Different Subjects: The Health Care System's Participation in the Differential Construction of the Cultural Citizenship of Cuban Refugees and Mexican Immigrants

Abstract

This paper explores the public health system's differential construction of Mexican and Cuban immigrants' "deservingness" of citizenship benefits and its preparation of them for different roles in U.S. society. Civic institutions such as the public health care system are charged with inculcating normative behavior in immigrants and instilling in them different conceptions about their rights and responsibilities. Faced with limited resources under the implementation of Medicaid managed care, hospital administrators created new categories of "deserving" and "undeserving" immigrants based on neoliberal standards of individual responsibility and self-discipline. As a result, hospital policies construct different types of "cultural citizenship" for Cuban and Mexican immigrants, preparing the former to be active citizens and discouraging the latter from pressing demands on American civil institutions. I show that this negative construction of Mexican immigrants' moral worth leads to unmet health needs and poor health outcomes.

Strawberry Fields as Extreme Environments: The Ecobiopolitics of Farmworker Health

“…When someone gets sick or hurt in the process, the blame is usually assigned to individuals' negligence, ignorance, or behavior. Similar patterns can be seen in the case of musculoskeletal injuries in farm work (Jain 2006;Saxton 2013), and with immigrant encounters with the health care system more generally (Holmes 2013;Horton 2004). Many of the farmworker pesticide safety strategies featured in educational materials developed by CA DPR and the EPA, and highlighted in intervention-based research (Bradman et al 2009;Salvatore et al 2008) emphasize individual-level behavioral changes such as hand washing, segregating work clothes from regular laundry, wearing protective gear, washing fresh produce before eating it, and keeping windows closed during pesticide applications.…”

“…Some attendees disregarded worker concern about exposure as a display of psychosomatics, an effort to get out of work early, or blamed the public for overdramatizing drift incidences. Other anthropologists (Holmes 2013;Horton 2004) have observed the overt downgrading of Latino and farmworker patients' ailments in clinical contexts. Mario's status in both the on-and off-the-farm hierarchies-as a harvester, as a Mexican, and, as I describe next, as someone who asserted himself with his employer and doctor-may also have contributed to the Downloaded by [Northeastern University] at 17:07 18 November 2014 quality of care he received, in addition to the overall toxic ignorance of the state, agribusinesses, health care providers, and farmworker peers.…”

“…These are ordinarily attributed to genetic predispositions (Montoya 2011) and poor people's failures to take care of themselves (Borovoy and Hine 2008;Guthman 2011;Horton 2004). Cancer and neurological problems are also linked to pesticide exposure (Alavanja, Hoppin, and Kamal 2004;Arcury et al 2006;Mills, Beaumont, and Nasseri 2006;Mills, Dodge, and Yang 2009).…”

Caesarean sections and breastfeeding initiation among migrants in Switzerland

“…‡ adjusted for sex, maternal age, and parity † adjusted for sex, maternal age, parity, birth weight, preterm delivery, multiple birth, and health facility, where delivery occurred ¥ adjusted for sex, maternal age, parity, birth weight, preterm delivery, multiple birth, transfer to ICU and health facility, where delivery occurred Birkhäuser Verlag, Basel, 2007 in Switzerland integration policies. Socio-economic factors and the legal status of migrants in the host country, which may differ between nationalities, contribute to the cultural identity (Horton 2004;Hall 2004). Portes and Rumbaut summarise factors shaping migrants' identities as follows: (1) human capital, infl uenced by educational background, occupational skills, fi nancial resources, and facility with the language; (2) the host society's reception of immigrant populations, particularly in relation to governmental policies, popular attitudes, and the presence of co-ethnic populations; and (3) the composition of immigrant families (Portes & Rumbaut 2001).…”

Multimethod Evaluation of Health Policy Change: An Application to Medicaid Managed Care in a Rural State

“…Triangulation (i.e., comparing observations, interviews, and documents) helped clarify themes, concerns, and meanings that emerged repeatedly. Separate articles provides a more complete description of our ethnographic data collection, analysis, and interpretation process (Horton 2004;Lamphere 2005;Willging, Waitzkin, and Wagner 2005).…”