Experiences of Disadvantage and Privilege of Care Recipients With a Migration Background in Acquired Brain Injury Rehabilitation: An Intersectional Analysis

Abstract

Health inequities exist between care recipients with or without a migration background, but there is insufficient knowledge about the mechanisms that lead to the reproduction of health inequities. This article aims to contribute to the understanding of how diversity, equity and inclusion (DEI) shape the experiences of care recipients with a disability and migration background in collaborative care networks, through an intersectional lens. A participatory study was conducted with professionals, carers, and care recipients with acquired brain injury (ABI) in nine community of practice (CoP) meetings. The study is part of a larger study and was guided by a hermeneutic framework focusing on reciprocal learning in the CoP through cocreative reflection and intersectional analysis of data. The experiences of nine care recipients with ABI and a migration background, collected in open interviews, were central to the analysis. Analysis was further substantiated by analyzing the stories of 21 carers with a migration background and 17 professionals, collected in semistructured interviews. An intersectionality lens was applied to understand the power dynamics in the experiences as expressed in the interviews and stories. Using vignettes of care recipients’ experiences, we present the following intersectional mechanisms that reproduce health inequities: (1) navigating diversity, (2) gender-related loneliness, (3) hidden challenges, and (4) challenging assumptions. We conclude that upon discharge home care recipients with ABI and a migration background fall into a lonely state of being, often with a lack of social support and experience financial difficulties. Care recipients disappear out of the healthcare system’ sight and are unable to find their way back. Diversity-responsive health care begins with a critical awareness of health inequities and the underlying mechanisms among professionals, healthcare institutions, and policy.