Listening to Chinese Immigrant Restaurant Workers in the Midwest: Application of the Culture-Centered Approach (CCA) to Explore Perceptions of Health and Health Care

ABSTRACT

This study engages with the culture-centered approach (CCA) to explore Chinese immigrant restaurant workers’ perception of the U.S. health care system and their interactions with the health care system in interpreting meanings of health. Chinese restaurant workers are marginalized because of their struggles on the job, their immigrant identity, and their negotiations with the structural contexts of occupation, migration status, and culture. In-depth interviews were conducted with 18 Chinese immigrant restaurant workers that lasted an average of 1.5 hours each, and were audiotaped. Interviews with participants highlighted critical issues in access to health care and the struggles experienced by restaurant workers in securing access to health, understood in the context of work. Critical to the workers’ discourse is the acknowledgment of structural constraints such as lack of insurance coverage, immigration status, and lack of understanding of how the U.S. health care system works.

Notes

¹ We have changed our names for the purposes of blind review.

² Subalternity refers to the condition of being erased from the discursive space. We use the term subalternity to describe Chinese immigrant restaurant workers because of their low-income status coupled with their occupational stress, undocumented status, and the corresponding lack of representation and recognition in mainstream U.S. discourses. The physical erasure of the Chinese restaurant worker from the mainstream space is articulated in his or her spatial location in the “back room” of restaurants, invisible from the spaces of recognition. Erasure is further embodied in these workers’ undocumented status; they can’t be recognized and represented politically. Drawing upon Ogden’s reference to the undocumented immigrant as a subaltern in the context of the United States because of her or his erased identity in the mainstream, we note that the Chinese immigrant restaurant worker is a subaltern, disconnected politically from systems of recognition and representation, and yet a participant as labor in the economy.

³ We have changed the names of the participants, organizations, county, and state for the purposes of blind review. The essay shared here is part of a larger research project on low-income Chinese immigrant health in Love County, working through the culture-centered approach to create spaces for policy advocacy and structural transformation. Activities emerging from this wider effort include white papers, policy briefs, and round-table conversations with policymakers. Note that Love County is a Midwestern town, with a limited number of Chinese restaurant workers, unlike the large metropolitan cities in the United States where Chinese workers have larger support networks, resources, and infrastructures within the context of a “Chinatown.”

⁴ We ensured the confidentiality of the data by storing the interview data with randomly assigned numbers. The audio recordings were stored safely on university equipment and were erased after transcription. Moreover, given that the participants shared their immigration status, we stored the demographic data separately from the transcripts. For the participants, the sharing of their undocumented status was an act of trust built through our continued presence and ongoing conversations, as well as through a sense of solidarity in wanting to document the effects on health of their undocumented status, and for us as researchers, protecting this trust was embodied in carrying out a series of steps to ensure that the marks of the undocumented status were not recognizable in the data while at the same time working through this important piece of information in voicing a politics of change.