Doctoral Dissertation Improvement Grant: Healthcare and Citizenship among Unionized Service Workers in Central Appalachia

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Graduate student, Rebecca Adkins Fletcher, supervised by Dr. Mary K. Anglin, will undertake research on health care benefits for rank-and-file service workers and their families in Appalachia. Transformations from an industrial to a service economy, rising insurance costs, neoliberal social policies, and decreased labor union power have increased the number of Americans with reduced access to health care, especially for service workers and women. Quantitative public health surveys measure access to health care for individuals but fail to account for or contextualize dynamic concerns of individuals and families. Grounded in the theoretical perspectives of political economic medical anthropology and citizenship, the researcher will focus on service workers in two unions to investigate the significance of health benefits resulting from union membership; explore health care concerns, barriers, and strategies to obtain care for individuals and households; and describe how union member and household concerns are reflected in the actions of two union locals. Her research will involve a large survey which will be followed up with focused case studies of twenty households. She also will employ standard ethnographic methods such as participant-observation at union events and within the community to increase understanding of local concerns and activism. Through an analysis of access to health care and substantive citizenship rights of workers in the fastest growing economic sector, this study addresses current U.S. and global processes of economic restructuring and marginalization. It also will contribute significantly to the education of a graduate student.