Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)

Graduate Group


First Advisor

Melissa J. Wilde


How do parents make medical decisions for themselves and their children? Why do some parents agree to interventions – such as vaccines, obstetrical treatment, and antibiotics – that others do not? And how do class and race shape those decisions? Past research has shown that white, middle class parents are the most likely to refuse medical interventions on philosophical grounds, including vaccines (Reich 2016a). Yet the existing research does not help us understand why others in similar circumstances don’t make the same choice, nor how we should understand working class patients with their own medical refusals.

The current study seeks to address these puzzles by taking a comparative view of medical decisions. Drawing on data from ninety interviews with middle- and working-class adults (overwhelmingly mothers) and over three years of ethnographic research, I show that community ties play a vital role in shaping participants’ medical decisions. These ties, mediated by social class and race, help participants interpret their interactions with the medical establishment, and orient patients towards either a skeptical or trusting relationship with providers. Ultimately, patients’ interpretations of those interactions, and if/how they draw on social support to make medical decisions going forward, determines their position in four distinct categories, which I label Entitled Skeptics, Constrained Skeptics, Believers, and Compliers.

Included in

Sociology Commons