Pub Date : 2023-10-30DOI: 10.1080/09581596.2023.2271137
Jennifer K. Felner, Andrew Stieber, Nichole McCune, Elizabeth Reed, Jerel P. Calzo
ABSTRACTDiscourse regarding public health problems disproportionately affecting marginalized communities may shape and sustain health inequities. Analyses of news media and public health communications in the wake of infectious disease outbreaks provides opportunities to examine how discourse produces dominant public perceptions about the drivers of health emergencies and who is responsible for protecting community health. Guided by Bacchi’s “What is the Problem Represented to Be?” analytic approach, this paper critically examines the discursive construction of problems and solutions in news media (n = 35) and public health communication (n = 18 press releases, n = 1 governmental report) regarding an unprecedented hepatitis A outbreak in San Diego, California, USA (2016–2018) that disproportionately affected people experiencing homelessness. We organize our findings around three elements of problem and solution representation with respect to the outbreak: 1. The inequitable attribution of risk and deservingness; 2. assumptions divorced from socio-structural factors and perspectives of marginalized populations; and 3. political theatre as a means of blame-shifting and (in)action. Overall, our findings suggest that even when structural-level issues were acknowledged within news media and public health communication as undergirding the ‘problem’ of the hepatitis A outbreak, outbreak discourse focused on individual-level responsibility for both the causes of and solutions to it (e.g. vaccines, criminalization of homelessness), and on shifting blame between government actors. These findings have implications for understanding the role that news media and public health agencies play in shaping public perception of the causes, consequences and solutions to infectious disease outbreaks that disproportionately affect marginalized populations.KEYWORDS: Homelessnesshealth communicationhealth inequitiesdisease outbreaks Disclosure statementNo potential conflict of interest was reported by the author(s).Additional informationFundingThe author(s) reported there is no funding associated with the work featured in this article.
{"title":"What’s the problem represented to be? A critical analysis of problem representation in news media and public health communication during a hepatitis A outbreak in San Diego, California, USA","authors":"Jennifer K. Felner, Andrew Stieber, Nichole McCune, Elizabeth Reed, Jerel P. Calzo","doi":"10.1080/09581596.2023.2271137","DOIUrl":"https://doi.org/10.1080/09581596.2023.2271137","url":null,"abstract":"ABSTRACTDiscourse regarding public health problems disproportionately affecting marginalized communities may shape and sustain health inequities. Analyses of news media and public health communications in the wake of infectious disease outbreaks provides opportunities to examine how discourse produces dominant public perceptions about the drivers of health emergencies and who is responsible for protecting community health. Guided by Bacchi’s “What is the Problem Represented to Be?” analytic approach, this paper critically examines the discursive construction of problems and solutions in news media (n = 35) and public health communication (n = 18 press releases, n = 1 governmental report) regarding an unprecedented hepatitis A outbreak in San Diego, California, USA (2016–2018) that disproportionately affected people experiencing homelessness. We organize our findings around three elements of problem and solution representation with respect to the outbreak: 1. The inequitable attribution of risk and deservingness; 2. assumptions divorced from socio-structural factors and perspectives of marginalized populations; and 3. political theatre as a means of blame-shifting and (in)action. Overall, our findings suggest that even when structural-level issues were acknowledged within news media and public health communication as undergirding the ‘problem’ of the hepatitis A outbreak, outbreak discourse focused on individual-level responsibility for both the causes of and solutions to it (e.g. vaccines, criminalization of homelessness), and on shifting blame between government actors. These findings have implications for understanding the role that news media and public health agencies play in shaping public perception of the causes, consequences and solutions to infectious disease outbreaks that disproportionately affect marginalized populations.KEYWORDS: Homelessnesshealth communicationhealth inequitiesdisease outbreaks Disclosure statementNo potential conflict of interest was reported by the author(s).Additional informationFundingThe author(s) reported there is no funding associated with the work featured in this article.","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136068827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-24DOI: 10.1080/09581596.2023.2271140
Michelle Peterie, Alex Broom, Katherine Kenny, Jennifer Broom, David Regan, Lise Lafferty, Angela Kelly-Hanku, Carla Treloar
The social organisation of economic life plays a pivotal role in assembling many emerging and enduring health problems. Yet throughout the recent history of global health challenges, an emphasis on the influence of economic systems has frequently been sidelined in favour of research that interrogates the behavioural and/or cultural dimensions of these problems. The global crisis of antimicrobial resistance provides a striking example of this trend, with analysis frequently and increasingly focusing on behavioural or technological fixes – for example, the need for responsible use of remaining antimicrobial drugs, or for revived efforts to identify new antimicrobial agents – while at times glossing over the market logics that reproduce the problem itself. With a few notable exceptions, the economic headwinds that shape the current antimicrobial resistance (AMR) scene have been largely decentred in scholarly discussions. In this article, we argue for a critical sociology of economies of resistance, contributing to burgeoning efforts to understand how economic structures both shape the acceleration of AMR and undermine the development of drug and diagnostic solutions.
