University of Kentucky doctoral student Patti Meyer, supervised by Dr. Mary K. Anglin, will investigate the healthcare strategies of South American female migrant careworkers laboring in the homes of elderly clients in Genoa, Italy. Elder care is an acute concern in many cities across the Global North, where the population is aging while family size is decreasing and women, who are the traditional caregivers, pursue work outside the household. Carework of elders in their homes by migrant workers is but one example of contemporary transnational migration and its linkages with the growth of health and family care as marketable commodities. The researcher has chosen Genoa as an appropriate site to investigate this phenomenon because Genoa has the largest percentage of adults over 80 in Europe.
Previous research has focused on the effects of migrant labor on the economies of the countries from which they come and to which they go. This project is looking at the effects on the careworkers themselves. In particular, the research will address the consequences of carework on the careworkers' own mental and physical health. This researcher will use data from semi-structured interviews with careworkers, semi-structured interviews with professionals who provide services to the careworkers, long-term participant observation, and archival data on migrants and labor markets in Italy to: 1) produce empirical data on health concerns of and healthcare resource use by migrant careworkers; and 2) investigate the relationships between health concerns, living/working conditions, and healthcare resource use of transnational migrants in informal work settings.
This research is important because it will bring together medical anthropology and labor theory in a new way, which will increase theoretical understanding of the individual-level consequences of migration and globalization. The research also will inform policy regarding the care of elders and those who care for them. Funding this project supports the education of a social scientist.
9/1/2011 This research was done in Genoa, Italy because it is a useful place for studying the conditions under which immigrant workers labor as they provide care to elders in their private homes. Genoa has the largest percentage of people over the age of 70 in any city of its size in the world and a tradition of sending and receiving immigrant workers. The main question behind this project was under the circumstances of providing labor-intensive, in-home supportive services, how do immigrant workers respond to their own mental and physical health needs? One motivation for this study was to learn which practices support caregivers, with the idea that these findings can improve the quality and safety of the care they provide to elders. The researcher collected data from semi-structured interviews with 50 careworkers, semi-structured interviews with 25 professionals who provide services to the careworkers, and interviews with 23 administrators in the health system, government agencies, labor unions, and the Catholic Church. All of the careworkers interviewed were women from South American countries, as these are the people who do most of the carework jobs in this city. Established anthropology methods such as long-term participant observation, and examination of written data in Italian archives were also employed to: 1) produce empirical data on health concerns of and healthcare resource use by migrant careworkers; and 2) investigate the relationships between health concerns, living/working conditions, and healthcare resource use of transnational immigrants in informal work settings. The data showed that the Catholic Church was important in promoting immigrants as able workers, aiding their elderly parishioners in finding help, and providing necessary mental health support to careworkers who experienced stress as a consequence of in-home carework. The data also revealed that the health care system of Italy functioned well to address the physical health concerns of immigrant careworkers. Common health concerns included: back problems, arm pain, headaches, and stomach problems. The influence of the relationship between the client and the worker was important for the general well-being of the worker and her ability to maintain her general health, have time for medical appointments, socialize outside of the workplace, and attend community events, such as church services. The well-established workers I interviewed recognized that Italy’s new anti-immigrant laws have the effect of scaring immigrants. Public health officials are concerned that such fear is keeping people away from healthcare resources, when these resources are available to all. The data also reveal that a few of the laws restricting healthcare for undocumented immigrants had to be altered as the medical professionals refused to cooperate in enforcing the law, and health administrators continued to serve all immigrants in Italy. This research on healthcare strategies of immigrant careworkers contributes to the ways medical anthropology, migration studies and social science understand human-economy-family care relationships and health and carework as commodities in today's global economy. It reveals the consequences for workers as they defray the costs of care for the Italian government and contribute to their home economies with their paychecks. As this study brings together medical anthropology and labor theory in a new way, the project has significant influence on anthropological thought and contributes to the education of social scientists. It also can inform policy regarding the care of elders and those who care for them. POLICY IMPLICATIONS AND PUBLIC HEALTH IMPLICATIONS A LOCALIZED DESCRIPTIVE STUDY CAN INFORM POLICY. The data collected through this research provides a close examination of the local context and daily practices of careworkers making decisions regarding healthcare resources. These findings inform international public health policy, especially important considering the demographic shifts resulting in many people living longer with multiple chronic conditions that trigger the need for care in the home. HUMAN RIGHTS, LABOR ORGANIZING, AND HEALTH ACCESS ARE CONNECTED BY THIS STUDY. This study examines: strategies for getting to health resources; responses of the Italian medical system personnel to the anti-immigrant legislation passed; use of non-State resources to meet health needs; the health consequences of caring for an elderly person in the private home; and ways to address these health consequences. These data have implications for understanding the ways in which the European Union and the Italian government act on their stated ideal of "healthcare as a human right" for this "invisible" group of immigrant workers. There are further implications of this study for other countries, including the United States, as demographics change and resources must be used in new ways to meet the needs of those who need some level of care "at home."
