University of Victoria

Health and Equity - the interrelationship II

How healing and illness is related to social structures, social processes and the social determinants of health. As well as the political, social and economic circumstances that shape the experiences of those involved.

Session Organizer: Saeed Hydaralli, York University, saeedhydar@hotmail.com ; Merle Jacobs, York University, merlej@yorku.ca

Resilience: A marginalizing concept for individuals and families with diverse abilities

Emily Hutcheon, University of Calgary, ejhutche@ucalgary.ca

The topic of resilience in families has captured the attention of social scientists since the 1970’s in fields of psychology, social psychology, psychopathology, and others. Early and current resilience studies employ an ecological approach, which emphasizes predictable relationships between risk and protective factors and transactional processes that foster resilience. Limitations of this approach, including limitations specific to populations deemed ‘impaired,’ have been acknowledged but remain unresolved. For example, existing definitions offer an understanding of how individuals and families ought to function – understandings which are founded in culturally sanctioned ways of functioning and in the fulfillment of similarly sanctioned roles. Resilience, so defined, obscures other ways of being/other criteria of success. I suggest that individuals and families are marginalized by current definitions of resilience and by deployments of this understanding in their lived realities. I draw from critical theoretical work on the topic of vulnerability to further suggest that a re-visitation of the resilience concept in theoretical and empirical domains is warranted. This paper draws from a larger study which investigated capacity for family and sibling support of adult children with a variety of ability-sets and mental health diagnoses (these include psychosis, addiction, and multiple diagnoses). I engage in a secondary analysis of data from individual and group interviews with three families which include members with diverse ability sets and diagnoses. Preliminary findings point to process and contradiction/paradox as important analytical dimensions when investigating resilience. I suggest that scholars across disciplines consider the following: 1) incorporating constructivist definitions of resilience (where resilience is seen as constructed, shared, and ordinary, and as a form of connectivity) into their frameworks; 2) exploring resilience outside the purview of competencies and abilities (for example, foreground alternative ability sets or subjectively constructed competencies); 3) providing a thorough and critical account of vulnerability in their notions of resilience.

Friday June 7, 2013 01:30 PM - 03:00 PM Building: Elliott Building, Room: E-167

Categories of health and harm: Classification and interdependence in thinking about Canada’s Truth and Reconciliation process.

Alexis Shotwell, Carleton University, Alexis_Shotwell@Carleton.ca

In this paper, I focus on Canada’s Truth and Reconciliation Commission, and the ways that categories of health, healing, and harm are used in managing histories and ongoing effects of Residential Schools in the TRC. In the first part, I argue for the connection between classification and racialization. In the second, I examine individualizing effects of what has been called “healthism,” contrasting such conceptions of health with an understanding of complex interdependence. In the third, I argue that at issue in the TRC process is a struggle between incompatible classifications of health and personhood. Understanding how to better practice wellness in the context of the TRC process points toward more adequate conceptions of health and flourishing in the wake of colonialism and its ongoing harms. If we understand classification itself as a central technology of colonialism, and colonialism as an ongoing process, we should worry about current strategies of reparation, response, and reconciliation that center classificatory work. However, since classification has been a cross-continental racialising tool and since we rely on classificatory work in opposing oppression, we must reckon with it. This difficult reckoning is particularly necessary in thinking about harm and resistance in the context of health categorization.

Friday June 7, 2013 01:30 PM - 03:00 PM Building: Elliott Building, Room: E-167

Equity in Nursing Culture and how it effects patients

Merle Jacobs, York University, merlej@yorku.ca

In order to discuss the culture of nursing, I researched hospital culture which provides insight into the the culture of nursing. Culture can also be understood through looking at the professional nurse, promotions, abuse and racism within the profession. In order for nurses to understand equity and how it affects health, cultural competency is currently a tool promoted in health education to help professionals provide health care to different populations. My research in Collegiality places abuse within nursing as a major issue that promotes conflictual behaviours between nurses as well as abuse towards their patients. Equity in heath care starts with equity in professional behaviours. This paper will discuss past research (2007) as well as the ongoing research (2012) in the area of nursing collegiality. Nursing collegiality is a way of understanding staff nurse culture, as this is the group of care providers closest to patients in care giving. My research focused on staff nurses interactions. Racism, abuse and harassment occurred within the group and also toward the group. Five case studies from patients provide the trickledown effect abuse has on patient care and how inequity has an overall effect on the most vulnerable in the health system, the patient.

Friday June 7, 2013 01:30 PM - 03:00 PM Building: Elliott Building, Room: E-167

Grist to the mill: An interdisciplinary meta-narrative synthesis approach to understanding health equity in a globalized food system

Anelyse Weiler, Simon Fraser University, aweiler@sfu.ca , Chris Hergesheimer, University of British Columbia, c.p.hergesheimer@gmail.com

In exploring pathways to health (in)equity through a globalized food system, an interdisciplinary approach offers a nuanced and comprehensive picture of the social determinants of health. However, multi-sited, cross-lingual and interdisciplinary research collaborations present considerable methodological challenges. Our 5-year research program, “Food systems and health equity in an era of globalization: Think, Eat and Grow Green Globally (TEG3),” includes research partners from Canada and Ecuador, whose disciplinary specialties range from epidemiology and public health to rural sociology.

In order to integrate existing knowledge on the relationships between food systems and health, we are conducting a meta-narrative synthesis. This methodology involves characterizing key-word themes from extensive literature reviews in English and Spanish databases, along with workshops among researchers to identify these knowledge themes. Our meta-narrative synthesis informs the design of primary research interventions to address crosscutting issues of food sovereignty and food security. Taking place at subsequent stages in the TEG3 project, these interventions will involve partnerships with food producers, consumers and Indigenous communities in Canada and Latin America.

Friday June 7, 2013 01:30 PM - 03:00 PM Building: Elliott Building, Room: E-167