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

研究生丽贝卡·阿德金斯·弗莱彻将在玛丽·K·安格林博士的指导下，对阿巴拉契亚地区普通服务人员及其家人的医疗福利进行研究。从工业经济向服务经济的转变、不断上涨的保险成本、新自由主义的社会政策以及工会力量的减弱，增加了获得医疗保健的美国人的数量，特别是服务工作者和妇女。量化的公共卫生调查衡量个人获得保健的情况，但没有考虑到个人和家庭的动态关切，也没有考虑到这些问题的背景。基于政治经济学、医学人类学和公民意识的理论视角，研究人员将聚焦于两个工会的服务工作者，以调查工会成员身份带来的健康福利的重要性；探索获得个人和家庭护理的卫生保健问题、障碍和策略；并描述工会成员和家庭关切如何反映在两个工会当地人的行动中。她的研究将涉及一项大型调查，随后将对20个家庭进行重点案例研究。她还将采用标准的人种学方法，如在工会活动和社区内观察参与者，以增加对当地关切和激进主义的理解。通过对增长最快的经济部门的工人获得医疗保健和实质性公民权利的分析，这项研究探讨了当前美国和全球经济结构调整和边缘化的进程。它也将对研究生的教育做出重大贡献。

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.