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.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:632773 |
| Date | January 2014 |
| Creators | Randhawa, Kirat |
| Publisher | University of Sussex |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://sro.sussex.ac.uk/id/eprint/51574/ |
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