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This study examines the association between digital information technology (DIT) use and the utilization of transnational healthcare (THC) in older migrants, and investigates how this relationship depends on social integration or perceived discrimination in health services in the destination country. The data from a population-based study conducted in Finland in 2019, which targeted Russian-speaking residents aged 50 and above (n = 1082) nationwide, are analyzed. The analysis demonstrates that those who had a high level of DIT use were significantly more likely to use THC than those who had a low level of use. However, the findings do not show that the relationship depends on social integration or perceived discrimination. Older migrants can actively use transnational networks to address their health and well-being issues by using DIT and seeking healthcare abroad. Their health service use can be illustrated as an active process involving various geographical domains.

This article develops sociological knowledge on daughterhood through an analysis of how separation shapes the emotional and moral dynamics of transnational daughterhood. Building on Finch, we look at daughtering as a set of concrete social practices that constitute kinship and carry the symbolic dimension of displaying the family-like character of relationships. Within this framework, we analyse how Latin American women living in Barcelona discuss their transnational family lives and filial responsibilities. We see family as finite, evolving in the past, present and future, and develop a threefold understanding of filial love as an institution imbued with formal expectations, a strong and complex emotion, and reciprocal embodied caring. We consider persisting physical separation in migration as a circumstance that demands not only practical solutions but also ongoing moral labour that sustains transnational bonds and notions of being a ‘good enough’ daughter.

The chapter examines the ways in which eldercare managers (e.g. head nurses, home care supervisors, ward managers) in Finland can justify the increasing recruitment of foreign-born workers to lower-level eldercare jobs that are decreasingly attractive to Finnish-born workers. The question we ask is, how can eldercare managers discursively cope with the potential criticism according to which the prevailing recruitment and employment tendencies exploit actors in structurally disadvantaged labor market positions? Our analysis demonstrates how eldercare managers can maintain affectively appealing impressions of their own actions by constructing foreign-born workers as subjects who are inherently interested in eldercare work, and less interested in wages and working conditions. When eldercare managers’ self-presentations depend on these win-win narratives, foreign-born workers’ abilities to mobilize counter-narratives at their workplace are highly limited. The chapter examines the ways in which eldercare managers (e.g. head nurses, home care supervisors and ward managers) in Finland can justify the increasing recruitment of foreign-born workers to lower-level eldercare jobs that are decreasingly attractive to Finnish-born workers. The question asked is: How can eldercare managers discursively cope with the potential criticism according to which the prevailing recruitment and employment tendencies exploit actors in structurally disadvantaged labor market positions? Our analysis demonstrates how eldercare managers can maintain affectively appealing impressions of their own actions by constructing foreign-born workers as subjects who are inherently interested in eldercare work and less interested in wages and working conditions. When eldercare managers’ self-presentations depend on these win-win narratives, foreign-born workers’ abilities to mobilize counter-narratives at their workplace are highly limited.

Globally spreading neoliberal doctrines regarding the need to ‘flexibilise’ the allegedly bureaucratic welfare states have been shown to contribute to the ‘flexibilisation’ of care work, involving austerity measures and reliance on migrant labour. Focusing on public eldercare in Finland, this chapter adds to the literature a close intersectional examination of the exploitative ‘coping management’ that the neoliberal discourse underpins. This management style fails to challenge inadequate resources and instead extorts nurses, treating them as disposable routine workers. We argue that coping management is expressed through ‘flexibility talk’ that emphasises personal characteristics rather than formal skills, and that there is an inherent affinity between ‘flexibility talk’ and ‘migrant flexibility talk’. We maintain that the re-articulation of care work as work requiring ‘flexibility’ and therefore particularly fitting for migrants has problematic gendered and racialised implications in the workplace. Our analysis draws on interviews with managers in public eldercare and observations from eldercare units in Finland. We show how the practices and discourses of flexibilisation help care managers to reconcile the practical and ethical dilemmas they face in ways that appear morally and locally sustainable to them. We have observed that care managers do not currently recognise migrant nurses as stakeholders worthy of equal recognition.

