Welcomed diversity? A comparison of low-threshold health and social organisations in an urban context

This research project will generate a systematic, qualitative comparison of low-threshold health and social care organisations in four European neighbourhoods, all characterised by highly diversified populations: Rosengård (Malmö) Tower Hamlets (London), El Raval (Barcelona), Belleville (Paris). We seek to analyse how these organisations respond to the increasing diversity of their users’ needs. In a society represented by multiple lifestyles and intersecting social divisions, healthcare and social service organisations have to adapt their policies and practices on an organisational and relational level. This adaptation to specific demands requires awareness that the use of protocols and practices that are based on social categories such as gender, origin, disability, age or religion, can incur the risk of new inequalities and multiple, overlapping discriminations. The increased differentiation in modern societies is most pronounced in cities, especially in urban areas with highly mobile populations. Therefore this research project is conducted at the scale of an urban neighbourhood focusing on low-threshold organisations that offer health and social service to the local population. We used a panel of mixed, qualitative methods such as observations of the neighbourhoods and the selected organisations as well as semi-structured interviews with professionals (manager, doctors, nurses, receptionist, social workers etc., N=63) and some of their clients (N=63). This provides information from two perspectives and allows us to answer to different research questions structured around five levels of analysis: access to care, client-expert relationship, participation, institutional environment, policy and management. This comparative study enables us to identify practices - relative to structural elements such as local economic and regulatory welfare constraints - and contributes to the public and scientific debate regarding equity in health and social care organisations, addressing multiple forms of discrimination and inequalities.