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Espinoza-Kulick MAV, Cerdeña JP. "We Need Health for All": Mental Health and Barriers to Care among Latinxs in California and Connecticut. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12817. [PMID: 36232112 PMCID: PMC9565216 DOI: 10.3390/ijerph191912817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/26/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
Latinx (im)migrant groups remain underserved by existing mental health resources. Past research has illuminated the complex factors contributing to this problem, including migration-related trauma, discrimination, anti-immigrant policies, and structural vulnerability. This paper uses decolonial-inspired methods to present and analyze results from two studies of Latinx (im)migrant communities in central California and southern Connecticut in the United States. Using mixed quantitative and qualitative analysis, we demonstrate the intersectional complexities to be addressed in formulating effective mental health services. Relevant social and structural factors including knowledge of mental health, access to insurance, and experiencing discrimination were significantly associated with anxiety symptoms, based on linear regression analysis. Ethnographic interviews demonstrate how complex trauma informs mental health needs, especially through the gendered experiences of women. Overlapping aspects of gender, language barriers, fear of authorities, and immigration status contoured the lived experiences of Latinx (im)migrants. Thematic analyses of open-ended survey responses also provide recommendations for solutions based on the experiences of those directly affected by these health disparities, particularly relating to healthcare access, affordability, and capacity. Building from these findings and past research, we recommend the adoption of a comprehensive model of mental health service provision for Latinx (im)migrants that takes into account Indigenous language access, structural competency, expanded health insurance, and resources for community health workers.
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Affiliation(s)
| | - Jessica P. Cerdeña
- Yale School of Medicine, Yale University, New Haven, CT 06520, USA
- Institute for Collaboration on Health, Implementation, and Policy (InCHIP), University of Connecticut, Storrs, CT 06269, USA
- Department of Anthropology, University of Connecticut, Storrs, CT 06269, USA
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2
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Rustoyburu C, Ariza L. Autonomy in Austerity Times. Examining Hormonal Contraceptive Implants in Argentina. Med Anthropol 2022; 41:747-761. [PMID: 35819822 DOI: 10.1080/01459740.2022.2098491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We present findings from a study on the implementation of hormonal contraceptive implants during the last wave of austerity measures in Argentina (2015-2019). Through the lens of "reproductive governance," we discuss continuities and changes in policy discourse that justified the provision of implants from 2014, before austerity measures started to be implemented, and after 2015. Using the concept of "stratified reproduction" in the light of demographic anxiety about teenage pregnancies, we also observe the key role of health professionals in actually enacting in the clinic key policy changes that characterized pregnancy among low-income, young, low-adherence and/or disabled women as a problem to be eradicated.
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Affiliation(s)
- Cecilia Rustoyburu
- CONICET, Facultad de Humanidades, Universidad Nacional de Mar del Plata, Mar del Plata, Argentina
| | - Lucía Ariza
- CONICET, Instituto de Investigaciones Gino Germani, Universidad de Buenos Aires, Buenos Aires, Argentina
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3
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Ally SZ. Coming Out of Employers' Homes:Migration, Domestic Work and Health Claims. Med Anthropol 2022; 41:342-358. [PMID: 35266846 DOI: 10.1080/01459740.2022.2037081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Migrant domestic workers in Kuwait live amid structural inequalities, including health disparities, yet little is known about how they manage wellness alongside imperatives to work and earn. In this article, I examine Sri Lankan women's coming out of employers' homes through authorized and unauthorized channels and how they use illness and exhaustion to justify their need for more autonomous conditions. Exploring the physical, emotional, and political dimensions of these processes, I highlight the Sri Lankan vernacular notion of "heart-being" within women's actions to safeguard health and seek existential grounding, as they assert biolegitimate claims to return home or live unauthorized.
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Affiliation(s)
- Sajida Zareen Ally
- Department of Anthropology, School of Global Studies, University of Sussex, Brighton, UK
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4
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Hoekstra E. "Not a free version of a broken system:" Medical humanitarianism and immigrant health justice in the United States. Soc Sci Med 2021; 285:114287. [PMID: 34364157 DOI: 10.1016/j.socscimed.2021.114287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/27/2021] [Accepted: 07/30/2021] [Indexed: 10/20/2022]
Abstract
Medical humanitarian organizations are increasingly the primary healthcare providers for unauthorized migrants in high-income countries. Existing studies of medical humanitarianism in the Global North reveal tensions between principles of traditionally apolitical humanitarianism and human rights. In practice, these tensions translate into organizational debates about prioritizing direct service provision to meet immediate needs or advocacy to effect long-term systemic change. Informed by these debates, this paper asserts the importance of immigration and health policy contexts as central to shaping the relationship between healthcare provision and political advocacy within medical humanitarian NGOs. Drawing from twelve months of fieldwork with medical humanitarian NGOs in Arizona, I analyze data from ethnographic participant observation and interviews with volunteer healthcare providers at a medical humanitarian organization I call Community Clinic of Phoenix (CCP), a free clinic for uninsured, undocumented immigrants. I find that, in the context of Arizona's anti-immigrant rhetoric and policies, CCP employs medical humanitarianism as both a discourse and a model of care to challenge immigrants' exclusion from health coverage and criminalization through immigration enforcement. The clinic's emphasis on immigrant health justice shapes their critiques of the structural failures of U.S. immigration and health systems, their approach to providing equitable access to quality healthcare for uninsured immigrants, and their work to create broad social change for immigrant rights and health justice. Driven by their mission of "not replicating a free version of a broken system," the clinic's healthcare provision amid a climate inhospitable to immigrants demonstrates the importance of both conceptualizing and practicing medical humanitarianism as healthcare advocacy.
