Putting together services to meet everyday health needs : Diversity and bricolage in Sweden, UK, Portugal and Germany

The inequitable distribution of both healthcare resources and minority ethnic populations in European cities has put particular pressures on health service delivery. Multi-cultural models of society have tended to try to educate migrants and newly formed minorities in how to use services ‘appropriately’, rather than to reconfigure services. As neighbourhoods have been getting more diverse, existing models of healthcare delivery do not work so well, despite the rhetoric of ‘patient-centred care’. This study maps how people in two highly diverse neighbourhoods, with residents differentiated by faith, income, age, gender and legal status, put together the everyday support and healthcare they need. To build up a picture of the range of what people do to support their own wellbeing, we map people’s use of official health services, voluntary group support, informal help, including online and social media sources. This information, gathered by interviews and observations in neighbourhoods, is turned into an app that can be viewed and updated and which is used to further investigate the health care services that are valued and contrast these with the gaps where support is lacking. This paper draws on initial mapping data from Swedish neighbourhoods to critique ethnicity as a concept to investigate inequalities and diversity in respect of individuals’ relationship with healthcare, different modes of provision, and responsibilities for welfare allocation. Superdiversity (Vertovec 2007) is tested as a concept suitable for reconfiguring health services to respond to the ongoing diversification of diversity