Medical diversity of migrants' physical and mental health understandings.

Health understandings of migrants, immigrants and persons with a migration background (in short: 'im/migrants') often diverge from the biomedical paradigm dominant in many host societies. Shaped by culturally diverse backgrounds, these understandings influence im/migrants' health practices and utilisation of formal healthcare services. This study aims to explore the health understandings of im/migrants residing in two socio-culturally diverse urban neighbourhoods: Bonn-Tannenbusch and Cologne-Mülheim, Germany. Employing a practice-theory approach (Schatzki 1996, 2002), a cross-sectional survey was conducted using a standardised online questionnaire. The instrument was developed based on earlier qualitative research findings. In total, 179 im/migrants and 172 respondents without an im/migration background participated in this study. Based on the collected data, two typologies of practice-shaping understandings of physical and mental health were developed. Several types of understandings were identified, each comprising varying combinations of explanatory concepts, which can be grouped into three broad categories: biomedical, alternative medical, and supernatural. A more detailed analysis was conducted on the identified types using descriptive statistics. This analysis showcases how health understandings differ from each other and how, in some cases, they share certain similarities. The findings underline that medical diversity, characterised as the coexistence and sometimes blending of ontologically diverse understandings and practices, is not marginal, but rather a pervasive feature of im/migrants' health understandings and practices in the two study sites. This article contributes to the knowledge on the diversity of health understandings in diverse neighbourhoods, and provides insight into the factors that influence the adoption or rejection of specific health practices.