Work, understood in its broadest sense, involves creating and serving for either one’s own or one’s dependants’ direct consumption, in exchange for pay and/or other support (Applebaum 1992). Unpaid work is that which is carried out for personal consumption or for others (e.g., household work, child care, attendance to the needs of the disabled or elderly, community service) and may be (but not always) accompanied by non-monetary rewards such as companionship, opportunities for creative growth, and so forth. Most of the activities that fall under unpaid work are in some way or other connected with the social reproduction of human...

Mainstream health and policy discourses now commonly acknowledge that where one lives affects how well one lives (Lalonde 1974; Romanow 2002). A recent Canadian study,How Healthy Are Rural Canadians(Canadian Institute for Health Information [CIHI] 2006), identified that as distance from an urban centre increases, health decreases, demonstrating that geography matters to health status and that geographical and socioeconomic disadvantages work together in complex ways to create negative health conditions for rural people. Rural women, in particular, are especially vulnerable to negative health conditions for they have been found to be less healthy compared with their urban counterparts as...

Recent international economic policy has been focused on boosting exports and free trade, deregulating domestic economies, liberalizing capital markets, and promoting market-based pricing. These macroeconomic ‘neoliberal’ reforms have typically been accompanied by policies to reduce public expenditure, including public outlay for health. Evidence mounting from low- and middle-income countries points to increasing inequality, as the affluent few can afford to overuse health care, paying for the consumed services out of pocket, while the bulk of the population face a ‘medical poverty trap,’ unable to access health care for even basic conditions (Sen 2002; Armstrong et al. 2003).

A question remains...

Despite the complexity of modern nursing and its position as an important health care profession, the paid care work or ‘intimate labour’ (Zelizer 2007) nurses perform for patients is often undervalued in many countries, resulting in comparatively low salaries and poor working conditions. The age-old dynamic of treating nursing as a homogeneous activity which requires ‘a pair of hands,’ and qualities such as dedication, sympathy, and altruism, are awarded less value than the scientific and rational expert-task of ‘curing’ associated with doctors, dentists, and other medical practitioners. This situation is worsened by neoliberal efficiency-driven policies that increasingly commodify and quantify...

Health care provided in the community, within people’s homes, is variably viewed as a key component of a fully functioning public health care system (NACA 2000; Romanow 2002), as an unwelcome intrusion into a living space full of private decisions about how to live a life (Angus et al. 2005), and as a form of underpaid, undervalued work, or intimate labour, that has become a gendered ghetto for marginalized women (Armstrong & Armstrong 1996; Aronson & Neysmith 2006; Benoit & Hallgrímsdóttir, this volume).

In confronting the significant challenges posed by home-based care we hope to encourage critical reflection on the...

Bridget is 87 years old, and she receives home care twice a week for two hours each visit. She has lived alone since her husband died nine years ago. She has a stepson whom she seldom sees, and a foster son who lives on the other side of the province. Bridget goes to the seniors’ centre regularly where she plays cards and other games. She does not want to move to a facility and is determined to stay in her own home as long as she can.

Bridget indicated that her health is ‘pretty poor’ as she suffers from physical...

This chapter explores the role of Aboriginal prenatal peer support workers in carrying out their everyday work in community-based prenatal, postnatal, and mother and infant health care services. These peer support workers are representative of a unique group of women who are at the same time First Nations community members, mothers, daughters, granddaughters, intimate partners, advocates for maternal and infant health and wellness and for cultural reclamation, and trained individuals responsible for the local delivery of primary health care services. The work that they do is challenged by several factors, including current imbalances in Canadian power relations relating to gender,...

Many Canadian social policies emphasize the obligation of individuals to care for their dependent family members, reflecting normative expectations that family members are responsible for providing support for one another. Such policies have particular implications for the economic, emotional, and physical well-being of those who do family care work, primarily mothers. In this chapter, we suggest that the concepts of familialism and responsibilization can help in understanding how care work after separation and/or divorce is highly gendered. We describe the implications of familialistic policies, practices and assumptions on mothers’ health and dignity, with a focus on the Canadian context. In...

In Canada, as throughout much of the Western world, the population is aging, with forecasts that seniors will almost double as a proportion of the population, from 13.2% in 2005 to 24.5% in 2036 (Turcotte & Schellenberg 2007). This demographic trend has generated concerns among policy makers and academics alike regarding the projected care needs of individuals in their later years. Although the proportion of men aged 45 years and older who reported providing some form of assistance to a senior remained roughly the same between 2002 and 2007 (19%), the proportion of women reporting providing such care increased from...

In the past decade, most provinces in Canada have experienced a dramatic increase in reports of child abuse and neglect. Government agencies report that they are consequently hard pressed to find additional out-of-home placements for children, particularly for children from poor families or from Aboriginal communities (Child Welfare League of Canada 2003; Ehrle, Geen, & Clark 2001). Seeking and making arrangements for the children to obtain ‘kin care,’ where members of extended families take on the care of children, is becoming an established practice. Kinship care, broadly defined as ‘the full continuum of care of children by relatives within and...

This chapter considers the role of volunteers as caregivers in hospitals. Many have argued that it is difficult for paid workers to combine the affective and instrumental components of care under the bureaucratic and time constraints imposed by economic organizations (Armstrong & Armstrong 2003; Brannon 1994; Browne 2003a, 2003b; Campbell 2000; Jones 1998). This leads me to ask how the unpaid work of hospital volunteers is also affected by such institutional regimes. To answer this question, I examine volunteer ‘job descriptions’ from four large teaching hospitals as well as data from interviews with volunteers. I show how hospitals define volunteers...

As the chapters in this volume demonstrate, intimate care is often received by populations who are vulnerable to a greater or lesser extent – children, the elderly, the infirm, and new mothers (Benoit & Hallgrímsdóttir, this volume). For some populations, intimate care needs arise from, and are intensified by, social stigmatization. Intimate care work in the context of persons with disabilities, addiction to illicit substances, mental health conditions, blood-borne and incurable infections, or for persons involved in income assistance and child welfare programs all takes place in the context of social stigma.

Goffman (1963: 3) definedstigmaas an ‘attribute that...

In this concluding chapter we draw on the theoretical and empirical materials presented by the contributors in earlier chapters of this volume to develop a gendered understanding of how neoliberal policy contexts shape the working environments and practices of those who provide health and social care in public and private domains. Our central interest is in highlighting the complex and context-sensitive political and social conditions that provide for – or undermine – dignity in performing care work/intimate labour work or receiving care or intimate services. We consider dignity for workers to flow from equitable and healthy working conditions, and remuneration that adequately...