IDEAS home Printed from https://ideas.repec.org/a/gam/jsoctx/v13y2023i5p120-d1141165.html
   My bibliography  Save this article

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

Author

Listed:
  • 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
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/2075-4698/13/5/120/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/2075-4698/13/5/120/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. 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.
    2. 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.
    3. 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.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Liu, Jiawei & Niederdeppe, Jeff, 2024. "Effects of communicating health disparities using social comparison framing: A comprehensive review," Social Science & Medicine, Elsevier, vol. 348(C).
    2. Judith Muhonja Ochieng & Janice D. Crist, 2021. "“I put diabetes on the shelf†: African-American Women’s Perceptions of Risk for Diabetes Complications," Clinical Nursing Research, , vol. 30(7), pages 1012-1022, September.
    3. Tamara Power & Denise Wilson & Odette Best & Teresa Brockie & Lisa Bourque Bearskin & Eugenia Millender & John Lowe, 2020. "COVID‐19 and Indigenous Peoples: An imperative for action," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(15-16), pages 2737-2741, August.
    4. Foorough Kavian & Kaye Mehta & Eileen Willis & Lillian Mwanri & Paul Ward & Sue Booth, 2020. "Migration, Stress and the Challenges of Accessing Food: An Exploratory Study of the Experience of Recent Afghan Women Refugees in Adelaide, Australia," IJERPH, MDPI, vol. 17(4), pages 1-16, February.
    5. 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.
    6. Stuart B. Kamenetsky & Vanessa Chen & Eyal Heled, 2024. "Matching patients with therapists in culturally diverse rehabilitation services during civil unrest," International Journal of Health Economics and Management, Springer, vol. 24(3), pages 407-418, September.
    7. Elisabeth Paul & Céline Deville & Oriane Bodson & N'koué Emmanuel Sambiéni & Ibrahima Thiam & Marc Bourgeois & Valéry Ridde & Fabienne Fecher, 2019. "How is equity approached in universal health coverage? An analysis of global and country policy documents in Benin and Senegal," ULB Institutional Repository 2013/298047, ULB -- Universite Libre de Bruxelles.
    8. Meenakshi Richardson & Sara F. Waters, 2023. "Indigenous Voices Against Suicide: A Meta-Synthesis Advancing Prevention Strategies," IJERPH, MDPI, vol. 20(22), pages 1-19, November.
    9. Gagnon-Dufresne, Marie-Catherine & Gautier, Lara & Beaujoin, Camille & Boivin, Pauline & Coulibaly, Abdourahmane & Richard, Zoé & Gomes de Medeiros, Stéphanie & Dutra Da Nóbrega, Raylson Emanuel & de , 2023. "Did the design and planning of testing and contact tracing interventions for COVID-19 consider social inequalities in health? A multiple case study from Brazil, Canada, France & Mali," Social Science & Medicine, Elsevier, vol. 335(C).
    10. Lisa Coulburn & Wendy Miller, 2022. "Prevalence, Risk Factors and Impacts Related to Mould-Affected Housing: An Australian Integrative Review," IJERPH, MDPI, vol. 19(3), pages 1-26, February.
    11. Barlow, P. & Thow, A.M., 2021. "Neoliberal discourse, actor power, and the politics of nutrition policy: A qualitative analysis of informal challenges to nutrition labelling regulations at the World Trade Organization, 2007–2019," Social Science & Medicine, Elsevier, vol. 273(C).
    12. Judith M. Ochieng & Janice D. Crist, 2021. "Social Determinants of Health and Health Care Delivery: African American Women’s T2DM Self-Management," Clinical Nursing Research, , vol. 30(3), pages 263-272, March.
    13. Sudeepa Khanal & Lira Ramadani & Melanie Boeckmann, 2023. "Health Equity in Climate Change and Health Policies: A Systematic Review," Sustainability, MDPI, vol. 15(13), pages 1-18, July.
    14. Karriem S. Watson & Katherine Y. Tossas & Yazmin San Miguel & Nicole Gastala & Liliana G. San Miguel & Scott Grumeretz & Vida Henderson & Robert Winn & Masahito Jimbo & Keith B. Naylor & Megan E. Greg, 2023. "Mi-CARE: Comparing Three Evidence-Based Interventions to Promote Colorectal Cancer Screening among Ethnic Minorities within Three Different Clinical Contexts," IJERPH, MDPI, vol. 20(22), pages 1-15, November.
    15. Kritika Rana & Andrew Page & Jennifer L. Kent & Amit Arora, 2022. "Pathways Linking Housing Inequalities and Health Outcomes among Migrant and Refugee Populations in High-Income Countries: A Protocol for a Mixed-Methods Systematic Review," IJERPH, MDPI, vol. 19(24), pages 1-12, December.
    16. Midas Hampton & Sabine O’Hara & Elizabeth Gearin, 2024. "Assessing Restorative Community Development Frameworks—A Meso-Level and Micro-Level Integrated Approach," Sustainability, MDPI, vol. 16(5), pages 1-16, March.
    17. Gemma Crawford & Elizabeth Connor & Kahlia McCausland & Karina Reeves & Krysten Blackford, 2022. "Public Health Interventions to Address Housing and Mental Health amongst Migrants from Culturally and Linguistically Diverse Backgrounds Living in High-Income Countries: A Scoping Review," IJERPH, MDPI, vol. 19(24), pages 1-22, December.
    18. Madeline Y Sutton & Simone C Gray & Kim Elmore & Zaneta Gaul, 2017. "Social Determinants of HIV Disparities in the Southern United States and in Counties with Historically Black Colleges and Universities (HBCUs), 2013–2014," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-12, January.
    19. Anna Ziersch & Clemence Due & Moira Walsh, 2023. "Housing in Place: Housing, Neighbourhood and Resettlement for People from Refugee and Asylum Seeker Backgrounds in Australia," Journal of International Migration and Integration, Springer, vol. 24(3), pages 1413-1436, September.
    20. Alexa Solazzo & Bridget Gorman & Justin Denney, 2020. "Does Sexual Orientation Complicate the Relationship Between Marital Status and Gender With Self-rated Health and Cardiovascular Disease?," Demography, Springer;Population Association of America (PAA), vol. 57(2), pages 599-626, April.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jsoctx:v:13:y:2023:i:5:p:120-:d:1141165. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.