Creating health care: how do people get the health care they need when they need it?
Prof. Hannah Bradby (Uppsala University)
Application to Forte:/Vetenskaps Rådet programme on health services
Three circumstances inform an unprecedented challenge for the Swedish health system’s ability to provide appropriate care to marginalised groups. First, the demand for an ever-growing range of therapeutics in the face of a slow-down in the growth rate of spending on health care. Second, the paradox that in times of illness, injury and distress, people consult a wide range of sources of informal help, most of which are invisible to the formal system of professional healthcare. In putting together different types of advice, support and expertise people try to meet their own healthcare needs pragmatically and creatively, which we term ‘bricolage’. Third, the diversification of the Swedish population (20% born outside Sweden or with parents/grandparents born outside Sweden, term ‘immigrant background’ (invandrarbakgrund)), means that shared expectations arising from experience of a common, stable culture cannot be taken for granted between health service user and provider. The collision of these three circumstances suggests a diverse complexity of possibilities informing the encounter between patient and professional during healthcare consultations that, in times of diversifying diversity and contracting resources, intensifies the demands put on such ‘bricolage’ to meet complex needs. This project uses innovative methods of digital visualisation to map how people put together their healthcare within two contrasting neighbourhoods. Dialogue conferences will be established to find methods whereby successful methods of bricolage can be sustainably supported in a way that makes formal systems of healthcare more responsive to people’s needs.