PurposeRecent scholarship reveals the imagery of the professional as the “ideal citizen”. The linkage between professionalism and citizenship is here approached from the perspective of democratic social justice in order to examine the persistence of gendered inequalities in the health care system. The paper aims to examine the ideas framing professionalism, both in sociological theory and historically, asking what gendered hierarchies mean in modern health care systems, and why and how they persist in the conditions of liberal democracy.Design/methodology/approachThe question is approached through both sociological literature and an analysis of historical framings of professionalism; the Finnish health care system is employed as a case. The reason for keeping the discussion close to a specific case is that different professional fields, countries and historic contexts differ from each other in democratically relevant respects.FindingsTraditional sociological theory assumed that professional privilege was based on essentially neutral expertise that benefits democracy only if protected from bureaucracy and politics. The recent theoretical turn reframes professional knowledge as socially defined, but the destabilisation of professional knowledge claims is not without problems. The paper refers to the persisting tensions between changing governance and gendered hierarchies in health care and argues for new approaches that suggest ways through which professional expertise can be democratically represented in politics.Originality/valueThe interdisciplinary framework uses political theory on social justice to examine how health care politics frame professionalism.

The market for professional services is increasingly international but comparisons have not been made between different professions nor on how state policies affect opportunities for mobility. This article considers three professions: engineers, physicians and psychologists and explores the similarities and differences in international labour market demand for occupations. It examines how state policies in four countries, Canada, Finland, France and the UK, aim to promote and control professional labour mobility and migration, and the differences across the three professions. Engineering is an international profession and the extent to which states encourage inward migration differs. Medicine is highly regulated in all four countries but inward migration of physicians varies depending on national policy. Psychologists are less mobile, and the extent of state sponsorship and regulation varies across countries. In all three professions, international organizations are a force encouraging global standards. The conclusion is that state policies reflect state interests and have a strong influence on patterns of mobility.

The professional terms for occupations that provide welfare services are changing, and here the introduction of new public management in the Nordic countries since the 1990s is indicative of wider developments. The article explores professional projects in welfare service work from both conceptual and empirical perspectives. The aim is to produce a gender-sensitive analysis of the professional projects at the lower levels of the occupational hierarchies in health care. The first part reviews the literature conceptualizing the societal and institutional embeddedness of professional projects. The institutional matrix of welfare states emerges as a key context in shaping the welfare service work performed by women-dominated professional groups. The second part examines the case of Finland and suggests that recent reforms have created new inequalities in the system of professions, in which occupational groups in welfare service work are becoming marginalized. This signals a move away from ‘democratic professionalism’ towards a revival of ‘old professionalism’.

Theories of professions and healthcare organisation have difficulty in explaining variation in the organisation of maternity services across developed welfare states. Four countries - the United Kingdom, Finland, the Netherlands and Canada - serve as our case examples. While sharing several features, including political and economic systems, publicly-funded universal healthcare and favourable health outcomes, these countries nevertheless have distinct maternity care systems. We use the profession of midwifery, found in all four countries, as a 'touchstone' for exploring the sources of this diversity. Our analysis focuses on three key dimensions: (1) welfare state approaches to legalising midwifery and negotiating the role of the midwife in the division of labour; (2) professional boundaries in the maternity care domain; and (3) consumer mobilisation in support of midwifery and around maternity issues.

In lay terms, childbirth is regarded as a purely biological event: what is more natural than birth and death? On the other hand, social scientists have long understood that ‘natural’ events are socially structured. In the case of birth, sociologists have examined the social and cultural shaping of its timing, outcome, and the organization of care throughout the perinatal period. Continuing in this tradition, we examine the peculiar social design of birth in the United States of America, contrasting this design with the ways birth is organised in Europe. We begin by showing how several key characteristics of the US health care system – including its inherent social inequality, its high level of medicalisation, and the substantial influence of private medical practice and insurance companies – influence the organization of maternity care there. We then explore how cultural characteristics of American society – its emphasis on individuality, the influence of moral conservatism in US politics, and the ease with which ordinary people take court action (the so-called ‘litigation culture’) – shape the delivery of care at birth. We conclude with a consideration of the implications of US maternity care exceptionalism for comparative sociological analysis.