Search

The COVID-19 pandemic has heightened and made visible the embodied consequences of water, sanitation and hygiene (WASH) inequalities and the relationalities of health in place. This paper combines insights from relational geographies and embodied epidemiology to explore psychosocial concerns among Ghanaian migrants in Canada due to their multiple and simultaneous roles in the WASH space in Ghana, particularly during the COVID-19 pandemic. We explored this using narratives from in-depth interviews with 27 participants (16 women and 11 men) residing in Ontario, Canada. The case of Ghana offers insight into how social ties with home communities could provide a safety net during emergencies but could also affect the psychosocial wellbeing of migrants. Results revealed four interrelated psychosocial stressors, including social stressors, financial stressors, stressors related to perceived inequality and stressors related to the fear of infection during WASH access. The paper underscores the urgent need for research to move beyond local health implications of WASH inequalities and begin to prioritize how these social inequalities are embodied at distant locations. • The COVID-19 pandemic has highlighted the global health interconnectedness • Embodied subjectivities of WASH insecurity span across space and time • Migrants embody multidimensional WASH psychosocial stressors because of their social connections with home • Policy responses must address WASH subjectivities beyond the local [ABSTRACT FROM AUTHOR]

Most home care for people living with chronic illness or disability is provided by informal, or unpaid, family members. Family caregivers in rural New Brunswick engage in essential work to maintain the home as a site of care. Renovations, property maintenance, and the administrative work involved in accessing medical equipment and managing staff are examples of the types of invisible labour involved in interacting with a complex care environment. Conversations with 13 family caregivers across a small rural Canadian province suggest that even when resources are 'available', place-based factors involved in caring at home in a rural setting make it difficult for carers to use these resources and accessing them becomes another form of work itself. Similar to Wiles et al.'s (2018) findings in their study of end-of-life family care in Aotearoa, New Zealand, carers in rural New Brunswick spoke of their activities as part of an ongoing process of interaction with the care recipient and care environment. Carers with fewer financial and material resources experienced higher burdens of invisible work. The paper sheds light on the types of labour involved in 'knowing, doing, and negotiating' care at home and re-categorizes these activities as 'health work' as a means of informing home care policy. The paper finds that family caregivers are aware of their invisible work, characterize it as essential health work, and seek recognition for their complex contribution to the formal health system. [ABSTRACT FROM AUTHOR]

Abstract: Resting on the notion that rural spaces are “food deserts,” rural adolescents are increasingly regarded as a “problem population” in Western obesity narratives. Using qualitative data gleaned from interviews with 51 teenage participants from rural areas across Canada, this paper focuses on the ways in which obesity is constructed as a rural disease in the Canadian context, demonstrating in particular how discourses of food deserts and related rural obesity rely on classist imaginings of obesity as a working-class embodiment. The paper will further question the understanding of the rural as a food desert, showing the ways in which rural teens acquire fresh, healthy foods in part through an informal economy of food growing and sharing. [Copyright &y& Elsevier]

This paper examines the role of culture and place in recovery from severe mental illness amongst a group of Québécois living in Montreal, Canada. Results indicate that dominant cultural characteristics of Québécois, such as a marked Roman Catholic heritage, use of the French language and a close affiliation with the natural territory of Québec can all play important roles in recovery from severe mental illness. The findings suggest that participants weave together places with cultural, familial and personal meaning to create their own healing landscapes. We propose ways to leverage place and dominant cultural traits to facilitate recovery. [ABSTRACT FROM AUTHOR]

Walkability indices are used to characterize the relationship between health and place. Indices make assumptions that affect analysis of the built environment and resulting walkability scores. This study compares three walkability indices created by health researchers focusing on the methods, variables, and walkability scores resulting from differences in definitions and methods. This paper deconstructs the walkability algorithms utilized by each index and rebuilds them in Vancouver, Canada. We find that neighbourhoods in the northern core closer to the downtown area have similar walkability scores across all three indices, while the outer peripheral neighbourhoods with moderate to low walkability have more variation in walkability scores across indices. Most walkability variables - residential density, street connectivity, and land-use - lack a rationale for inclusion, often assumed by researchers. Walkability indices used in health research prove to be incongruent with each other and misrepresentative of actual human behavior. We explore the impact of variable selection and methodologies on indices in the interest of more rigorous health research. [ABSTRACT FROM AUTHOR]

