;Ratcliffe, 2015) to call attention to a set of changes that are demographic, economic, and social and to index an increase in the speed, spread, and scale of migration. Our own research has highlighted that "superdiversity has the potential to throw new light on how healthcare is sought and negotiated, particularly in terms of the assistance provided by others" (Green et al, 2014(Green et al, , p. 1217. But the term superdiversity has not caught on in medical sociology.…”

“…This paper examines the concept of superdiversity as proposed by Vertovec (2007) and developed by Meissner and Vertovec (2014) and asks what it might offer critical studies of illness, health, and healthcare. We draw case studies from our multicountry interview study of adults' strategies for healthcare that demonstrated the complexity of diversity such that simple divisions between migrants and non-migrants or ethnic minority and majority have limited explanatory power (Green et al, 2014). …”