Women's domestic health work in poverty: A comparison of Mexican American and Anglo households.

Abstract

The purpose of this dissertation was to identify the components of women's domestic health work in networks surrounding poor Mexican American and Anglo households and compare women's experiences as domestic health workers. Women representing 10 Mexican American households and 10 Anglo households and their surrounding domestic networks were recruited for this study. Criteria for participation included the presence of at least one child in the household $\le$5 years of age and household income at or below the federally-defined weighted poverty threshold. Sources included, first, 66 interviews with women (n = 26) residing in the study households. Second, women kept 3-week daily health diaries on behalf of all household members. And third, women participated in an inventory of household medications. The study employed several analytic methods, including descriptive statistical analyses, phenomenological insight, taxonomic analyses of women's knowledge structures, life history analysis, thematic analysis, and narrative analyses. The results of the study emphasized several points, including the: (a) gendered but hotly contested nature of domestic responsibility for health, with responsibility negotiated between men and women in households, and disputed between households and social service agencies; (b) significant role played by women's informal networks in defining and evaluating the enactment of maternal responsibility; (c) workings of women's coalitions and cooperatives that protect women's threatened interests and redistribute resources among women; (d) influences governing the transmission of child health and illness knowledge and skills across generations of women; (e) double-edged nature of self-medication that appears as both a source of female autonomy and expertise, yet paradoxically and simultaneously can act as an inappropriate, self-palliating balm for the hurt incurred from inadequate accessibility to quality professional health care for poor women and children; and (f) cross-cutting influences of ethnicity and historical situation in each of the above domains. Women pieced together resources from their cultural background, femaleness, and sometimes their poverty; all these factors also entailed contradictory disadvantages in the production of household health. The health and social policy implications of this study were described in detail in the dissertation, as were the women's own visions for an approximation of utopia.