{"title":"Economies of resistance","authors":"Michelle Peterie, Alex Broom, Katherine Kenny, Jennifer Broom, David Regan, Lise Lafferty, Angela Kelly-Hanku, Carla Treloar","doi":"10.1080/09581596.2023.2271140","DOIUrl":"https://doi.org/10.1080/09581596.2023.2271140","url":null,"abstract":"The social organisation of economic life plays a pivotal role in assembling many emerging and enduring health problems. Yet throughout the recent history of global health challenges, an emphasis on the influence of economic systems has frequently been sidelined in favour of research that interrogates the behavioural and/or cultural dimensions of these problems. The global crisis of antimicrobial resistance provides a striking example of this trend, with analysis frequently and increasingly focusing on behavioural or technological fixes – for example, the need for responsible use of remaining antimicrobial drugs, or for revived efforts to identify new antimicrobial agents – while at times glossing over the market logics that reproduce the problem itself. With a few notable exceptions, the economic headwinds that shape the current antimicrobial resistance (AMR) scene have been largely decentred in scholarly discussions. In this article, we argue for a critical sociology of economies of resistance, contributing to burgeoning efforts to understand how economic structures both shape the acceleration of AMR and undermine the development of drug and diagnostic solutions.","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135315669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-20DOI: 10.1080/09581596.2023.2265045
Anne Waugh, Andrea Bombak, Patricia Thille, Kerstin Roger, Kelsey Mann, Natalie Riediger
Sugar-sweetened beverages (SSB) have been identified as a health policy target, due to their associations with weight gain. However, fatness or ‘obesity’ is associated with stigma, and for ‘obese’ children, mother blame; thus, SSB policies must be evaluated for their potential to reinforce existing forms of stigma. The purpose of this study was to explore discourses mobilized in discussion of SSB consumption and purchasing amongst residents of a middle-upper class neighborhood in Winnipeg, Canada. We conducted a critical discourse analysis of qualitative interviews from 2019, with English-speaking, adult participants using purposive sampling. Eighteen participants were recruited; fifteen were women, all self-identified as white and spoke about (grand)parenting. Considerations of weight stigmatization informed analysis. Participants utilized a personal responsibility discourse to determine the acceptability of SSB purchasing and consumption. Negative emotions, or judgements, shaped discussion of regular SSB consumption, consumption by higher-weight individuals, or consumption in specific contexts, which were unacceptable. Parental responsibility was a discourse applied to children’s SSB intake and elicited judgmental language, particularly among mothers. The discourses utilized by dominant social groups are stigmatizing, particularly when directed towards higher-weight individuals, leading to maternal blame. Therefore, the impact of SSB policies on stigma, including weight-based stigma, should be carefully considered prior to implementation.
