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（Rebecca Adkins Fletcher）将在玛丽·k·安格林（Mary K. Anglin）博士的指导下，对阿巴拉契亚地区普通服务工作者及其家人的医疗保健福利进行研究。从工业经济向服务业经济的转变、保险成本的上升、新自由主义社会政策以及工会力量的减弱，使得获得医疗保健的美国人越来越少，尤其是服务业工人和妇女。定量公共卫生调查衡量个人获得卫生保健的机会，但未能说明个人和家庭动态关注的问题或将其纳入背景。基于政治、经济、医学人类学和公民的理论视角，研究人员将重点关注两个工会的服务工作者，以调查工会成员资格带来的健康益处的意义；探讨个人和家庭获得保健的保健问题、障碍和战略；并描述工会成员和家庭的关切如何反映在两个当地工会的行动中。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。她还将采用标准的民族志方法，如在工会活动和社区内进行参与者观察，以增加对当地问题和行动主义的理解。通过对增长最快的经济部门工人获得医疗保健和实质性公民权利的分析，本研究解决了当前美国和全球经济结构调整和边缘化的进程。这对研究生的教育也有很大的帮助。

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.