Date Available


Year of Publication


Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation


Arts and Sciences



First Advisor

Dr. Mary K. Anglin


This research on healthcare strategies of home-based, low-wage, immigrant careworkers contributes to the ways medical anthropology, migration studies and social science understand human-economy-family care relationships and health and carework as commodities in today's global economy. It reveals the consequences for workers as they defray the costs of care for the Italian government and contribute to their home economies. This research was conducted in Genoa, Italy, which has the largest percentage of people over the age of 70 in any city of its size in the world and a tradition of sending and receiving immigrant workers. The main question was: Under the circumstances of providing labor-intensive, in-home supportive services, how do immigrant workers respond to their own health needs?

The researcher collected data from interviews with 50 careworkers, 25 professionals who provide services to the careworkers, and 23 administrators in the health system, government agencies, labor unions, and the Catholic Church. The careworkers interviewed were women from South America, as they do most of the carework jobs in this city. Long-term participant observation and interview data were analyzed to: 1) produce empirical data on health concerns of and healthcare resource use by migrant careworkers; and 2) investigate the relationships between health concerns, living/working conditions, and healthcare resource use of transnational immigrants in the informal economy. The data showed that the Catholic Church promoted immigrants as able workers, aided their elderly parishioners, and provided necessary mental health support to careworkers who experienced stress. The data also revealed that the health care system of Italy functioned well to address the physical health concerns of immigrant careworkers. The relationship between the client and the worker was important for the general well-being of the worker and her ability to maintain her general health, have time for medical appointments, socialize outside of the workplace, and attend community events. This study examined: strategies for using health resources; responses of the Italian medical system personnel to anti-immigrant legislation; use of non-State resources to meet health needs; the health consequences of caring for an elderly person in the private home; and ways to address these health consequences.