Health citizenship reveals ‘extra’ work managing biopolitical risk for immigrants in Canada during COVID-19 : a qualitative study

Abstract

One's health security (i.e., the ability to minimize risks and respond to public health threats) is a conferred right of citizenship but individuals construct identities during the process of securing their health. However, how this occurs, in relationship to the state, remains largely implicit or taken-for-granted. The Coronavirus Disease 2019 (COVID-19)' provided a unique opportunity to explore the relationship between oneself and governing social norms of health citizenship. We drew on secondary analysis of data from a previous (published) qualitative descriptive study that was conducted during May to September 2020 of COVID-19, to explore 72 immigrants' experience (from 21 countries) of health security in the Greater Toronto Area, Canada. Data were collected through semi-structured interviews and analysed using critical realism. The majority of participants were women. We demonstrate how individuals implicitly engaged in ‘extra’ work—gendered and driven by mechanisms of good citizenship—connected to the will to health, against ethopolitical work to regulate risks, of and for themselves, in public discourse. Public discourse tended to follow racialized hegemonic norms, which also reproduced systemic cultural racism. We argue that empathetic understanding of this process is conducive to enhancing one's resistance to stereotypes, and to bolstering immigrants' resilience to seeking health security during public health emergencies.