My health and theirs: clients constructing meanings for a health service programme for unemployed people

Health care research has been more interested in identifying reasons why people do not participate in health interventions than in trying to understand the reasons why they do. This study examined how unemployed people position themselves with regard to a new health service which was set up as part of an institutional strategy for delivering and enabling their access to health care. Positioning theory was used as a methodological framework to analyse participants' responses to the novel health service. The focus was on two main issues: the way clients' positions are established through discourse, and the range of factors that come into play in determining those positions. The analysis revealed six positions unemployed people use when encountering the studied service: the docile citizen, the rebel, the socially responsible citizen, the distinctive individual, the independent actor and the calculating client. These positions and associated discourses display the different sets of rights and duties of the client and simultaneously define the positions of the service. While illustrating how a health service engaged with the ideology of equality is integrated into the value framework of the clients, the findings contribute to the ongoing debate on need of particular health services for unemployed people.