{"title":"‘If you’re serious about losing weight, why are you drinking all those Cokes?’: a critical discourse analysis of interviews on sugar-sweetened beverages amongst residents of a middle to upper class neighborhood in Winnipeg, Manitoba","authors":"Anne Waugh, Andrea Bombak, Patricia Thille, Kerstin Roger, Kelsey Mann, Natalie Riediger","doi":"10.1080/09581596.2023.2265045","DOIUrl":"https://doi.org/10.1080/09581596.2023.2265045","url":null,"abstract":"Sugar-sweetened beverages (SSB) have been identified as a health policy target, due to their associations with weight gain. However, fatness or ‘obesity’ is associated with stigma, and for ‘obese’ children, mother blame; thus, SSB policies must be evaluated for their potential to reinforce existing forms of stigma. The purpose of this study was to explore discourses mobilized in discussion of SSB consumption and purchasing amongst residents of a middle-upper class neighborhood in Winnipeg, Canada. We conducted a critical discourse analysis of qualitative interviews from 2019, with English-speaking, adult participants using purposive sampling. Eighteen participants were recruited; fifteen were women, all self-identified as white and spoke about (grand)parenting. Considerations of weight stigmatization informed analysis. Participants utilized a personal responsibility discourse to determine the acceptability of SSB purchasing and consumption. Negative emotions, or judgements, shaped discussion of regular SSB consumption, consumption by higher-weight individuals, or consumption in specific contexts, which were unacceptable. Parental responsibility was a discourse applied to children’s SSB intake and elicited judgmental language, particularly among mothers. The discourses utilized by dominant social groups are stigmatizing, particularly when directed towards higher-weight individuals, leading to maternal blame. Therefore, the impact of SSB policies on stigma, including weight-based stigma, should be carefully considered prior to implementation.","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":"7 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135567655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-20DOI: 10.1080/09581596.2023.2268822
Lori E. Ross, Merrick Pilling, Jijian Voronka, Kendra-Ann Pitt, Elizabeth McLean, Carole King, Yogendra Shakya, Kinnon R. MacKinnon, Charmaine C. Williams, Carol Strike, Adrian Guta
Hiring peer researchers – individuals with lived experience of the phenomenon under study – is an increasingly popular practice. However, little research has examined experiences of peer research from the perspectives of peer researchers themselves. In this paper, we report on data from a participatory, qualitative research project focused on four intersecting communities often engaged in peer research: mental health service user/consumer/survivor; people who use drugs; racialized; and trans/non-binary communities. In total, 34 individuals who had worked as peer researchers participated in semi-structured interviews. Transcripts and interviewer reflections were analyzed using a participatory approach. Many participants reported exposure to intersecting forms of systemic oppression (racism, transphobia, ableism, and classism, among others) and disparagement of their identities and lived experiences, both from other members of the research team and from the broader institutions in which they were working. Peer researchers described being required to perform academic professionalism, while simultaneously representing communities that were explicitly or implicitly denigrated in the course of their work. Practices of resistance to these harms were evident throughout the interviews, and participants often made strategic decisions to permit themselves to be tokenized, out of the expectation of promised benefits to their communities. However, additional harms were often experienced when these benefits were not realized. These findings point towards the need for a more reflexive and critical approach to the use of peer research.
{"title":"‘I will play this tokenistic game, I just want something useful for my community’: experiences of and resistance to harms of peer research","authors":"Lori E. Ross, Merrick Pilling, Jijian Voronka, Kendra-Ann Pitt, Elizabeth McLean, Carole King, Yogendra Shakya, Kinnon R. MacKinnon, Charmaine C. Williams, Carol Strike, Adrian Guta","doi":"10.1080/09581596.2023.2268822","DOIUrl":"https://doi.org/10.1080/09581596.2023.2268822","url":null,"abstract":"Hiring peer researchers – individuals with lived experience of the phenomenon under study – is an increasingly popular practice. However, little research has examined experiences of peer research from the perspectives of peer researchers themselves. In this paper, we report on data from a participatory, qualitative research project focused on four intersecting communities often engaged in peer research: mental health service user/consumer/survivor; people who use drugs; racialized; and trans/non-binary communities. In total, 34 individuals who had worked as peer researchers participated in semi-structured interviews. Transcripts and interviewer reflections were analyzed using a participatory approach. Many participants reported exposure to intersecting forms of systemic oppression (racism, transphobia, ableism, and classism, among others) and disparagement of their identities and lived experiences, both from other members of the research team and from the broader institutions in which they were working. Peer researchers described being required to perform academic professionalism, while simultaneously representing communities that were explicitly or implicitly denigrated in the course of their work. Practices of resistance to these harms were evident throughout the interviews, and participants often made strategic decisions to permit themselves to be tokenized, out of the expectation of promised benefits to their communities. However, additional harms were often experienced when these benefits were not realized. These findings point towards the need for a more reflexive and critical approach to the use of peer research.","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":"87 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135616435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-19DOI: 10.1080/09581596.2023.2265049