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Affiliation(s)
- Erin Hoekstra
- Marquette University, USA; Department of Social and Cultural Sciences, Lalumiere Hall, 340, 1310 W. Clybourn St., Milwaukee, WI, 53233, USA.
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5
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Abstract
In this introduction, we propose the notion of 'embodied belonging' as a fruitful analytical heuristic for scholars in medical and psychological anthropology. We envision this notion to help us gain a more nuanced understanding of the entanglements of the political, social, and affective dimensions of belonging and their effects on health, illness, and healing. A focus on embodied belonging, we argue, reveals how displacement, exclusion, and marginalization cause existential and health-related ruptures in people's lives and bodies, and how affected people, in the struggle for re/emplacement and re/integration, may regain health and sustain their well-being. Covering a variety of regional contexts (Germany/Vietnam, Norway, the UK, Japan), the contributions to this special issue examine how embodied non/belonging is experienced, re/imagined, negotiated, practiced, disrupted, contested, and achieved (or not) by their protagonists, who are excluded and marginalized in diverse ways. Each article highlights the intricate trajectories of how dynamics of non/belonging inscribe themselves in human bodies. They also reveal how belonging can be utilized and drawn on as a forceful means and resource of social resilience, if not (self-)therapy and healing.
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Affiliation(s)
- Dominik Mattes
- Collaborative Research Center Affective Societies, Freie Universität Berlin, Berlin, Germany.
| | - Claudia Lang
- Institute of Anthropology, University of Leipzig, Leipzig, Germany ,Max Planck Institute for Social Anthropology, Halle, Germany
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6
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Abstract
This paper engages with the notion of 'embodied belonging' through an ethnography of the social and material aspects of accessing mental health care in the UK. I focus on moments of access and transition in a voluntary sector organisation in London: an intercultural psychotherapy centre, serving a range of im/migrant communities. Whilst both 'belonging' and 'place' are often invoked to imply stability, I explore how material contexts of access and inclusion can paradoxically be implicated in the ongoing production of precarity-of unstable, uncertain, and vulnerable ways of being. A sociomaterial analysis of ethnographic material and visual data from two creative mapping interviews attends to material and spatial aspects of the centre and its transitory place in the urban environment. It demonstrates how these aspects of place became entangled in client experiences of access: uncertainties of waiting, ambivalence towards belonging to a particular client group, and questions around deservingness of care. This engendered an embodied and situated experience of 'precarious belonging'. I therefore argue that precarity should be 'placed', both within the concept of embodied belonging, and ethnographically, within the material constraints, impermanence, and spatial politics of projects to include the excluded in UK mental health care.
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7
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Pursch B, Tate A, Legido-Quigley H, Howard N. Health for all? A qualitative study of NGO support to migrants affected by structural violence in northern France. Soc Sci Med 2020; 248:112838. [PMID: 32062568 DOI: 10.1016/j.socscimed.2020.112838] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 02/03/2020] [Accepted: 02/04/2020] [Indexed: 11/28/2022]
Abstract
France hosts approximately 368,000 'persons of concern' (e.g. refugees, stateless, people in refugee-like situations, asylum-seekers). Northern France has become a focal area, due to its proximity to the Dover entry-point to the UK and larger numbers of migrants. This study used a structural violence lens to explore the provision of health services to migrants in Calais and La Linière in northern France, to contribute to discourse on the effects of structural violence on non-state service providers and migrants in precarious conditions and inform service provision policies. Our qualitative study design used semi-structured key-informant interviews, conducted in summer 2017 with 20 non-governmental service-providers, 13 who had worked in Calais and 7 in La Linière migrant camp. We analysed interviews thematically, using inductive coding. Themes from analysis were: (i) power dynamics between NGOs and the state; (ii) resource allocation and barriers to accessing services; and (iii) effects of structural violence on social determinants of health. NGO service provision varied due to tense power dynamics between state and NGOs, shifting state requirements, and expanding roles. Interviewees described ongoing uncertainties, and inherent disempowerment associated with humanitarian aid, as negatively affecting migrant health and wellbeing, increasing illness risks, and providing unequal life chances. Structural realities including violence appeared to negatively affect migrant social determinants of health, reducing healthcare access, social inclusion, and sense of empowerment. The role of NGOs in providing migrant health services in northern France was complex and contested. Structural violence negatively affected migrant wellbeing through restricted services, intentional chaos, and related disempowerment. The violence exerted on migrants appeared to diminish their life chances while being an ineffective deterrent, indicating better approaches are needed.
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Affiliation(s)
- Benita Pursch
- King's College London, Department of Global Health and Social Medicine, Strand, London, United Kingdom
| | - Alexandra Tate
- King's College London, Faculty of Medicine, Strand, London United Kingdom; London School of Hygiene and Tropical Medicine (LSHTM), Department of Global Health and Development, 15-17 Tavistock Place, London, WC1H 9SH, United Kingdom
| | - Helena Legido-Quigley
- London School of Hygiene and Tropical Medicine (LSHTM), Department of Global Health and Development, 15-17 Tavistock Place, London, WC1H 9SH, United Kingdom; National University of Singapore, Saw Swee Hock School of Public Health, 12 Science Drive 2, Singapore
| | - Natasha Howard
- London School of Hygiene and Tropical Medicine (LSHTM), Department of Global Health and Development, 15-17 Tavistock Place, London, WC1H 9SH, United Kingdom; National University of Singapore, Saw Swee Hock School of Public Health, 12 Science Drive 2, Singapore.
