Inequalities at work: health care workers and clients in a community clinic Public Deposited

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  • March 20, 2019
Creator
  • Deeb-Sossa, Natalia
    • Affiliation: College of Arts and Sciences, Department of Sociology
Abstract
  • My dissertation is a study of health care workers and clients in a private, not-for-profit health care center. Through participant observation and in-depth interviews I analyze how workers at a community clinic reproduce or respond to inequalities of race, class, and gender in their interactions with each other and in their daily work with poor clients, especially Latinas/os. As a symbolic interactionist and feminist ethnographer, I studied how health care providers came to act as they did as well as the consequences of their behavior for their clients, other staff, and themselves. I identify how inequality was reproduced, including the interactions, roles, identities, meanings, and emotions that were central to the people at the clinic. In Chapter 1, I explore how the Black female staff draw on racialized and gendered rhetorics to criticize and claim status over Latinas. These rhetorics followed from the discourses constructed and used by white elites to reinforce racism and sexism. Black women used these rhetorics as a way to respond to the changes in the racial make-up of clients and the accompanying hiring of bilingual staff, mostly Latinas. Similarly, Latinas used images of pushy, bossy, and "uppity Black women" against the Black staff. I argue that these strategies divided low-status workers. In Chapter 2, I examine how the Maternity Care Coordinators (MCCs) maintained a moral identity as good health care providers. The MCCs defined Latinas as the "neediest of the needy" and "Americans" as the privileged clients. They thought differently about the Latina, Black, and white women they served. In Chapter 3, I explore how the white high-status staff's solidarity-talk kept them from seeing the significance of race in interactions among staff members. The rhetoric used largely by the white high-status staff protected them from having to "see" their own race and did not help Latina and Black staff develop solidarity. Finally, in the conclusion I highlight how the staff might have come to recognize racism, sexism, and class inequality if organizational arrangements had been different.
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  • Kleinman, Sherryl
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