Mikayla Syanne Alsopp, James Blair, William Minter, Mariah Sanders, Dominique Béhague
ABSTRACTThis paper presents findings from a qualitative study exploring how students at a university in the southern USA conceptualize, theorize, and attempt to influence the role ‘social factors’ play in mental illness and well-being. Drawing on models of research co-production and principles of critical pedagogy, a group of 10 university students (‘student researchers’) worked with a faculty member to develop and conduct the study. The results highlight three ways in which the student interviewees (‘student interlocutors’) theorize ‘the social’. The first two – (1) via the ‘social determinants of health’ and (2) by means of theories on ‘neoliberal subjectivity’ – provide a powerful frame for interrogating hierarchical systems of power. However, because neither of these corresponds to our interest in producing knowledge for social change, we used prefigurative and speculative approaches to explore a third notion of the social, that of (3) ‘world-making practices’. We conclude by reflecting on the relevance of this project for educators, learners, and researchers seeking to deepen knowledge and theories of the social in mental health. We argue that co-produced research that draws from principles of critical pedagogy can enhance interdisciplinary collaboration and lead to more nuanced, transformative, and innovative analyses.KEYWORDS: Social context of mental healthco-productioncritical pedagogystudent mental health AcknowledgementWe would like to thank the other student researchers who participated in early phases of this research: Katherine Carlsen, Andriana Johnson, Francis Lee, Victoria Mityul, Payton Robinette, and Michael West. This project would not have been possible without your insights and enthusiasm. We are also grateful to comments provided by members of faculty at the Department of Medicine, Health, and Society seminar series.Disclosure statementNo potential conflict of interest was reported by the author(s).Notes1. We use the term ‘interlocutor’ rather than ‘study participants’ to emphasize the collaborative and always-situated nature of knowledge creation in qualitative, open-ended research (Simpson, Citation2011).2. Using open-ended methods, interlocutors were asked to self-identify in terms of gender, ethnicity, and race: 27 identified as women, 6 as men; 22 as non-white or persons of color, 11 as white, and 12 as international students, 10 of whom identified as non-white; and nine students were either first- or second-generation university attendees. While interlocutors were not explicitly asked about their mental health, approximately half of them reported having sought psychological help during their studies, either on or off campus.3. These additional questions were used with 25 of our 33 interlocutors.4. 11 of our 33 interlocutors answered these questions.5. Students leading this movement are pressuring the university administration to rename Calhoun Hall, named after William Henry Calhoun (1815–1865), a Nashville silversmit
{"title":"Rethinking and remaking “the social”: co-production, critical pedagogy, and mental health among university students in the USA","authors":"Mikayla Syanne Alsopp, James Blair, William Minter, Mariah Sanders, Dominique Béhague","doi":"10.1080/09581596.2023.2265049","DOIUrl":"https://doi.org/10.1080/09581596.2023.2265049","url":null,"abstract":"ABSTRACTThis paper presents findings from a qualitative study exploring how students at a university in the southern USA conceptualize, theorize, and attempt to influence the role ‘social factors’ play in mental illness and well-being. Drawing on models of research co-production and principles of critical pedagogy, a group of 10 university students (‘student researchers’) worked with a faculty member to develop and conduct the study. The results highlight three ways in which the student interviewees (‘student interlocutors’) theorize ‘the social’. The first two – (1) via the ‘social determinants of health’ and (2) by means of theories on ‘neoliberal subjectivity’ – provide a powerful frame for interrogating hierarchical systems of power. However, because neither of these corresponds to our interest in producing knowledge for social change, we used prefigurative and speculative approaches to explore a third notion of the social, that of (3) ‘world-making practices’. We conclude by reflecting on the relevance of this project for educators, learners, and researchers seeking to deepen knowledge and theories of the social in mental health. We argue that co-produced research that draws from principles of critical pedagogy can enhance interdisciplinary collaboration and lead to more nuanced, transformative, and innovative analyses.KEYWORDS: Social context of mental healthco-productioncritical pedagogystudent mental health AcknowledgementWe would like to thank the other student researchers who participated in early phases of this research: Katherine Carlsen, Andriana Johnson, Francis Lee, Victoria Mityul, Payton Robinette, and Michael West. This project would not have been possible without your insights and enthusiasm. We are also grateful to comments provided by members of faculty at the Department of Medicine, Health, and Society seminar series.Disclosure statementNo potential conflict of interest was reported by the author(s).Notes1. We use the term ‘interlocutor’ rather than ‘study participants’ to emphasize the collaborative and always-situated nature of knowledge creation in qualitative, open-ended research (Simpson, Citation2011).2. Using open-ended methods, interlocutors were asked to self-identify in terms of gender, ethnicity, and race: 27 identified as women, 6 as men; 22 as non-white or persons of color, 11 as white, and 12 as international students, 10 of whom identified as non-white; and nine students were either first- or second-generation university attendees. While interlocutors were not explicitly asked about their mental health, approximately half of them reported having sought psychological help during their studies, either on or off campus.3. These additional questions were used with 25 of our 33 interlocutors.4. 