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8
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Abstract
Drawing on fieldwork and interviews in Oslo and Bergen, Norway, this article discusses irregular migrants' experiences of existential displacement and the tactics they use to try to re-establish a sense of emplacement and belonging. More specifically, it argues that irregular migrants' experiences of embodied unbelonging are a consequence of a violent form of governmentality that includes specific laws, healthcare structures, and migration management rationalities. The article makes this argument by tracing how these experiences translate into embodied effects that feature prominently in migrants' narratives of suffering while living in a country that purports to provide welfare services to all. The narratives of their state of being-in-the-world are ways through which migrants both experience and express the violence and deprivation they face. I argue that these narratives are instances of structures of feeling (Williams 1973), which are shaped by modes of governmentality. The article shows that irregular migrants' coping strategies centrally involve faith, religious communities and friends. Irregular migrants draw on these relationships to get by, access healthcare, and to resist the (health) effects of social deprivation and political violence. These relationships allow irregular migrants to find meaningful ways of being-in-the-world and rebuilding, to some extent, a sense of entitlement and belonging.
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Affiliation(s)
- Synnøve K. N. Bendixsen
- grid.7914.b0000 0004 1936 7443Department of Social Anthropology, University of Bergen, Bergen, Norway
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9
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Cerón A, Jerome J. Engaging with the Right to Health: Ethnographic Explorations of the Right to Health in Practice. Med Anthropol 2019; 38:459-463. [DOI: 10.1080/01459740.2019.1639173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Alejandro Cerón
- Department of Anthropology, University of Denver, Denver, Colorado, USA
| | - Jessica Jerome
- Department of Health Sciences, DePaul University, Chicago, Illinois, USA
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10
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Abstract
The "right to health" operates as a buzzword in Indonesia to frame health policies as beneficial to citizens. Right to health is equated with access to Western biomedical services. Within the policy on partnership between biomedical and traditional midwives, only the biomedical midwife can fulfill the right to health. The "traditional" midwife is reframed as her assistant. Right to health language hides underlying tensions in relationships between these two categories of midwives by presenting the policy as mutually beneficial. Right to health language is effective in the post-Suharto era as it aligns with other incontestable values, including democracy and modernity.
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Affiliation(s)
- Priscilla Magrath
- Department of Health Promotion Sciences, University of Arizona, Tucson, Arizona, USA
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11
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Armin JS. Administrative (in)Visibility of Patient Structural Vulnerability and the Hierarchy of Moral Distress among Health Care Staff. Med Anthropol Q 2019; 33:191-206. [DOI: 10.1111/maq.12500] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Revised: 11/20/2018] [Accepted: 11/21/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Julie S. Armin
- Family and Community Medicine, College of Medicine University of Arizona
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12
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Assor Y, Goodman YC. Beyond Ethics: Professionalism and Social Belonging in Social Workers’ Moral Deliberations. ETHNOS 2019. [DOI: 10.1080/00141844.2019.1575889] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Yael Assor
- Department of Anthropology, University of California-Los Angeles, Los Angeles, USA
| | - Yehuda C. Goodman
- Department of Sociology and Anthropology, Hebrew University of Jerusalem, Jerusalem, Israel
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13
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Morgan LM. "Human Life is Inviolable": Costa Rica's Human Rights Crucible. Med Anthropol 2018; 38:493-507. [PMID: 30299172 DOI: 10.1080/01459740.2018.1510394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The Costa Rican Constitutional Court banned in vitro fertilization in 2000, citing the inviolability of life. Conservatives hoped the ban would initiate a hemispheric movement to protect the unborn. But in 2012 the Inter-American Court of Human Rights ruled that reproductive rights are human rights and that women's rights take precedence over embryo rights. The episode precipitated a national identity crisis: how could a country that supports universal health care be labeled a human rights violator as a result of its efforts to protect nascent human life? Expanding the health and human rights framework helps us appreciate how IVF became Costa Rica's human rights crucible.
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Affiliation(s)
- Lynn M Morgan
- Department of Sociology and Anthropology, Mount Holyoke College , South Hadley , Massachusetts , USA
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14
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Abstract
I analyze the alternative tactics and logics of Las Fuertes, a feminist organization that has taken an "alegal" approach to realizing the human right to abortion in the conservative Mexican state of Guanajuato. Since a series of United Nations agreements throughout the 1990s enshrined reproductive rights as universal human rights, Mexican feminists have adopted the human rights platform as a lobbying tool to pressure the government to reform restrictive abortion laws. This strategy bore fruit in Mexico City, with passage of the historic 2007 abortion legalization. Las Fuertes has leveraged the human rights strategy differently - to justify the direct provision of local abortion accompaniment in a context of near-total abortion criminalization. By directly seizing abortion rights, rather than seeking to implement them through legalistic channels, Las Fuertes has effectively challenged Mexican reproductive governance in an adversarial political environment.
