Health-Care Recourses in the City: from a Diverse Set of Services and Practices to a Supportive Combination of Urban Policies?
The city can be seen as a health-care services supplier. As such and considering the way these services are made accessible, the urban environment highly contributes to supporting people’s health. In particular, it can support people living with a chronic condition to cope with illness and to adapt their way of life to their dependency on medical services. This article analyzes the way chronically ill persons have access and use health-care services from the respective viewpoints of the health-care provider and the patient. Thus, on the one hand, the article describes the mechanisms through which health-care organization and geographical distribution influence patients’ health-care pathways (hospital-centred care, level and forms of health-care integration, amount and diversity of services, spatial distribution of specialized hospital services). On the other hand, it presents a typology of the different ways chronically ill people circulate between diverse health-care providers in the city by relying on their potential mobility. Cross-viewing of these two angles highlights that each type of practice mobilizes certain aspects of the urban health-care system. In conclusion, the article explores the way complementary sectorial urban policies could potentially support or compensate health care territorial organization in order to reduce health-care access inequalities. The presented results mainly stem from the qualitative analysis of a set of interviews conducted with health-care professionals and people living with HIV, in Brussels (Belgium) and Rouen (France).