Theorizing Precarization and Racialization as Social Determinants of Health: A Case Study Investigating Work in Long-Term Residential Care

This thesis uses anti-racist and feminist political economy of health perspectives that intersect with immigrant status, in order to analyze the findings from a single-case study investigating the social determinants of health and work precarization in a residential long-term care (LTC) facility in Toronto, Ontario. Throughout this dissertation, I use mixed methods case study to investigate social, political, and economic implications in the lives of health care workers. Observation, interview, and survey methods were utilized to investigate workers health in relation to the precarization of work. Specifically, I used the concept of precarization as a lens to track the ways in which work relations impact the other social determinants of health. The main areas of focus include the intersections of gender, work, and occupational health with race, immigrant status, and culture; the ways in which precarization affects employees in this specific health care sector; the implications of precarization in the health and wellbeing of workers and their families; the role of (un)paid care work and social support provided by family members; and the exercise of strength, resilience, resistance, agency, and coping strategies. Broadly, I will argue that precarization in LTC is an increasingly experienced phenomenon, and that various levels of precarization are experienced by particular workers who are women, racialized persons, and immigrants. This study contributes to our understanding of racialization as a social determinant of health, and analyzes the health impacts of workplace inequality through the lens of precarization. The study makes the case for closer attention to racism and precarity both on and as social determinants of health.