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Affiliation(s)
- Elyse Ona Singer
- a Department of Anthropology , University of Oklahoma , Norman , Oklahoma , USA
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15
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Sangaramoorthy T. “Putting Band-Aids on Things That Need Stitches”: Immigration and the Landscape of Care in Rural America. AMERICAN ANTHROPOLOGIST 2018. [DOI: 10.1111/aman.13054] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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16
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Lawrance BN. Ebola’s Would-be Refugees: Performing Fear and Navigating Asylum During a Public Health Emergency. Med Anthropol 2018; 37:514-532. [DOI: 10.1080/01459740.2018.1457660] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Singer EO. From Reproductive Rights to Responsibilization: Fashioning Liberal Subjects in Mexico City's New Public Sector Abortion Program. Med Anthropol Q 2017; 31:445-463. [PMID: 27380813 DOI: 10.1111/maq.12321] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 06/07/2016] [Accepted: 06/27/2016] [Indexed: 11/29/2022]
Abstract
Building on medical anthropology literature that analyzes doctor-patient interactions as a charged site for the production of political subjectivities, I demonstrate how a central feature of Mexico City's new public sector abortion program involves "responsibilization." In accordance with entrenched Ministry of Health objectives, providers transmit a suite of values about personal responsibility and self-regulation through the use of birth control, hinging abortion rights to responsible reproductive subjectivity. Based on 18 months of ethnographic research across program clinics, including 75 interviews with patients and providers, I show how interrupción legal del embarazo protocols fashion "responsibilized" liberal subjects. I argue that the recent granting of abortion rights in Mexico City-ostensibly a new moment for the construction of women's citizenship-instead reflects and extends long-standing state agendas of "reproductive governance." My analysis of reproductive rights as the newest framing of ongoing population policies in Mexico adds to a critical anthropology of human rights and of liberal projects of governance.
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Willen SS, Knipper M, Abadía-Barrero CE, Davidovitch N. Syndemic vulnerability and the right to health. Lancet 2017; 389:964-977. [PMID: 28271847 DOI: 10.1016/s0140-6736(17)30261-1] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 06/09/2016] [Accepted: 11/30/2016] [Indexed: 01/10/2023]
Abstract
Investigators working both in syndemics, a field of applied health research with roots in medical anthropology, and in the field of health and human rights recognise that upstream social, political, and structural determinants contribute more to health inequities than do biological factors or personal choices. Syndemics investigates synergistic, often deleterious interactions among comorbid health conditions, especially under circumstances of structural and political adversity. Health and human rights research draws on international law to argue that all people deserve access not only to health care, but also to the underlying determinants of good health. Taking the urgent matter of migrant health as an empirical focus, we juxtapose the fields of syndemics and health and human rights, identify their complementarities, and advocate for a combined approach. By melding insights from these fields, the combined syndemics/health and human rights approach advanced here can provide clinicians and other key stakeholders with concrete insights, tools, and strategies to tackle the health inequities that affect migrants and other vulnerable groups by: (1) mapping the effect of social, political, and structural determinants on health; (2) identifying opportunities for upstream intervention; and (3) working collaboratively to tackle the structures, institutions, and processes that cause and exacerbate health inequities. Undergirding this approach is an egalitarian interpretation of the right to health that differs from narrow legalistic and individual interpretations by insisting that all people are equal in worth and, as a result, equally deserving of protection from syndemic vulnerability.
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Affiliation(s)
- Sarah S Willen
- Department of Anthropology, University of Connecticut, Storrs, CT, USA.
| | - Michael Knipper
- Institute for the History of Medicine, Justus Liebig University Giessen, Giessen, Germany
| | | | - Nadav Davidovitch
- Department of Health Systems Management, Ben Gurion University of the Negev, Beersheva, Israel
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19
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Rousseau C, Oulhote Y, Ruiz-Casares M, Cleveland J, Greenaway C. Encouraging understanding or increasing prejudices: A cross-sectional survey of institutional influence on health personnel attitudes about refugee claimants' access to health care. PLoS One 2017; 12:e0170910. [PMID: 28196129 PMCID: PMC5308802 DOI: 10.1371/journal.pone.0170910] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 01/12/2017] [Indexed: 11/30/2022] Open
Abstract
Background This paper investigates the personal, professional and institutional predictors of health institution personnel's attitudes regarding access to healthcare for refugee claimants in Canada. Methods In Montreal, the staff of five hospitals and two primary care centres (n = 1772) completed an online questionnaire documenting demographics, occupation, exposure to refugee claimant patients, and attitudes regarding healthcare access for refugee claimants. We used structural equations modeling to investigate the associations between professional and institutional factors with latent functions of positive and negative attitudes toward refugee's access to healthcare. Results Younger participants, social workers, participants from primary care centres, and from 1st migrant generation had the lowest scores of negative attitudes. Respondents who experienced contact with refugees had lower scores of negative attitudes (B = -14% standard deviation [SD]; 95% CI: -24, -4%). However, direct contact with refugees increased scores of negative attitudes in the institution with the most negative attitudes by 36% SD (95% CI: 1, 71%). Interpretation Findings suggest that institutions influence individuals’ attitudes about refugee claimants’ access to health care and that, in an institutional context of negative attitudes, contact with refugees may further confirm negative perceptions about this vulnerable group.