11 of our 33 interlocutors answered these questions.5. Students leading this movement are pressuring the university administration to rename Calhoun Hall, named after William Henry Calhoun (1815–1865), a Nashville silversmit","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135779391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Public Health Ontario (PHO) is mandated by legislation to share scientific advice during infectious disease outbreaks and help reduce health inequities in Ontario, Canada. PHO was founded in part to address the failures of Ontario’s public health system during the 2003 outbreak of SARS-CoV-1, which included the failure to address airborne transmission. By January 2021, public health authorities had access to a body of literature suggesting SARS-CoV-2 was airborne, and had received urgent warnings from scientists. We set out to document how PHO responded to the likelihood – and, eventually, the certainty – of airborne transmission in the context of its guidance for congregate settings such as long-term care and shelters. In October 2021, we reviewed PHO’s public, written COVID-19 guidance for these settings, with a focus on indoor air quality (IAQ) measures that mitigate airborne transmission, such as ventilation. We identified 11 PHO documents for congregate settings. They contained no references to IAQ measures. We did, however, find references to IAQ measures in parallel documents for schools, summer camps, and clinical offices. Our findings demonstrate PHO omitted key infection prevention measures from its COVID-19 guidance for congregate settings, putting workers and residents at greater risk of exposure, illness and death, and exacerbating health inequities.
{"title":"Systematically omitting indoor air quality: sub-standard guidance for shelters, group homes and long-term care in Ontario during the COVID-19 pandemic","authors":"Amy Katz, Tianyuan Li, LLana James, Jeffrey Siegel, Patricia O’Campo","doi":"10.1080/09581596.2023.2262736","DOIUrl":"https://doi.org/10.1080/09581596.2023.2262736","url":null,"abstract":"Public Health Ontario (PHO) is mandated by legislation to share scientific advice during infectious disease outbreaks and help reduce health inequities in Ontario, Canada. PHO was founded in part to address the failures of Ontario’s public health system during the 2003 outbreak of SARS-CoV-1, which included the failure to address airborne transmission. By January 2021, public health authorities had access to a body of literature suggesting SARS-CoV-2 was airborne, and had received urgent warnings from scientists. We set out to document how PHO responded to the likelihood – and, eventually, the certainty – of airborne transmission in the context of its guidance for congregate settings such as long-term care and shelters. In October 2021, we reviewed PHO’s public, written COVID-19 guidance for these settings, with a focus on indoor air quality (IAQ) measures that mitigate airborne transmission, such as ventilation. We identified 11 PHO documents for congregate settings. They contained no references to IAQ measures. We did, however, find references to IAQ measures in parallel documents for schools, summer camps, and clinical offices. Our findings demonstrate PHO omitted key infection prevention measures from its COVID-19 guidance for congregate settings, putting workers and residents at greater risk of exposure, illness and death, and exacerbating health inequities.","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135858186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-12DOI: 10.1080/09581596.2023.2262739
Saara Greene, Mary Vaccaro, Alexe Bernier, Gabrielle Griffith, Allyson Ion, Rochelle Maurice, Chelsea Gabel, Marisa Blake
ABSTRACTSince the shift to legalizing recreational cannabis use in Canada in 2018, there has been increased attention on the consequences of cannabis use on women’s reproductive and maternal health, with particular attention to the impact of cannabis in utero and through breastfeeding. This has resulted in an intense focus on the behaviors of individuals who consume cannabis during the perinatal period, which raises questions about the impact this has on women and mothers who have historically been under the surveillance of the Canadian public health, health and social care, and legal systems. Grounded in an intersectional feminist framework that acknowledges how race, ability, class, and other social positions impact and differentiate women’s experience, this paper presents findings emerging from a participatory arts-based research approach called Photovoice with 23 mothers living throughout Canada. All participants consumed cannabis during pregnancy and breastfeeding and illustrated through photographs and individual and group discussion how their experiences of intersectional stigma and surveillance by health and social care providers resulted in barriers to accessing cannabis-related information and support. Implications arising from our inquiry suggest there is a dire need for public health, perinatal care, and social care responses that run counter to the current context where stigma and fear prevent parents from accessing cannabis information and support.KEYWORDS: Cannabispregnancybreastfeedingintersectional stigmasurveillance Disclosure statementNo potential conflict of interest was reported by the author(s).Notes1. Although we used the terms parents and chestfeeding in our proposal and recruitment process to be inclusive of all pregnant, infant feeding and parenting individuals, all participants who participated in the study identified themselves as Mothers who breastfeed.2. The TRC issues 94 calls to action call on all levels of the Canadian government to work together to repair the harm caused by residential schools and begin the process of reconciliation.Additional informationFundingThis study was funded by the Social Science & Humanities Research Council (Grant number 435-2019-0215) and an RFP from the Canadian Centre on Substance Use and Addiction (Cannabis Closing the Gaps RFP).
