Contextualizing:One Neighborhood at a Time to

Enable Structural Changes

Andrea Chircop, RN, MN, PhD(c)School of Nursing, Dalhousie University

CPHA Conference, Halifax, June 2008

Distribution of Canada’s PopulationSource: Canadian Institute for Health Information (2006). Improving the Health of Canadians: An Introduction to Health in Urban Places. Pp.8.

Pattern of Health Between NeighborhoodsSource: Canadian Institute for Health Information (2006). Improving the Health of Canadians: An Introduction to Health in Urban Places. Pp.49

We know that….Residents of Canada’s cities are not equally healthy

Health outcomes among neighborhoods within the same cities vary

This raises implications for policy makers BUT

The mechanisms are not clear!CIHI

2006

Contextualizing: Magnifying the fine print of neighborhoods

For social policy to be relevant and responsive to the daily challenges of people’s lives, contextualized knowledge is necessary.

Mothers’ Health Decisions in Low-Income Urban Neighborhoods

An urban ethnography guided by an ecofeminist framework

Research ObjectivesTo provide a forum for low-income mothers

to articulate how they experience and negotiate their own and their families’ health in an urban environment

To influence public policy relevant to low-income mothers living in urban environments

MethodEthnographic data collection over 12

months time period including:Individual (at time repeated) semi-structured interviews PhotovoiceParticipant ObservationDocument Analysis

Preliminary ThemesNegotiating Urban Infrastructure

Negotiating Childcare

Negotiating Nutrition

Goals and Aspirations

Personal Skills & Resources

Negotiating Urban Infrastructure

Affordable housingPublic TransportationSafety

Playgrounds &ParksServicesGeographic Isolation

Negotiating ChildcareLack of Daycare Centers

Long Waiting Lists

Early Childhood Education

Mothers ability to work outside the home

Negotiating NutritionLooking for Deals

Transportation

Food bank

Borrowing Money

Hunting & Fishing

Goals and AspirationsMotivation for Change

Getting back into routine

Wanting it better for their children

Personal Skills & ResourcesFormal Education

Parenting

Creativity

Problem Solving

What next?Continue the dialogue with policy decision-makers

Responsibility of the researcher

Ongoing productive relationships with a MUTUL goal of reducing health inequities