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Affiliation(s)
- Cécile Rousseau
- Department of Social and Cultural Psychiatry, McGill University, Montreal, Quebec, Canada
- * E-mail:
| | - Youssef Oulhote
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America
| | - Mónica Ruiz-Casares
- Department of Social and Cultural Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Janet Cleveland
- Research Centre of the University Institute with Regard to Cultural Communities, CIUSSS Centre-Ouest de l’Ile de Montreal, Montreal, Quebec, Canada
| | - Christina Greenaway
- Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada
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20
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Brada BB. The Contingency of Humanitarianism: Moral Authority in an African HIV Clinic. AMERICAN ANTHROPOLOGIST 2016. [DOI: 10.1111/aman.12692] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Shalev G. A Doctor's Testimony: Medical Neutrality and the Visibility of Palestinian Grievances in Jewish-Israeli Publics. Cult Med Psychiatry 2016; 40:242-62. [PMID: 26374749 DOI: 10.1007/s11013-015-9470-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This paper follows the testimony of Izzeldin Abuelaish, a Palestinian physician who bears witness to his experiences working, living, and suffering under Israeli rule. He presents his story as a doctor's story, drawing on his identity as a medical professional to gain credibility and visibility and to challenge the limited legitimacy of Palestinian grievances. In this paper, I explore his testimony as a medical voice that at once recounts the suffering and loss endured by the Palestinian people and also struggles to negotiate the values associated with being a "reliable" witness. Consequently, I ethnographically examine the social life and reception of his story in Jewish-Israeli publics. In comparison with most Palestinian narratives, Abuelaish's testimony achieved an extremely rare degree of visibility and sympathy, a phenomenon that calls out for analysis. I identify the boundaries that typically render Palestinian grievances invisible to Israeli publics and suggest how medicine's self-proclaimed ethos of neutrality served as a channel for crossing them. Finally, I reflect on the political possibilities and limitations of medical witnessing to render suffering visible and arouse compassion toward those construed as a dangerous/enemy Other.
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Affiliation(s)
- Guy Shalev
- Department of Anthropology, University of North Carolina at Chapel Hill, 301 Alumni Building, Chapel Hill, NC, 27599, USA.
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22
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Ruiz-Casares M, Cleveland J, Oulhote Y, Dunkley-Hickin C, Rousseau C. Knowledge of Healthcare Coverage for Refugee Claimants: Results from a Survey of Health Service Providers in Montreal. PLoS One 2016; 11:e0146798. [PMID: 26789844 PMCID: PMC4720478 DOI: 10.1371/journal.pone.0146798] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 12/21/2015] [Indexed: 12/04/2022] Open
Abstract
Following changes to the Interim Federal Health (IFH) program in Canada in 2012, this study investigates health service providers' knowledge of the healthcare coverage for refugee claimants living in Quebec. An online questionnaire was completed by 1,772 staff and physicians from five hospitals and two primary care centres in Montreal. Low levels of knowledge and significant associations between knowledge and occupational group, age, and contact with refugees were documented. Social workers, respondents aged 40-49 years, and those who reported previous contact with refugee claimants seeking healthcare were significantly more likely to have 2 or more correct responses. Rapid and multiple changes to the complex IFH policy have generated a high level of confusion among healthcare providers. Simplification of the system and a knowledge transfer strategy aimed at improving healthcare delivery for IFH patients are urgently needed, proposing easy avenues to access rapidly updated information and emphasizing ethical and clinical issues.
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Affiliation(s)
- Mónica Ruiz-Casares
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- SHERPA-Institut Universitaire, Centre intégré universitaire de santé et de services sociaux du Centre-Ouest-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Janet Cleveland
- SHERPA-Institut Universitaire, Centre intégré universitaire de santé et de services sociaux du Centre-Ouest-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Youssef Oulhote
- Harvard School of Public Health, Cambridge, Massachusetts, United States of America
| | - Catherine Dunkley-Hickin
- Center for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, Quebec, Canada
| | - Cécile Rousseau
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- SHERPA-Institut Universitaire, Centre intégré universitaire de santé et de services sociaux du Centre-Ouest-de-l'Île-de-Montréal, Montreal, Quebec, Canada
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23
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Migration as a social determinant of health for irregular migrants: Israel as case study. Soc Sci Med 2015; 147:89-97. [PMID: 26552014 DOI: 10.1016/j.socscimed.2015.10.046] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 10/19/2015] [Accepted: 10/19/2015] [Indexed: 11/20/2022]
Abstract
More than 150,000 irregular migrants reside in Israel, yet data regarding their utilization of and perceived barriers to health care services are limited. Drawing on semi-structured interviews conducted with 35 irregular migrant adults between January and September 2012, this article analyzes the role of migration as a social determinant of health for irregular migrants, and especially asylum seekers. We analyze two kinds of barriers faced by migrants when they attempt to access health care services: barriers resulting directly from their migration status, and barriers that are common among low-income communities but exacerbated by this status. Migration-related barriers included a lack of clear or consistent legislation; the threat of deportation; the inability to obtain work permits and resulting poverty and harsh living and working conditions; and discrimination. Barriers exacerbated by migrant status included prohibitive cost; poor and confusing organization of services; language barriers; perceived low quality of care; and social isolation. These findings support recent arguments that migrant status itself constitutes a social determinant of health that can intersect with other determinants to adversely affect health care access and health outcomes. Findings suggest that any meaningful effort to improve migrants' health will depend on the willingness of clinicians, public health officials, and policymakers to address the complex array of upstream political and socio-economic factors that affect migrants' health rather than focusing on narrower questions of access to health care.