This paper presents research findings that advance knowledge around the power and agency families with children with complex care needs (CCN). Our conceptual framework uses concepts from geography towards situating the experiences and social realities of family carers within the 'embodied space of care'. The data originate from a longitudinal qualitative study of Canadian families with children with CCN. Findings reveal that interactions and decision-making processes relating to health and everyday life were complex and socially interconnected, and emphasize the need for provisions for family-based decision-making and enhanced social inclusion of families and the importance of the renegotiation of power. [ABSTRACT FROM AUTHOR]

In 2010, Castleden and colleagues published a paper in this journal using the concept of 'place' as an analytic tool to understand the nature of palliative care provision in a rural region in British Columbia, Canada. This publication was based upon pilot data collected for a larger research project that has since been completed. With the addition of 40 semi-structured interviews with users and providers of palliative care in four other rural communities located across Canada, we revisit Castleden and colleagues' (2010) original framework. Applying the concept of place to the full dataset confirmed the previously published findings, but also revealed two new place-based dimensions related to experiences of rural palliative care in Canada: (1) borders and boundaries; and (2) 'making' place for palliative care progress. These new findings offer a refined understanding of the complex interconnections between various dimensions of place and palliative care in rural Canada. [ABSTRACT FROM AUTHOR]

The planet is rapidly urbanizing, the need for actionable evidence to guide the design of cities that help (not hinder) our health has never felt more urgent. One essential component of healthy city design is improving neighborhood conditions in previously disinvested areas. To ensure equitable city design, policy makers, city planners, health practitioners, and researchers are interested in understanding the complex relationship between urban change, gentrification, and population health. Yet, the causal link between gentrification and health outcomes remain unclear. Without clear and consistent gentrification measures, researchers struggle to identify populations who are exposed to gentrification, and to compare health outcomes between exposed and unexposed populations. To move the science forward, this paper summarizes the challenges related to gentrification measurement in the United States and Canada when aspiring to conduct studies to analyze causal relationships between gentrification and health. The paper concludes with a series of recommendations for studies aimed at examining both causes and consequences of gentrification and health. [ABSTRACT FROM AUTHOR]

For refugees who undergo permanent resettlement, characteristics of the resettlement context influence their ability to heal from pre-migration persecution and achieve a sense of wellbeing. This ethnographic study examines the impact of place-related determinants on the sense of wellbeing experienced by refugees resettled in a small urban center. The paper reports on the results of in-depth interviews that were conducted with ten former refugees in St. John's, Canada. We found that challenges and coping resources both emerged from the same aspects of the city, including its built environment, natural environment, history, culture, and low ethnic diversity. Future research should attend to how aspects of the resettlement context can simultaneously challenge and support refugees' sense of wellbeing. [ABSTRACT FROM AUTHOR]

This paper is based on a qualitative study conducted in a rural community in British Columbia, Canada. Ethnographic methods were used to: (1) to bring youth voice to the literature on emotional distress; and (2) to capture the ways in which context shapes young peoples' experiences of emotional distress within their everyday lives. Our findings demonstrate how socio-structural contextual factors such as the local economy, geographical segregation, racism, ageism, and cutbacks in health and social service programming operate to create various forms of disconnection, and intersect in young peoples' lives to shape their experiences of emotional distress. [ABSTRACT FROM AUTHOR]

This paper extends the concept of therapeutic landscapes by investigating how green and blue spaces affect older adult health and wellbeing. We draw on interview data from participants aged 65–86 years old who described their everyday experiences with green and especially blue spaces across Metro Vancouver, Canada. Landscapes embedded with therapeutic qualities included parks, gardens, street greenery, lakes, and the ocean. Interactions with these spaces influenced participants' perceived physical, mental, and social health. Issues of safety, accessibility, and personal perception complicated this relationship. Overall, the findings indicate that nature plays a nuanced and influential role in the everyday lives of older adults. Better understanding how older adults experience health and landscape is critical towards developing everyday contact with nature that can improve quality of life for ageing populations. [ABSTRACT FROM AUTHOR]

