Doctoral Dissertation Research: Cancer, Citizenship, and Scarcity in the Land of Opportunity

University Of Arizona, Tucson AZ

Investigators

Abstract

University of Arizona doctoral student, Julie Armin, supervised by Dr. Mark A. Nichter, will undertake ethnographic research on the lived-experience of cancer treatment for uninsured patients who qualify for state-funded care. Because cancer is a disease dependent upon high-tech medical interventions, it offers a particularly rich locus for examining how the experience of health care is affected by ability to pay. As the United States improves access to cancer screenings through programs that offer free or reduced-cost exams, there is an accompanying need for treatment among low-income and uninsured individuals. This ethnographic study of patients, families, and health care providers will examine the experiences of these new "medical citizens," who make claims on various health care resources, including hospitals, medical experts, lay professionals, charities, and state programs. The research will be conducted in Tucson, Arizona, a city less than an hour from the United States-Mexico border, with a population that often looks to Mexico for less expensive health care. The researcher will use a combination of ethnographic research methods, including in-depth interviews, structured observations, and participant-observation. The research goals are: 1) to document the experience of financial treatment policies from the individual, household, and health care provider perspectives; 2) to examine the clinical bureaucratic practices that invite or restrict access to health care; and 3) to explore the work done by individuals, families and providers who take responsibility for cancer care, with particular attention to gender. The research is important because it will contribute to theories that seek to explain why social inequalities persist, even in equality-promoting democracies. The research also will help to illuminate how the work as well as the costs occasioned by serious illness are distributed. In addition, research findings may inform the public policy analyses that seek to determine how policy may both enable and constrain individuals, and possibly contribute to health disparities. Supporting this research also supports the education of a social scientist.