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Tiedje K, Plevak DJ. Medical humanitarianism in the United States: Alternative healthcare, spirituality and political advocacy in the case of Our Lady Guadalupe Free Clinic. Soc Sci Med 2014; 120:360-7. [DOI: 10.1016/j.socscimed.2014.05.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 05/02/2014] [Accepted: 05/12/2014] [Indexed: 11/29/2022]
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Good BJ, DelVecchio Good MJ, Abramowitz S, Kleinman A, Panter-Brick C. Medical humanitarianism: Research insights in a changing field of practice. Soc Sci Med 2014; 120:311-6. [DOI: 10.1016/j.socscimed.2014.09.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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26
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Parson N, Escobar R, Merced M, Trautwein A. Health at the Intersections of Precarious Documentation Status and Gender-Based Partner Violence. Violence Against Women 2014; 22:17-40. [PMID: 25148835 DOI: 10.1177/1077801214545023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article is based on qualitative research investigating Spanish-speaking immigrant women's experiences of gender-based intimate partner violence (GBPV) and help seeking in New Jersey (2006-2008). Methods included interviews with these women, health care and social service providers, and community members. This article reveals that as many immigrant women live at the intersections of structural, normalized, and gender-based partner violence, integrated social service responses emerge as key health care responses to GBPV. The health impacts of undocumented and precariously documented migration and GBPV demand policy interventions and dedication of resources to address the multi-faceted needs of this population.
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Affiliation(s)
- Nia Parson
- Southern Methodist University, Dallas, TX, USA
| | | | - Mariam Merced
- Robert Wood Johnson University Hospital, New Brunswick, NJ, USA
| | - Anna Trautwein
- Saint Peter's University Hospital, New Brunswick, NJ, USA
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Quesada J, Arreola S, Kral A, Khoury S, Organista KC, Worby P. "As Good As It Gets": Undocumented Latino Day Laborers Negotiating Discrimination in San Francisco and Berkeley, California, USA. CITY & SOCIETY 2014; 26:29-50. [PMID: 24910501 DOI: 10.1111/ciso.12033] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Undocumented Latino day laborers in the United States are vulnerable to being arrested and expelled at any time. This social fact shapes their everyday lives in terms of actions taken and strategies deployed to mitigate being confronted, profiled, and possibly incarcerated and deported. While perceptions of threat and bouts of discrimination are routine among undocumented Latino day laborers, their specific nature vary according to multiple social factors and structural forces that differ significantly from locale to locale. The experience of discrimination is often tacitly negotiated through perceptions, decisions, and actions toward avoiding or moderating its ill effects. This essay examines urban undocumented Latino day laborers over a variety of sites in the greater San Francisco Bay Area, which, compared to many metropolitan areas in the U.S. is "as good as it gets" in terms of being socially tolerated and relatively safe from persecution. Nonetheless, tacit negotiations are necessary to withstand or overcome challenges presented by idiosyncratic and ever changing global, national/state, and local dynamics of discrimination. [undocumented Latino laborers, social exclusion, discrimination, tacit negotiation].
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28
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Morgan LM. Claiming Rosa Parks: conservative Catholic bids for 'rights' in contemporary Latin America. CULTURE, HEALTH & SEXUALITY 2014; 16:1245-1259. [PMID: 24592819 DOI: 10.1080/13691058.2014.885086] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
When the Rosa Parks Prize was awarded to a conservative Argentine senator in 2009 for her outspoken opposition to contraception, sterilisation and abortion, it was clear that something odd was happening. This paper documents the appropriation of 'human rights' discourses by conservative Catholics in Latin America, where the recent success of reproductive and sexual rights social movements has generated a significant backlash. It specifically traces an effort by Catholic legal scholars to justify what they term 'a distinctively Latin American approach to human rights' while ignoring decades of human rights activism by others. Opponents of reproductive and sexual rights are deploying rights-talk selectively and strategically, it is argued, using this as secular cover to advance pro-life and pro-family policies.
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Affiliation(s)
- Lynn M Morgan
- a Department of Sociology and Anthropology , Mount Holyoke College , South Hadley , USA
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29
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Nading AM. "Love isn't there in your stomach": a moral economy of medical citizenship among Nicaraguan community health workers. Med Anthropol Q 2013; 27:84-102. [PMID: 23674324 DOI: 10.1111/maq.12017] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Drawing on participant-observation in Nicaraguan dengue prevention campaigns and a series of semistructured interviews with Nicaraguan health ministry personnel, this article shows how community health workers (CHWs) balanced two kinds of "medical citizenship." In some situations, CHWs acted as professional monitors and models of hygienic behavior. At other times, CHWs acted as compassionate advocates for their poor neighbors. In 2008, Nicaragua's Sandinista government moved to end a long-standing policy of paying CHWs, recasting them as citizen-volunteers in a "popular struggle" against dengue. Although CHWs approved of the revival of grassroots advocacy, they were hostile to the elimination of compensation. Framing this ambivalence as part of CHWs' desire to serve as "brokers" between the poor and the state, I suggest that attention to medical citizenship provides insight into the sometimes contradictory ways in which CHWs engage the participatory health policies now taking hold in Latin America and elsewhere.
