Migrants' and immigrants' understandings of health and disease. Medical diversity in two diverse urban neighbourhoods

Health and disease are understood in diverse ways, and im/migrants bring cultural backgrounds that shape explanatory concepts. These understandings influence health practices and may affect utilisation of healthcare institutions. Yet most research focuses on biomedical perspectives, offering limited insight into how alternative medical, and supernatural understandings shape im/migrants' health practices. This study examined im/migrants in two German urban neighbourhoods (Bonn-Tannenbusch and Cologne-Mülheim), using a practice-theory approach (Schatzki, 1996, 2002). Qualitative, semi-structured interviews revealed biomedical, alternative medical, and supernatural explanatory concepts that either travelled from countries of origin or were acquired after migration. We analysed the role of social groups, distinguishing between communities with shared migration backgrounds, other local communities, translocal communities, and healthcare institutions. From this, we developed a typology of four practice-shaping understandings of health and disease. We also examined medical diversity, defined as the blending of different understandings and practices, finding it to be a common rather than exceptional feature. These results highlight the diversity of im/migrants' health understandings and explain why individuals adopt some practices while rejecting others.