Lynn Abou-Jaoudé

Thesis subject: Users in vulnerable situation(s) in the health system: normative experiences and new ways of life

Thesis abstract:

Inspired by Canguilhem’s reflection on what constitutes the normal and the pathological, we examine how health system users represent and manage preventive health opportunities. We conducted participant observations and interviews (65 exploratory and 10 phenomenological accompanied by projective techniques) with users of the Health Examination Center of the Pasteur Institute of Lille. This center aims to better support users in precarious situations. Participants experience different vulnerable situations that we present using an intersectional approach. Data analyses reveal normative tensions when confrontations occur between individual experiences and medical rationality. The management of vulnerable conditions as well as the healthcare pathway consists of an emotional journey including emotions such as fear of illness and guilt related to the non-conformity to institutionalized health standards. But by mobilizing their resources and capacities, users can explore other health strategies to try to adapt the social norms to their health state, thus creating “new ways of life”. Concerning social resources, trust and confidence play a crucial role in empowering the user through these new ways of life. We conclude this research with a discussion on the implications of the application of an intersectional approach to vulnerability, as well as the proposal to transform the health system into a trustful space for the user.

Thesis supervisors:

• Hélène GORGE, HDR, Associate Professor at the University of Lille
• Coralie BERTHIER, Manager of the Clinical Research Department at the Pasteur Institute of Lille

Project funding: This work is funded by the National Center for Precision Diabetic Medicine – PreciDIAB. PreciDIAB is jointly supported by the French Government under the « Investissements d’Avenir » (Investments for the Future) program managed by the « Agence Nationale de la Recherche » (ANR, French National Agency for Research ; reference: ANR-18-IBHU-0001), by the European Union through the « Fonds européen de développement régional » (FEDER - NP0025517) and the « Conseil Régional des Hauts-de-France » (Hauts-de-France Regional Council) (Agreement 20001891/NP0025517), and by the « Métropole Européenne de Lille » (MEL, European Metropolis of Lille) (Agreement 2019_ESR_11).