Gender, Family, and Healthcare during Unemployment: Healthcare Seeking, Healthcare Work, and Self-Sacrifice.

Objective: This study investigates how healthcare seeking for oneself and "healthcare work" for family-constellations that include the continuation of health insurance, access to formal medical care, and medication adherence-change during a period of unemployment. Background: "Intensive mothering" norms that promote selfless caregiving may discourage women's (but not men's) engagement in own healthcare seeking behavior. Breadwinning norms may oblige men (but not women) to provide income and other resources, including health insurance. Method: This paper relies on data from 100 in-depth interviews with unemployed men and women conducted from 2013 to 2015. An iterative coding process guided data analysis; themes and patterns were evaluated to determine their importance across the data. Results: After a job loss, many women (but few men) stopped seeking previously maintained healthcare for themselves. In contrast, some men rejected obligations to provide health insurance for their family. Moreover, the majority of women (but few men) discussed the prioritization of family in their healthcare decision-making. Conclusion: The intersection of financial inequalities and changing gender norms in healthcare seeking and family healthcare work placed a unique toll on women's health. Implications: These findings expand current understanding of how gender functions as a primary frame and how these frames change, suggesting that gender beliefs about family responsibilities extend to healthcare seeking and family healthcare work and are constrained by social class, even as gender frames change to reshape men's obligations to provide health insurance.