April 7-9, 2022 • Hyatt Regency • Lexington, KY
Communication Strategies to Promote Comprehensive Well-being
Communication Strategies to Promote Comprehensive Well-being
Abstract: Conceptualizing Moral Boundary Work: Women’s Communicative Labor to be Seen as Credible Witnesses to Their Health
Chronic illnesses involve a great deal of labor. Illness trajectory theory posits that labor involves illness-related work, biographical work (i.e., identity work), and everyday life work (e.g., household tasks). Communication scholars argue that communication is a separate line of work, not merely a means of completing other lines of illness work. Studies exploring communication work suggest but do not explicate how or why communication work is particularly burdensome for individuals occupying lower rungs on the “hierarchy of illness” (i.e., non-visible, underfunded, without diagnostic labels). We take a critical approach to communication work, foregrounding issues of power, collapsing the private-public binary, and critiquing the status quo, and forward the concept of moral boundary work: the communicative labor individuals endure to be taken seriously for their health issues and seen as deserving of time, attention, and care. We apply the concept to the case of women, who are more often than men impacted by “low-prestige” illnesses (e.g., autoimmune diseases). Our research question was: RQ: How do women engage in moral boundary work as a means of legitimizing their health issues? We recruited 36 women living in the United States who identified as having been dismissed or not taken seriously for their health issues for an interview study advertised through personal networks and a university-wide e-newsletter. We offered a $15 Amazon e-gift card for participation. Interviews occurred via Zoom (M = 51 minutes). Women were 32.64 years of age on average; had a range of health issues (e.g., mental health, gastrointestinal, autoimmune, reproductive); identified as White (69.4%), Black (5.6%), Latino (2.8%), Filipino (2.8%), and mixed race (16.7%); reported an average household income of $87,000; and had associate’s degrees or greater. We are currently analyzing the transcripts using a phronetic iterative approach, alternating between emergent readings of the data and etic readings of existing literature on communication work and women’s health dismissals. We have developed initial themes based on re-cast propositions of communication work: communication work is exhausting and humiliating (e.g., retelling traumatic stories; repeated, often invasive testing; being ridiculed, shamed, and made to be a burden); communication work is a matter of health and safety (e.g., enduring physical/emotional abuse, deteriorating mental/physical health, diagnostic delays); communication work entails preparing evidence and anticipating a fight (e.g., collecting health data, marshaling witnesses); and communication work entails concerted effort to present illness in credible ways (i.e., rational, fact-based, performing emotions (or not)). We also add the proposition, communication work involves advocating for self and others (e.g., challenging physicians, using platforms to encourage social change and healthcare improvements). This study adds to mounting evidence that women must frequently engage in moral boundary work to be seen as credible witnesses of their own health. This study also extends current theorizing about the nature of communication work, showcasing how such labor is power-laden, physically and emotionally burdensome, and informed by sociocultural context. Finally, this study demonstrates women’s resilience as they subvert systems of oppression in medicine to receive care they need and deserve.