For several decades, the emphasis on abstinence within homeless support systems has presented significant barriers to care for those who continue to use alcohol or drugs further marginalizing them in terms of housing and health/social services. In response, health care specialists and policymakers have recommended the integration of harm reduction philosophies and interventions into system-level responses to end homelessness. Managed alcohol programs (MAPs) have been developed to this end and have demonstrated positive results. While recent studies of MAPs have focused attention on reductions in alcohol related harms few have examined their meaning from the perspective of clients or considered the role of place. In this paper, we utilize the ‘enabling places’ frameworks to identify the place-bound properties that make a difference in the recovery journeys of clients. Drawing on in-depth interviews with clients from one program we develop a description of MAPs as enabling places that afford the elemental resources for personal recovery. [ABSTRACT FROM AUTHOR]

Drawing on qualitative data generated from an ethnographic study exploring Canadian youth’s understanding of health, this paper examines youth’s perspectives of the relationships between health and environment. Seventy-one youth (12 to 19 years of age) took part in individual and focus group interviews, as well as in photovoice interviews. Although initial discourse about health mainly focused on healthy eating and exercise, youth were more enthused and able to share their thoughts and feelings about the relationships between health and environment during the photovoice interviews. For these youth, good health was defined and visualized as “being outside” in a safe, clean, green, and livable space. Youth talked about conditions contributing to healthy environments and how healthy environments contributed to a strong sense of place. Overall, the conversations about the environment evoked many feelings in the youth. Results are discussed in the context of current research and in relation to youth, but also more broadly in relation to research on health and environment. [ABSTRACT FROM AUTHOR]

Resource-dependent communities in hinterland regions of Australia, Canada and elsewhere are rapidly aging, yet many features that distinguish them (e.g., geographic remoteness, small populations, infrastructure built with younger persons in mind) also pose significant challenges for healthy aging. These challenges can lead to substantial gaps in access to formal health and social services, with negative implications for older residents aging-in-place and the development aspirations of resource frontier communities. In this paper, we explore the efforts of voluntary sector leaders to transform resource communities into more livable and supportive places for older adults. We offer a case study of two small towns in Canada's aging resource frontier; one forestry-dependent and the other dependent on coal mining. Our findings suggest that place integration develops through volunteer work and explains how voluntarism works as both a process and outcome of 'placemaking'. We argue that greater attention to place integration is needed to bring into focus the transformative potential of the voluntary sector in creating supportive and sustainable environments for healthy aging. [ABSTRACT FROM AUTHOR]

Abstract: Many Aboriginal children living in Canadian cities experience high levels of perinatal and infant health challenges. Despite efforts to reduce inequities in early childhood development, numerous urban Aboriginal families have poor access to preventive care. In this paper, we challenge conventional notions of access and use a postcolonial population health perspective to explain how access to preventive care for Aboriginal families is influenced by safety and responsiveness within care experiences. We explore an approach to care that addresses the safety of care spaces and care places. The potential of this approach for improving access to preventive services for Aboriginal families may be of considerable interest to urban preventive health policy or health system managers. [Copyright &y& Elsevier]

Abstract: Studies that explore social capital and political will be in the context of safe drinking water provision in rural Canada are limited. This paper presents findings from a study that examines the capacity of rural Canadian communities to attain regulatory compliance for drinking water. Interviews were conducted with water operators and managers in ten rural communities across Atlantic Canada to identify the burden of compliance arising from the implementation of, and adherence to, drinking water regulations. This research identifies the operator as being particularly burdened by regulatory compliance, often resulting in negative consequences including job stress and a strained relationship with the community they serve. Findings indicate that while regulations are vital to ensuring safe drinking water, not all communities have the resources in place to rise to the challenge of compliance. As a result, some communities are being negatively impacted by these regulations, rather than benefit from their intended positive effect. [Copyright &y& Elsevier]

