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The Cultural Dimension of Clinical Vulnerability: Repeated Access to Emergency Units and Discontinuity in Health and Social Care Pathway

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  • Laura Bertini-Soldà

    (Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, 6928 Manno, Switzerland)

Abstract

Swiss health and social care system is complex and is based on universal coverage. However, discontinuity in health and social path and repeated access to emergency units are symptoms of inequity. The aim of this paper is to highlight the interactions between vulnerable patients with socio-sanitary actors to propose some innovative solutions to promote social justice. A six-month ethnography of 15 vulnerable patients’ health and social transitions in the region of Ticino Canton in Switzerland gives new insight into conflict situations in assistance relationships, where reciprocal stereotyping between professionals and patients undermines continuity of care. The cultural dimension of health and social institutions is identified in the problem-solving approach which is legitimized as the only one for dealing with complex situations. The analysis shows how clinical vulnerability relates strongly to an unmanaged so-called liminality phase. Culture is an invisible dimension in care, but its effects on equity are major. Two possible interventions are discussed, which are culturally informed reorganization of the care network and collaboration with a sociosanitary cultural mediator.

Suggested Citation

  • Laura Bertini-Soldà, 2023. "The Cultural Dimension of Clinical Vulnerability: Repeated Access to Emergency Units and Discontinuity in Health and Social Care Pathway," Societies, MDPI, vol. 13(5), pages 1-13, May.
    • Handle: RePEc:gam:jsoctx:v:13:y:2023:i:5:p:120-:d:1141165
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    References listed on IDEAS

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    1. Braveman, P.A. & Kumanyika, S. & Fielding, J. & LaVeist, T. & Borrell, L.N. & Manderscheid, R. & Troutman, A., 2011. "Health disparities and health equity: The issue is justice," American Journal of Public Health, American Public Health Association, vol. 101(SUPPL. 1), pages 149-155.
    2. Anna Ziersch & Moira Walsh & Clemence Due & Emily Duivesteyn, 2017. "Exploring the Relationship between Housing and Health for Refugees and Asylum Seekers in South Australia: A Qualitative Study," IJERPH, MDPI, vol. 14(9), pages 1-20, September.
    3. Jessica Naidu & Elizabeth Oddone Paolucci & Tanvir C. Turin, 2023. "A Critical Lens on Health: Key Principles of Critical Discourse Analysis and Its Benefits to Anti-Racism in Population Public Health Research," Societies, MDPI, vol. 13(2), pages 1-10, February.
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