{"title":"“Digging in”: stigma and surveillance in the lives of pregnant and breastfeeding mothers who consume cannabis","authors":"Saara Greene, Mary Vaccaro, Alexe Bernier, Gabrielle Griffith, Allyson Ion, Rochelle Maurice, Chelsea Gabel, Marisa Blake","doi":"10.1080/09581596.2023.2262739","DOIUrl":"https://doi.org/10.1080/09581596.2023.2262739","url":null,"abstract":"ABSTRACTSince the shift to legalizing recreational cannabis use in Canada in 2018, there has been increased attention on the consequences of cannabis use on women’s reproductive and maternal health, with particular attention to the impact of cannabis in utero and through breastfeeding. This has resulted in an intense focus on the behaviors of individuals who consume cannabis during the perinatal period, which raises questions about the impact this has on women and mothers who have historically been under the surveillance of the Canadian public health, health and social care, and legal systems. Grounded in an intersectional feminist framework that acknowledges how race, ability, class, and other social positions impact and differentiate women’s experience, this paper presents findings emerging from a participatory arts-based research approach called Photovoice with 23 mothers living throughout Canada. All participants consumed cannabis during pregnancy and breastfeeding and illustrated through photographs and individual and group discussion how their experiences of intersectional stigma and surveillance by health and social care providers resulted in barriers to accessing cannabis-related information and support. Implications arising from our inquiry suggest there is a dire need for public health, perinatal care, and social care responses that run counter to the current context where stigma and fear prevent parents from accessing cannabis information and support.KEYWORDS: Cannabispregnancybreastfeedingintersectional stigmasurveillance Disclosure statementNo potential conflict of interest was reported by the author(s).Notes1. Although we used the terms parents and chestfeeding in our proposal and recruitment process to be inclusive of all pregnant, infant feeding and parenting individuals, all participants who participated in the study identified themselves as Mothers who breastfeed.2. The TRC issues 94 calls to action call on all levels of the Canadian government to work together to repair the harm caused by residential schools and begin the process of reconciliation.Additional informationFundingThis study was funded by the Social Science & Humanities Research Council (Grant number 435-2019-0215) and an RFP from the Canadian Centre on Substance Use and Addiction (Cannabis Closing the Gaps RFP).","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136014572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-12DOI: 10.1080/09581596.2023.2260936
Angèle Bilodeau, Catherine Chabot, Mélissa Di Sante, Nadine Martin, Louise Potvin
Action aimed at developing healthier living conditions requires intersectoral collaboration, both across sectors and between levels of government. It also calls for the commitment of political and institutional authorities at municipal and higher levels. This article focuses on strategies of local intersectoral networks rooted in civil society for addressing living conditions. A longitudinal cross-case analysis was performed on eight case studies in Montreal (Canada). Data sources include 1445 documents and 41 interviews. Case studies were analyzed based on a theoretical framework focusing on critical events and a repertoire of transitional outcomes (TOs) that local intersectoral networks mobilised in order to produce change. The analysis focussed on the distribution of TOs in each case. Two types of strategies were identified. The Do It strategy relied primarily on acquiring resources as well as expanding and strengthening networks and projects. In this strategy, networks held the key decision-making and action levers to drive projects by themselves. In contrast, the Make It Happen strategy was mainly constructed around actions that led to self-representation and influencing others. In this strategy, networks held certain levers – such as mobilizing their citizen and community bases – but they also had to convince decision-makers to support action. This article describes and compares the key features of these two types of action strategies for local change.
