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Precarity and health: Theorizing the intersection of multiple material-need insecurities, stigma, and illness among women in the United States.
Whittle, Henry J; Leddy, Anna M; Shieh, Jacqueline; Tien, Phyllis C; Ofotokun, Ighovwerha; Adimora, Adaora A; Turan, Janet M; Frongillo, Edward A; Turan, Bulent; Weiser, Sheri D.
Afiliación
  • Whittle HJ; Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK. Electronic address: h.whittle@qmul.ac.uk.
  • Leddy AM; Division of Prevention Science, Department of Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA.
  • Shieh J; Institute for Global Health Sciences, UCSF, San Francisco, CA, USA.
  • Tien PC; Department of Medicine, UCSF and Medical Service, Department of Veteran Affairs Medical Center, San Francisco, CA, USA.
  • Ofotokun I; School of Medicine, Emory University and Grady Healthcare System, Atlanta, GA, USA.
  • Adimora AA; School of Medicine and UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
  • Turan JM; Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham (UAB), Birmingham, AL, USA.
  • Frongillo EA; Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
  • Turan B; Department of Psychology, UAB, Birmingham, AL, USA.
  • Weiser SD; Division of HIV, ID and Global Medicine, Department of Medicine, UCSF, San Francisco, CA, USA.
Soc Sci Med ; 245: 112683, 2020 01.
Article en En | MEDLINE | ID: mdl-31760320
Material-need insecurities (including insecurities in basic resources such as income, food, housing, and healthcare) are widespread in the United States (US) and may be important predictors of poor health outcomes. How material-need insecurities besides food insecurity are experienced, however, remains under-researched, including how multiple material-need insecurities might intersect and converge on the individual. Here we used qualitative methods to investigate experiences with multiple material-need insecurities among 38 food-insecure women aged over 50 years living with or at risk for HIV in the US. Our aims were: (1) to understand the co-experience of material-need insecurities beyond food insecurity; (2) to elucidate how multiple material-need insecurities might intersect; and (3) to discover how this intersection might be detrimental to health. During November 2017-July 2018, we conducted semi-structured interviews at three sites across the US (Northern California, Georgia, North Carolina) and analyzed the data using an inductive-deductive approach. We identified a common and complex picture of multiple material-need insecurities, stigma, and illness among participants across all three sites. There were five primary themes: (1) insecure income arising from a combination of precarious wage labor and federal disability benefits; (2) resultant experiences of uncertainty, compromised quality, insufficiency, and having to use socially unacceptable coping strategies across finances, food, housing, and healthcare; (3) participants' disempowerment arising from their engagement with social safety net institutions; (4) closely related experiences of intersectional stigma and discrimination; and (5) negative implications for health across a wide range of illnesses. By employing the sociological concept of precarity-a term denoting the contemporary convergence of insecure wage labor and retraction of the welfare state-we combine these themes into a unifying framework of precarity and health. This framework may prove useful for testing how the widespread intersection of multiple material-need insecurities interacts with stigma and discrimination to negatively impact physical and mental health.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Mujeres / Infecciones por VIH / Costo de Enfermedad / Estigma Social / Inseguridad Alimentaria Tipo de estudio: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Aspecto: Determinantes_sociais_saude Límite: Adult / Aged / Female / Humans / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Soc Sci Med Año: 2020 Tipo del documento: Article Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Mujeres / Infecciones por VIH / Costo de Enfermedad / Estigma Social / Inseguridad Alimentaria Tipo de estudio: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Aspecto: Determinantes_sociais_saude Límite: Adult / Aged / Female / Humans / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Soc Sci Med Año: 2020 Tipo del documento: Article Pais de publicación: Reino Unido