We all deserve access to good health care, no matter what our occupation

by Dr. Cecilia Benoit, Dr. Mikael Jansson,
Dr. Bonnie Leadbeater and Dr. Bill McCarthy

Since first announcing our study on the health and access to health services by three groups of personal services occupations there has been news coverage, a Times Colonist editorial and a published commentary by the secretary-treasurer of the Cosmetologists’ Association of B.C., suggesting the study draws dubious and unfair comparisons between sex workers, food and beverage workers, and hairstylists.

The editorial stated that drawing attention to the similarities shared by these workers is like lumping together surgeons and butchers, drug dealers and pharmacists or motorcycle cops and members of the Hell’s Angels. It claims our study delivers the “casual insult of lumping hard-working, law-abiding waitresses and hairstylists with ‘sex workers.’”

This kind of reaction exemplifies why a study such as ours is needed. The continued stigmatization of sex workers as marginal members of society, not worthy of the same legal and medical protection as other workers, must end if they are to have access to the same services offered unquestioningly to others. A study such as ours can provide a much-needed, objective examination of a group of workers as members of the workforce.

Given that workers in all three groups in our study have, on average, similar levels of education and income and experience some of the same workplace stresses and conditions, the stigmatization of sex workers is, indeed, the dramatic difference that sets them apart.

The common threads that the three groups share form the basis for our research. These occupations are often low-paying, provide little autonomy, and require workers to manage customers’ feelings about the service they receive while sometimes hiding or disguising their own emotions.

Although hairstylists and food service workers have the option of taking formal training, the available 1995 data on Canadian workers reports their average annual income is still much lower than the national average—similar to the median income of sex workers in Victoria (about $18,000). The other outstanding similarity between the three groups is that between 75 to 80 per cent of them are female.

But it’s not only the similarities among these groups of workers that are important to this study. The differences among them allow us to address important questions about the health costs of these occupations not only to the individuals who work in them, but to the taxpayer as well. The study will allow us to make recommendations about the prevention of health problems and ways of increasing early and humane access to services for stigmatized workers and their children and others in service-related jobs who, while accepted by society, also frequently lack influence.

Our study is asking some basic questions: Do differences in working conditions affect workers’ health? Do differences in working conditions affect access to health services for workers and their children? And do occupations with a high level of stigma, such as sex trade work, leave workers and their children especially vulnerable to health problems and subject to unique difficulties in accessing health and other services?

We could have chosen to exclude sex workers from our study, but that would just perpetuate the stigmatization that has followed them for centuries—even while successive societies have continued to generate plenty of consumers for their services. We chose to include sex workers because they count, because their children count and because the impact of their work on them is similar to that on employees in more accepted occupations.

This study has potential benefits for workers in all three occupational groups. It promises to shed light on their work situations, and present them with an opportunity to voice their health concerns and their difficulties in seeking health services. The study also has potential benefits to taxpayers in producing knowledge that could be useful in reducing the costs of chronic and untreated emotional and physical illnesses among workers in all these occupations.

UVic sociologist Dr. Cecilia Benoit is principal investigator of the research project, Marginalized Populations’ Work, Health and Access to Services. Drs. Mikael Jansson, Bonnie Leadbeater and Bill McCarthy are her co-investigators.