{"title":"Two strategies used by local intersectoral networks to create healthier environments: a cross-case analysis in the Montreal urban setting","authors":"Angèle Bilodeau, Catherine Chabot, Mélissa Di Sante, Nadine Martin, Louise Potvin","doi":"10.1080/09581596.2023.2260936","DOIUrl":"https://doi.org/10.1080/09581596.2023.2260936","url":null,"abstract":"Action aimed at developing healthier living conditions requires intersectoral collaboration, both across sectors and between levels of government. It also calls for the commitment of political and institutional authorities at municipal and higher levels. This article focuses on strategies of local intersectoral networks rooted in civil society for addressing living conditions. A longitudinal cross-case analysis was performed on eight case studies in Montreal (Canada). Data sources include 1445 documents and 41 interviews. Case studies were analyzed based on a theoretical framework focusing on critical events and a repertoire of transitional outcomes (TOs) that local intersectoral networks mobilised in order to produce change. The analysis focussed on the distribution of TOs in each case. Two types of strategies were identified. The Do It strategy relied primarily on acquiring resources as well as expanding and strengthening networks and projects. In this strategy, networks held the key decision-making and action levers to drive projects by themselves. In contrast, the Make It Happen strategy was mainly constructed around actions that led to self-representation and influencing others. In this strategy, networks held certain levers – such as mobilizing their citizen and community bases – but they also had to convince decision-makers to support action. This article describes and compares the key features of these two types of action strategies for local change.","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":"199 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135969122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-25DOI: 10.1080/09581596.2023.2260935
Bernadette Kina Kombo, Matthew Thomann, Helgar Musyoki, Kennedy Olango, Samuel Kuria, Martin Kyana, Memory Otieno, Margaret Njiraini, Janet Musimbi, Pariniti Bhattacharjeea, Robert Lorway, Lisa Lazarus
ABSTRACTSince the 1990s, researchers have used community-based participatory approaches to achieve outcomes relevant to local communities, to build collaborative and sustainable research infrastructures, and to address disparities in knowledge production. Notwithstanding these strengths, communities and researchers have questioned its success in addressing power imbalances inherent in collaborative research encounters. In this methodological paper, we describe a novel community-based program science approach to guide an interdisciplinary research project on HIV self-testing among men who have sex with men in three Kenyan counties. Drawing on ethnographic field notes, we detail how community researchers and their academic and programmatic partners collaborated through all phases of the research process, including research design and data collection. Importantly, community researchers also played an integral role in data analysis and dissemination, going well beyond the conventional role of ‘community engagement’ in global health research. We also present findings from qualitative interviews conducted by community researchers with their peers to inform the rollout of HIV self-testing kits in their respective county-contexts. Our approach highlights that engaging community directly in evidence production allows research findings – owned and generated by communities on their own behalf – to be fed more swiftly and effectively into community-led program delivery.KEYWORDS: Community-based participatory researchmen who have sex with menHIV testing Disclosure statementNo potential conflict of interest was reported by the author(s).Notes1. Article 162 of the Kenyan Penal Code, a relic of British colonial-era laws criminalizing ‘carnal knowledge against the order of nature’, was upheld by the Kenyan High Court in 2019.Additional informationFundingThe work was supported by the Bill and Melinda Gates Foundation [OPP-11191068].
{"title":"From collaborator to colleague: a community-based program science approach for engaging Kenyan communities of gay, bisexual and other men who have sex with men in HIV research","authors":"Bernadette Kina Kombo, Matthew Thomann, Helgar Musyoki, Kennedy Olango, Samuel Kuria, Martin Kyana, Memory Otieno, Margaret Njiraini, Janet Musimbi, Pariniti Bhattacharjeea, Robert Lorway, Lisa Lazarus","doi":"10.1080/09581596.2023.2260935","DOIUrl":"https://doi.org/10.1080/09581596.2023.2260935","url":null,"abstract":"ABSTRACTSince the 1990s, researchers have used community-based participatory approaches to achieve outcomes relevant to local communities, to build collaborative and sustainable research infrastructures, and to address disparities in knowledge production. Notwithstanding these strengths, communities and researchers have questioned its success in addressing power imbalances inherent in collaborative research encounters. In this methodological paper, we describe a novel community-based program science approach to guide an interdisciplinary research project on HIV self-testing among men who have sex with men in three Kenyan counties. Drawing on ethnographic field notes, we detail how community researchers and their academic and programmatic partners collaborated through all phases of the research process, including research design and data collection. Importantly, community researchers also played an integral role in data