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Affiliation(s)
- Alex M Nading
- Department of Anthropology, Franklin and Marshall College
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30
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Vanthuyne K, Meloni F, Ruiz-Casares M, Rousseau C, Ricard-Guay A. Health workers' perceptions of access to care for children and pregnant women with precarious immigration status: health as a right or a privilege? Soc Sci Med 2013; 93:78-85. [PMID: 23906124 DOI: 10.1016/j.socscimed.2013.06.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Revised: 06/04/2013] [Accepted: 06/07/2013] [Indexed: 10/26/2022]
Abstract
The Canadian government's recent cuts to healthcare coverage for refugee claimants has rekindled the debate in Canada about what medical services should be provided to individuals with precarious immigration status, and who should pay for these services. This article further explores this debate, focussing on the perceptions of healthcare workers in Montreal, a large multiethnic Canadian city. In April-June 2010, an online survey was conducted to assess how clinicians, administrators, and support staff in Montreal contend with the ethical and professional dilemmas raised by the issue of access to healthcare services for pregnant women and children who are partially or completely uninsured. Drawing on qualitative analysis of answers (n = 237) to three open-ended survey questions, we identify the discursive frameworks that our respondents mobilized when arguing for, or against, universal access to healthcare for uninsured patients. In doing so, we highlight how their positions relate to their self-evaluations of Canada's socioeconomic situation, as well as their ideological representations of, and sense of social connection to, precarious status immigrants. Interestingly, while abstract values lead some healthcare workers to perceive uninsured immigrants as "deserving" of universal access to healthcare, negative perceptions of these migrants, coupled with pragmatic considerations, pushed most workers to view the uninsured as "underserving" of free care. For a majority of our respondents, the right to healthcare of precarious status immigrants has become a "privilege", that as taxpayers, they are increasingly less willing to contribute to. We conclude by arguing for a reconsideration of access to healthcare as a right, and offer recommendations to move in this direction.
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Affiliation(s)
- Karine Vanthuyne
- Department of Sociology and Anthropology, 120 Université Ottawa, Ottawa, ON, K1N 6N5 Canada.
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31
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Guell C. Self-Care at the Margins: Meals and Meters in Migrants’ Diabetes Tactics. Med Anthropol Q 2012; 26:518-33. [DOI: 10.1111/maq.12005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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32
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Willen SS. Migration, "illegality," and health: mapping embodied vulnerability and debating health-related deservingness. Soc Sci Med 2011; 74:805-11. [PMID: 22257746 DOI: 10.1016/j.socscimed.2011.10.041] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2011] [Revised: 10/13/2011] [Accepted: 10/25/2011] [Indexed: 11/25/2022]
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33
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Sargent C, Larchanché S. Transnational Migration and Global Health: The Production and Management of Risk, Illness, and Access to Care. ANNUAL REVIEW OF ANTHROPOLOGY 2011. [DOI: 10.1146/annurev-anthro-081309-145811] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Globalization, including the global flows of people, is clearly linked to disease transmission and vulnerability to health risks among immigrant populations. Anthropological research on transnational migration and health documents the implications of population movements for health and well-being. Studies of immigrant health reveal the importance of the social, political, and economic production of distress and disease as well as the structures and dynamics that produce particular patterns of access to health services. This review points to underlying political, economic, and social structures that produce particular patterns of health and disease among transnational migrants. Both critical and phenomenological analyses explore ideas of alterity and community, which underlie the production and management of immigrant health. Research on immigrant health underscores the importance of further attention to policies of entitlement and exclusion, which ultimately determine health vulnerabilities and accessibility of health care.
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Affiliation(s)
- Carolyn Sargent
- Department of Anthropology, Washington University in St. Louis, St. Louis, Missouri 63130
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34
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Gottlieb N, Filc D, Davidovitch N. Medical humanitarianism, human rights and political advocacy: the case of the Israeli Open Clinic. Soc Sci Med 2011; 74:839-45. [PMID: 21911276 DOI: 10.1016/j.socscimed.2011.07.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 07/09/2011] [Accepted: 07/27/2011] [Indexed: 11/30/2022]
Abstract
In the context of neo-liberal retrenchments humanitarian NGOs have become alternative healthcare providers that partially fill the vacuum left by the welfare state's withdrawal from the provision of services to migrants and other marginalized populations. In many cases they thus help to build legitimacy for the state's retreat from social responsibilities. Human rights organizations play an important role in advocating for migrants' rights, but in many cases they represent a legalistic and individualized conceptualization of the right to health that limits their claims for social justice. This paper analyzes the interactions and tensions between the discourses of medical humanitarianism, human rights and political advocacy using the example of an "Open Clinic" run by an Israeli human rights organization as a case-study: In 2007 dramatically increasing patient numbers provoked an intense internal debate concerning the proposal to temporarily close the "Open Clinic" in order to press the government to take action. Based on protocols from internal meetings and parliamentary hearings and in-depth interviews, we have analyzed divergent contextualizations of the Clinic's closure. These reflect conflicting notions regarding the Clinic's variegated spectrum of roles--humanitarian, political, legitimizing, symbolic, empowering and organizational--and underlying conceptualizations of migrants' "deservingness". Our case-study thus helps to illuminate NGOs' role in the realm of migrant healthcare and points out options for a possible fruitful relationship between the divergent paradigms of medical humanitarianism, human rights and political advocacy.
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Affiliation(s)
- Nora Gottlieb
- Department of Health Systems Management, Ben-Gurion University, P.O.B. 635, 84105 Beer Sheva, Israel.
