Abstract
Using data from 77 supervisors in seven hospitals across the U.S. that participated in a national workforce development program for low-wage frontline workers, we explain how supervisors justified and reproduced social inequalities by accepting culture of poverty and neoliberal discourses and how supervisors used these discourses to resolve identity-work dilemmas. We demonstrate how supervisors engaged in identity talk that justified deprivation for workers and shielded management from blame. We discuss how supervisors subtly invoked class, race, and gender stereotypes—and thus reproduced ideologies supportive of structural inequalities—as they crafted accounts that drew attention away from economic and organizational problems and focused on the victims. This research extends the literature on blame attribution, explained here as victim-blaming in disguise, which subsequently shaped supervisors’ perceptions of their staff, defined workers’ opportunities, and inadvertently, reproduced inequality.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bonilla-Silva, Eduardo. 2006. Racism without racists: Color-blind racism and the persistence of racial inequality in the United States. Washington DC: Rowman & Littlefield Publishers.
Bourgault, Sophie. 2017. Prolegomena to a caring bureaucracy. European Journal of Women’s Studies 24 (3): 202–217.
Bureau of Labor Statistics. 2020. U.S. Department of Labor, Occupational Outlook Handbook, Healthcare Occupations. https://www.bls.gov/ooh/healthcare/home.htm. Accessed 18 Apr 2021.
Byrd, W. Carson. 2019. Hillbillies, genetic pathology, and white ignorance: Repackaging the culture of poverty within color-blindness. Sociology of Race and Ethnicity 5 (4): 532–546.
Cassiman, Shawn A. 2008. Resisting the neo-liberal poverty discourse: On constructing deadbeat dads and welfare queens. Sociology Compass 2 (5): 1690–1700.
Charmaz, Kathy. 1994. Identity dilemmas of chronically ill men. The Sociological Quarterly 35 (2): 269–288.
Charmaz, Kathy. 2014. Constructing grounded theory. Thousand Oaks: Sage.
Connor, Stuart. 2010. Promoting ‘employ ability’: The changing subject of welfare reform in the UK. Critical Discourse Studies 7 (1): 41–54.
Dervin, Fred. 2015. Discourses of othering. The international encyclopedia of language and social interaction, 1-9. 1st ed. John Wiley & Sons, Ltd. https://onlinelibrary.wiley.com/doi/abs/10.1002/9781118611463.wbielsi027. Retrieved 19 March 2021.
Ducey, A. 2009. Never good enough: Health care workers and the false promise of job training. Ithaca, NY: Cornell University Press.
Dunn, Jennifer L., and S.J. Creek. 2015. Identity dilemmas: Toward a more situated understanding. Symbolic Interaction 38 (2): 261–284.
Friedson, Eliot. 2001. Professionalism, the third logic: On the practice of knowledge. Chicago: University of Chicago Press.
Gallagher, Charles. 2003. Color-blind privilege: The social and political functions of erasing the color line in post race America. Race, Gender & Class: 22–37.
Gallagher, C. 2015. Color-blind egalitarianism as the new racial norm. In Theories of race and ethnicity: Contemporary debates and perspective, ed. K. Murji and J. Solomos, 40–56. United Kingdom: Cambridge University Press.
Gassner, Drorit, and Anat Gofen. 2018. Street-level management: A clientele-agent perspective on implementation. Journal of Public Administration Research and Theory 28 (4): 551–568.
Goffman, Erving. 1963. Behavior in public places: Notes on the social organization of gatherings. New York: MacMillan.
Gordon, Milton M. 1964. Assimilation in American life: The role of race, religion, and national origins. Duke University. Oxford University Press on Demand.
Gunnarsson, Nina V., Helana Hemmingsson, and Lars-Christer Hydé. 2013. Mothers’ accounts of healthcare encounters: Negotiating culpability and fulfilling the active mother role. Discourse & Society 24 (4): 446–460.
Hannan, Michael T., and John Freeman. 1984. Structural inertia and organizational change. American Sociological Review 49 (2): 149–164.
Hood, C. 2010. The blame game: Spin, bureaucracy, and self-preservation in government. New Jersey: Princeton University Press.
Jason, Kendra, and Sarah H. Pollock. 2018. Account-giving and contending with real and imagined audiences in evaluation research. SAGE Publications Ltd. https://methods.sagepub.com/case/account-giving-contending-with-real-imagined-audiences-evaluation-research. Retrieved 19 March 2021.
Kalleberg, Arne L., Barbra F. Reskin, and Ken Hudson. 2000. Bad jobs in America: Standard and nonstandard employment relations and job quality in the United States. American Sociological Review 65 (2): 256–278.
Kleinman, S. 2007. Feminist fieldwork analysis. Thousand Oaks, CA: Sage.
Leana, Carrie R., Vikas Mittal, and Emily Stiehl. 2012. PERSPECTIVE—Organizational behavior and the working poor. Organization Science 23 (3): 888–906.
Leicht, Kevin T., and Jonathan Marx. 1997. The consequences of informal job finding for men and women. Academy of Management Journal 40 (4): 967–987.
Lipsky, Michael. 1980. Street-level bureaucracy: Dilemmas of the individual in public services. New York: Russell Sage Foundation.
Lofland, John. 1995. Analytic ethnography: Features, failings, and futures. Journal of Contemporary Ethnography 24 (1): 30–67.
Manley, Kim, Angie Titchen, and Sally Hardy. 2009. Work-based learning in the context of contemporary health care education and practice: A concept analysis. Practice Development in Health Care 8 (2): 7–127.
