The Caring Class. Precarization of paid care workers in long-term care and its relation to health, an intersectional perspective.

The health of paid care workers in long-term care is under pressure, but not for all care workers alike (chapter 1 and 2). Therefore, this thesis addresses health inequities among paid care workers. This thesis presents several participatory studies which were conducted by the author, together with paid care workers and a professional photographer. These studies unravel the health strategies of women (chapter 3) and men (chapter 4) working in long-term care and the health issues of self-employed care workers (chapter 5) before and during (chapter 6) the COVID-19 pandemic. All studies were done from a critical gender, diversity-sensitive and intersectional perspective. They present insights for care workers, occupational health professionals, HRM professionals and policy makers in long-term care. This thesis is also relevant for Participatory Health Researchers (PHR) who aim to make their research more critical and diversity-sensitive, as it explores the relevance of intersectionality for PHR (chapter 7 and 8). A series of portraits ‘What You Don’t See’, made by photographer Janine Schrijver in co-creation with care workers and the author, is part of the research presented in this thesis (chapter 9). These portraits address urgent health issues that often remain invisible, including racism and poverty, which squeezes paid care workers out of the organizations into self-employment. Concerns about the health of paid care workers are a persistent societal issue in the Netherlands. They have become increasingly pressing as more and more paid care workers find themselves in precarious positions, no longer able to sustain their own health or support themselves financially. Therefore, this thesis explores the economic, societal and political forces that contribute to the precarization of paid care workers in the Netherlands (chapter 10). Protecting, maintaining and repairing the health of paid care workers is not just an issue of care workers or employers. It is a societal issue and shaped by political choices.