Paper short abstract:

Structured moral navigation reveals how inequity, people's moral frameworks, and the unfolding of life interact in precarious contexts. Analysing health-seeking practices in London and Marseille during COVID-19 using this lens can give insights into designing care-pathways in health services.

Paper long abstract:

To provide adequate services, health providers and civil society organisations need for their care pathways to be adapted to the reality of health-seeking practices. In turn, in urban superdiverse environments, advice and health-seeking differs between social groups (according to gender, income, race and ethnicity, migration status and so on). In circumstances of extreme precarity – cost of living crisis, in-poverty employment, racism and discrimination, etc.- uncertainty and lived experience play a major role (MacGregor et al 2020). People do not behave in a predicted linear fashion solely according to their socio-demographic characteristics, but rather experience precarious life and deal with emergent and unexpected challenges and priorities of an uncertain environment (Al-Mohammad and Peluso 2012). People’s ethical frameworks – how they behave as ethical agents, morally bound to others (their peers, their families, etc.)- shape how people seek health advice and their decisions when engaging with health providers and public services (Ripoll et al 2022). Therefore, health seeking practices are more akin to navigation. I propose the concept of structured moral navigation, expanding the frameworks set out by Vigh (2009) and White and Jha (2021) to show the interaction between structure and the unfolding of life in the context of uncertainty and precarity when racialised and minoritised communities are accessing health services. I draw on our recent research on health-seeking during COVID-19 and health equity post-COVID-19 in London and Marseille, as well as secondary analysis of qualitative data repositories compiled during the pandemic to explore this lens on health-seeking practices.