analysis and dissemination, going well beyond the conventional role of ‘community engagement’ in global health research. We also present findings from qualitative interviews conducted by community researchers with their peers to inform the rollout of HIV self-testing kits in their respective county-contexts. Our approach highlights that engaging community directly in evidence production allows research findings – owned and generated by communities on their own behalf – to be fed more swiftly and effectively into community-led program delivery.KEYWORDS: Community-based participatory researchmen who have sex with menHIV testing Disclosure statementNo potential conflict of interest was reported by the author(s).Notes1. Article 162 of the Kenyan Penal Code, a relic of British colonial-era laws criminalizing ‘carnal knowledge against the order of nature’, was upheld by the Kenyan High Court in 2019.Additional informationFundingThe work was supported by the Bill and Melinda Gates Foundation [OPP-11191068].","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135815214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-21DOI: 10.1080/09581596.2023.2259063
Sophie McKenzie, Cassandra Hesse, Anna Carson, Trevor Goodyear, Rod Knight
ABSTRACTThis study explores service providers’ accounts of working with sexual and gender minority (SGM) youth and the improvised and non-institutionalized adaptations to their delivery of care in response to the COVID-19 pandemic. We present a narrative analysis of data from qualitative, in-depth semi-structured interviews conducted between July 2020 and August 2021 with 16 service providers who deliver programs and services for SGM youth in British Columbia (BC), Canada. Drawing on a central narrative of uncertainty in driving improvised adaptations to service provision amid the pandemic, we identified three sub-narratives: (i) uncertainty as characteristic of liminality; (ii) uncertainty as conducive to cooperation and collaboration; and (iii) uncertainty as enabling ‘blue-sky thinking’ and innovation. In each sub-narrative, we document service providers’ accounts of how they navigated both uncertainty in the absence of direction from their organizations and constraint by COVID-19 public health mandates and guidelines. Amid pandemic-driven interruptions in structured guidance, these improvised practices of care became key in shaping the delivery of care to SGM youth in BC. These accounts offer insights into how uncertainty can be harnessed as a potent source of improvement of services for SGM youth now and throughout future phases of the COVID-19 pandemic.KEYWORDS: Uncertaintysexual and gender minoritiesyouthCOVID-19adaptations AcknowledgementsWe acknowledge our participants, each of whom took time from their busy schedules to share information about their experiences. We would also like to thank Naseeb Bolduc, Peter Hoong and Alya Govorchin for their contributions to this study.Disclosure statementNo potential conflict of interest was reported by the author(s).Additional informationFundingWe acknowledge the support of our funder, the Canadian Institutes of Health Research [CTW-155550].
{"title":"“Anticipate the need”: a narrative analysis of service providers’ experiences working with sexual and gender minority youth in British Columbia, Canada, during the COVID-19 pandemic","authors":"Sophie McKenzie, Cassandra Hesse, Anna Carson, Trevor Goodyear, Rod Knight","doi":"10.1080/09581596.2023.2259063","DOIUrl":"https://doi.org/10.1080/09581596.2023.2259063","url":null,"abstract":"ABSTRACTThis study explores service providers’ accounts of working with sexual and gender minority (SGM) youth and the improvised and non-institutionalized adaptations to their delivery of care in response to the COVID-19 pandemic. We present a narrative analysis of data from qualitative, in-depth semi-structured interviews conducted between July 2020 and August 2021 with 16 service providers who deliver programs and services for SGM youth in British Columbia (BC), Canada. Drawing on a central narrative of uncertainty in driving improvised adaptations to service provision amid the pandemic, we identified three sub-narratives: (i) uncertainty as characteristic of liminality; (ii) uncertainty as conducive to cooperation and collaboration; and (iii) uncertainty as enabling ‘blue-sky thinking’ and innovation. In each sub-narrative, we document service providers’ accounts of how they navigated both uncertainty in the absence of direction from their organizations and constraint by COVID-19 public health mandates and guidelines. Amid pandemic-driven interruptions in structured guidance, these improvised practices of care became key in shaping the delivery of care to SGM youth in BC. These accounts offer insights into how uncertainty can be harnessed as a potent source of improvement of services for SGM youth now and throughout future phases of the COVID-19 pandemic.KEYWORDS: Uncertaintysexual and gender minoritiesyouthCOVID-19adaptations AcknowledgementsWe acknowledge our participants, each of whom took time from their busy schedules to share information about their experiences. We would also like to thank Naseeb Bolduc, Peter Hoong and Alya Govorchin for their contributions to this study.Disclosure statementNo potential conflict of interest was reported by the author(s).Additional informationFundingWe acknowledge the support of our funder, the Canadian Institutes of Health Research [CTW-155550].","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136136905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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