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Kawabata, Makie.
Social construction of health inequities : a critical ethnography on day labourers in Japan.
Ph. D. -- University of Toronto, 2009
Ottawa : Library and Archives Canada = Bibliothèque et Archives Canada, [2010]
3 microfiches
Includes bibliographical references.
Although evidence of health inequities abound, why people in lower socio-economic classes have poorer health has not been sufficiently explored. The purpose of this study is to examine day labourers' pathways to health inequities in a segregated, urban district in Japan. Critical ethnography was employed to investigate day labourers' social environments and cultural behaviours in order to reveal the ways that social inequalities embedded in mainstream society and the day labourers' sub-culture produce and sustain day labourers' disadvantages, leading them into poorer health than the average population. Data were collected through observations of day labourer's daily activities, events within the district and their interactions with social workers at a hospital. In addition, interviews were conducted with 16 day labourers and 11 professionals and advocates. The study found several components in the pathways to health inequities of day labourers. First, certain people in Japan are ostracized from the social, economic and political mainstream due to an inability to enact traditional Japanese labour practices. Commonly such exclusions make men become day labourers to survive. In a day labourer district, they are exposed to further social inequalities embedded in the work system and their living circumstance. Living and working as a member of the day labour community, they develop collective strategies in order to survive and preserve their social identities as day labourers. However, such strategies do not provide people with opportunities to lead healthy lives. The study also identified several social determinants of health for day labourers, including: (1) employment, (2) working conditions, (3) temporary living, (4) housing quality, (5) social networks and support, (6) marginalized neighbourhood, (7) access to health care, and (8) gender. The findings contribute to a better understanding of social construction of health inequities, which provides insight on the impact of precarious work in the Japanese society at large. Implications of these findings for public health policy and practice are also discussed.