Randhawa, Kirat (2014) Illness and healthcare experiences of recent low-income international migrants in a UK city. Doctoral thesis (PhD), University of Sussex.

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Abstract

Multiple factors account for inequality in health outcomes and in access to healthcare in the UK, including ethnicity and length of residence in the country. This thesis explores the subjective experiences of a group of recent low-income international migrants who live in Brighton and Hove and have used local health services to seek care for a range of illnesses and conditions. The project was formulated in collaboration with Brighton and Hove City Council and the then NHS Brighton and Hove (now Brighton and Hove Clinical Commissioning Group), using local professional knowledge and experience to recruit participants and collect narratives from a ‘hard to reach’ social group.

The theoretical background of this thesis draws on ‘lived’ experience in the context of illness. Analysis of qualitative interviews, using narrative typologies derived from the work of Frank (1991), revealed both the commonalities across and the specificities of illness experiences, and highlighted a multi-factorial web of bio-psychosocial and economic factors at play. The interviews overwhelmingly fitted with a chronic, ‘chaos’ typology, in which diagnoses were commonly contested.

The particularities of recent migrant status impacted upon participants’ illness experiences and healthcare use. Migrants made comparisons with health systems in their countries of origin and managed healthcare through social networks. The findings from the data analysis around patient experience showed that the overall experience was negative, characterised by disappointment, with communication and access problems as recurrent themes. These outcomes may be explained by both direct and indirect discrimination. Direct discrimination and stigma were perceived by many participants in the attitudes and practices of staff, which some participants linked to their own ethnicity, immigration status and faith. From this study it is possible to hypothesise that healthcare practices and policy may give rise to some of the perceptions of discrimination.

Item Type:	Thesis (Doctoral)
Schools and Departments:	School of Global Studies > Geography
Subjects:	H Social Sciences > HT Communities. Classes. Races > HT0101 Urban groups. The city. Urban sociology > HT0201 City population including children in cities, immigration H Social Sciences > HV Social pathology. Social and public welfare. Criminology > HV0697 Protection, assistance and relief > HV0700 Special classes > HV4005 Immigrants R Medicine > RA Public aspects of medicine > RA0001 Medicine and the state. Including medical statistics, medical economics, provisions for medical care, medical sociology > RA0418 Medicine and society. Social medicine. Medical sociology
Depositing User:	Library Cataloguing
Date Deposited:	10 Dec 2014 07:43
Last Modified:	25 Sep 2015 14:55
URI:	http://sro.sussex.ac.uk/id/eprint/51574

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