Maynard-Moody, S.W., M. Musheno, and M.C. Musheno. 2003. Cops, teachers, counselors: Stories from the front lines of public service. Ann Arbor MI: The University of Michigan Press.
Maume, David J. Jr. 1999. Glass ceilings and glass escalators: Occupational segregation and race and sex differences in managerial promotions. Work and Occupations 26 (4): 483–509
Mencken, F. Carson, and Idee Winfield. 2000. Job search and sex segregation: does sex of social contact matter? Sex Roles 42 (9): 847–864.
Morgan, J.C., and B. Farrar. 2015. Building meaningful career lattices: Direct care workers in long-term care. In Caring on the clock: The complexities and contradictions of paid care work, ed. A. Armenia, C. Stacey, and M. Duffy, 275–286. New Brunswick, NJ: Rutgers University Press.
Moynihan, Daniel P. 1965. The negro family: The case for national action (No. 31–33). US Government Printing Office. https://web.stanford.edu/~mrosenfe/Moynihan's%20The%20Negro%20Family.pdf. Retrieved 19 March 2021.
Neubeck, Kenneth J., and Noel A. Cazenave. 2001. Welfare racism: Playing the race card against America’s poor. New York: Routledge.
Oliveira, Helena Costa, Lúcia Lima Rodrigues, and Russell Craig. 2020. Bureaucracy and the balanced scorecard in health care settings. International Journal of Health Care Quality Assurance 33 (3): 247–259.
Potter, Jonathan, and Derek Edwards. 2003. Rethinking cognition: On coulter on discourse and mind. Human Studies 26 (2): 165–181.
Riccucci, Norma M., Marcia K. Meyers, Irene Lurie, and Jun Seop Han. 2004. The implementation of welfare reform policy: The role of public managers in front-line practices. Public Administration Review 64 (4): 438–448.
Robert Wood Johnson Foundation. 2006. Workers who care: A graphical profile of the frontline health and healthcare workforce. Health Workforce Solutions, LLC.
Ryan, W. 1976. Blaming the victim. Revised Edition. New York, NY: Vintage Books.
Schindel, Jennifer, Edward O'Neal, Brian Iammartino, Kim Solomon, David Cherner, and Janine Santimauro. 2006. Workers who care: A graphical profile of the frontline health and health care workforce. Princeton, NC: Robert Wood Johnson Foundation.
Schostak, J.F. 2002. Understanding, designing and conducting qualitative research in education: Framing the project. United Kingdom: Open University Press.
Schwalbe, Michael L. 1988. Sources of self-esteem in work: What's important for whom? Work and Occupations 15 (1): 24–35.
Schwalbe, Michael L., and Douglas Mason-Schrock. 1996. Identity work as group process. In Advances in Group Processes, eds. Barry Markowsky, Michael Lovaglia, and Robin Simon, 115-150. Bingley. Emeral Group Publishing Limited.
Scott, Marvin B., and Stanford M. Lyman. 1968. Accounts. American Sociological Review 1 (33): 46–62.
Seale, Elizabeth, Alison Buck, and Kylie Parrotta. 2012. Who's to blame? The identity talk of welfare-to-work program managers. Sociological Perspectives 55 (3): 501–527.
Seccombe, K., K.B. Walters, and D. James. 1999. “Welfare mothers” welcome reform, urge compassion. Family Relations 48 (2): 197–206. https://doi.org/10.2307/585084.
Stainback, Kevin. 2008. Social contacts and race/ethnic job matching. Social Forces 87 (2): 857–886.
Stainback, Kevin. 2018. Organizations, employment discrimination, and inequality. In The Oxford handbook of workplace discrimination, eds. Adrienne J. Colella and Eden B. King, 41-58. Oxford: Oxford University Press.
Turgeon, Brianna. 2018. A critical discourse analysis of welfare-to-work program managers’ expectations and evaluations of their clients’ mothering. Critical Sociology 44 (1): 127–140.
Turgeon, Brianna, Tiffany Taylor, and Laura Niehaus. 2014. Contrasts and classtalk: A critical discourse analysis of welfare-to-work program managers. Discourse & Society 25 (5): 656–671.
Van Cleve, Nicole Gonzalez. 2016. Crook county: Racism and injustice in America’s largest criminal court. Stanford: Stanford University Press.
Van De Mieroop, Dorien. 2011. Identity negotiations in narrative accounts about poverty. Discourse & Society 22 (5): 565–591.
Watkins-Hayes, C. 2009. The new welfare bureaucrats: Entanglements of race, class, and policy reform. Chicago, IL: University of Chicago Press.
Weber, M. 1946. Bureaucracy. In From max Weber, ed. H. Gerth and C. Wright Mills, 196–244. New York: Oxford University Press.
Wiggan, Jay. 2012. Telling stories of 21st century welfare: The UK coalition government and the neo-liberal discourse of worklessness and dependency. Critical Social Policy 32 (3): 383–405.
Winter, S.C. 2012. Implementation perspectives: Status and reconsideration. In The SAGE handbook of public administration, ed. B. Guy Peters and J. Pierre, 265–278. Thousand Oaks, CA: Sage.
Acknowledgements
The authors would like to thank Dr. Michael Schwalbe and Dr. Christine Mallinson for feedback on early drafts of this manuscript.
Funding
Robert Wood Johnson Foundation with supplementary funds from the Hitachi Foundation.
Author information
Authors and Affiliations
Corresponding author
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Jason, K., Turgeon, B. Victim-Blaming in Disguise? Supervisors’ Accounts of Problems in Healthcare Delivery. Qual Sociol 44, 253–270 (2021). https://doi.org/10.1007/s11133-021-09479-y
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11133-021-09479-y