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35
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Willen SS. How is health-related "deservingness" reckoned? Perspectives from unauthorized im/migrants in Tel Aviv. Soc Sci Med 2011; 74:812-21. [PMID: 21821324 DOI: 10.1016/j.socscimed.2011.06.033] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2010] [Revised: 06/10/2011] [Accepted: 06/16/2011] [Indexed: 11/18/2022]
Abstract
Do unauthorized im/migrants have a right to health? Do they deserve health care, or health protection, or access to the social determinants of good health? Are they party to prevailing social contracts, or does their exclusion from mainstream systems of health promotion, prevention, and care "make sense"? Questions like these, which generate considerable attention in multiple spheres of scholarship, policy, and public debate, revolve around an issue that merits substantially greater consideration among social scientists of health: health-related "deservingness." In addition to putting the issue of health-related deservingness squarely on the map as an object of analysis, this article further argues that we cannot focus solely on those with power, influence, and public voice. Rather, we also must investigate how deservingness is reckoned in relation to--and, furthermore, from the perspectives of-- unauthorized im/migrants and members of other groups commonly constructed in public and policy discourse as undeserving. Additionally, we must consider the complicated relationship between universalizing juridical arguments about formal entitlement to health rights, on one hand, and situationally specific, vernacular moral arguments about deservingness, on the other. The paper analyzes findings from a 29-month mixed-methods study conducted in Tel Aviv, Israel, that approached unauthorized im/migrants as subjects, rather than simply objects, of ethical deliberation. Participants' conceptions of health-related deservingness are investigated using two sources of data: (1) quantitative findings from a self-administered, closed-ended survey conducted with 170 im/migrant patients at an NGO-run Open Clinic (2002-2003), and (2) qualitative findings from the larger ethnographic study of which the survey was part (2000-2010). The study findings both (1) contradict commonly circulating assumptions that unauthorized im/migrants are "freeloaders," and (2) highlight the need for rigorous investigation of how unauthorized im/migrants, among other marginalized and vulnerable groups, conceptualize their own relative deservingness of health-related concern and investment.
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Affiliation(s)
- Sarah S Willen
- University of Connecticut, Department of Anthropology, 354 Mansfield Road, Unit 2176, Beach Hall, Storrs, CT 06269-2176, USA.
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36
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Viladrich A. Beyond welfare reform: reframing undocumented immigrants' entitlement to health care in the United States, a critical review. Soc Sci Med 2011; 74:822-9. [PMID: 21745706 DOI: 10.1016/j.socscimed.2011.05.050] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Revised: 05/22/2011] [Accepted: 05/25/2011] [Indexed: 11/27/2022]
Abstract
This article addresses the main scholarly frames that supported the deservingness of unauthorized immigrants to health benefits in the United States (U.S.) following the passage of the Personal Responsibility Work Opportunity Reconciliation Act (PRWORA), known as the Welfare Reform bill, in 1996. Based on a critical literature review, conducted between January 1997 and March 2011, this article begins with an analysis of the public health rhetorics that endorsed immigrants' inclusion into the U.S. health safety net. In this vein, the "cost-saving" and "the effortful immigrant" frames underscore immigrants' contributions to society vis-à-vis their low utilization of health services. These are complemented by a "surveillance" account that claims to protect the American public from communicable diseases. A "maternalistic" frame is also discussed as a tool to safeguard families, and particularly immigrant mothers, in their roles as bearers and caretakers of their American-born children. The analyses of the "chilling" and the "injustice" frames are then introduced to underscore major anthropological contributions to the formulation of counter-mainstream discourses on immigrants' selective inclusion into the U.S. health care system. First, the "chilling effect," defined as the voluntary withdrawal from health benefits, is examined in light of unauthorized immigrants' internalized feelings of undeservingness. Second, an "injustice" narrative highlights both the contributions and the limitations of a social justice paradigm, which advocated for the restoration of government benefits to elderly immigrants and refugees after the passage of PRWORA. By analyzing the contradictions among all these diverse frames, this paper finally reflects on the conceptual challenges faced by medical anthropology, and the social sciences at large, in advancing health equity and human rights paradigms.
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Affiliation(s)
- Anahí Viladrich
- Queens College & The Graduate Center, The City University of New York, Flushing, New York City, NY 11367, USA.
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37
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Chavez LR. Undocumented immigrants and their use of medical services in Orange County, California. Soc Sci Med 2011; 74:887-93. [PMID: 21684055 DOI: 10.1016/j.socscimed.2011.05.023] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2010] [Revised: 05/14/2011] [Accepted: 05/17/2011] [Indexed: 10/18/2022]
Abstract
Does an undocumented immigration status predict the use of medical services? To explore this question, this paper examines medical care utilization of undocumented Latino immigrants compared to Latino legal immigrants and citizens, and non-Latino whites in Orange County, California. Data were collected through a random sample telephone survey of 805 Latinos and 396 non-Hispanic whites between January 4 and January 30, 2006. Findings show that undocumented immigrants had relatively low incomes and were less likely to have medical insurance; experience a number of stresses in their lives; and underutilize medical services when compared to legal immigrants and citizens. Predictors of use of medical services are found to include undocumented immigration status, medical insurance, education, and gender. Undocumented Latinos were found to use medical services less than legal immigrants and citizens, and to rely more on clinic-based care when they do seek medical services.
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Affiliation(s)
- Leo R Chavez
- Department of Anthropology, University of California, Campus Drive, Irvine, CA 92617, USA.
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