Abstract: Overweight/obesity represent a significant public health problem in Canada and abroad. The objective of this paper is to identify potential associations between overweight/obesity and individual as well as socio-environmental determinants. The data sources used are the 2003 Canadian Community Health Survey and the Desktop Mapping Technologies Incorporated database. Geographical Information Systems are first employed to create neighbourhood-level variables such as neighbourhood walkability and fast food accessibility. Multivariate analysis is then applied to estimate the relative effects of individual- and neighbourhood-level risk-factors of overweight/obesity. Results demonstrate the important role of the built-environment after adjustment for demographic, socio-economic and behavioural characteristics. Findings support the rationale that reversing current trends will require a multifaceted public health approach where interventions are developed from the individual- to the neighbourhood-level, with a particular focus on altering obesogenic environments. [Copyright &y& Elsevier]

Abstract: Social health inequalities are smaller in rural than urban areas because, some argue, people’s social conditions are estimated at a small-area level, hiding variability at the individual or household level. This paper compares inequalities in survival according to an individual and area-based version of a deprivation index among a large sample of Canadians living in various urban and rural settings. Results show that survival inequalities in small towns and rural areas are lower than elsewhere when an area-based index is used, except in the remote hinterland, but of equal magnitude when the individual version of this index is considered. [Copyright &y& Elsevier]

Abstract: Palliative care is intimately connected with place, yet little research has explored these relationships in depth, especially with respect to rural and remote settings. This paper uses multiple dimensions of the concept ‘place’ as an analytic tool to understand the nature of palliative care provision in a rural region of British Columbia, Canada. We draw upon primary data from formal and informal providers (n=31) to explore the social and physical place of rural palliative care. We unpack four highly geographic issues raised by participants, namely: (1) distance, (2) location, (3) aesthetics, and (4) sites of care. This analysis reveals a rich and complex experience of rural care-giving long overlooked in palliative care research and policy. [Copyright &y& Elsevier]

Abstract: The paper is based on an ethnographic study conducted in a rural community in British Columbia, Canada. The study examined the impact of community culture on youth''s development as sexual beings. We describe how social and geographical forces intersect to affect youth''s lives and trace the ways in which deprivation of various forms of capital as well as social practices contribute to some youth being located in undesirable social positions. Our findings illustrate how the effects of stigmatisation, self-segregation, and other forms of symbolic violence can extend beyond health impacts and into the broader social realm. [Copyright &y& Elsevier]

Abstract: This paper uses the aggregate data from the Public Use Microdata Files (PUMF) of Canadian National Population Health Survey to estimate income related health inequalities across the ten Canadian provinces. The unique features of the PUMF allow for a meaningful cross-provincial comparison of health indices and their measured inequalities. It concludes that health inequalities favouring the higher income people do exist in all provinces when health status is either self assessed or measured by the health utility index. Moreover, it finds considerable variations in measured health inequalities across the provinces with consistent rankings for certain provinces. [Copyright &y& Elsevier]

Abstract: This paper considers how long-term care restructuring, under the rubric of managed competition, has increased pressure on voluntary sector providers of long-term care to elderly populations in small, rural places. Drawing on in-depth interviews with key-informants from non-profit organizations, we present a case study set in rural Ontario to develop a situated understanding of the impact of restructuring on voluntary sector providers of long-term care. We contend that managed competition (underway in Ontario since 1995) has constrained providers, eroded service choices, and reduced access to long-term care in rural areas leaving rural populations more disadvantaged than ever before when it comes to public service provisioning. [Copyright &y& Elsevier]

This paper investigates community perceptions of and coping responses to a petrochemical refinery in Oakville, Ontario. The analysis of in-depth interviews (n=29) revealed the effects of social and community factors on residents’ everyday life experiences of refinery emissions, and the factors that shape residents’ perceptions and responses after the refinery''s implementation of extensive measures to reduce emissions and odours. Overall, residents reported a reduction in odours from the refinery. While the refinery now poses a minimal or tolerable level of risk to some people in the community, it is still intolerable to others. The results show residents’ shifting concerns, with their fears now focused on invisible emissions. Residents continue to employ both action-focused and emotion-focused coping strategies. These findings suggest that refinery intervention may have to move beyond the focus on technological measures to reduce odours to address the psychological and social concerns of residents. [Copyright &y& Elsevier]

This paper examines the relative contributions of compositional and contextual effects on the one hand, and behavioural and material factors on the other, to help explain smoking initiation. We present results from a cross-sectional, multi-level analysis linking data from pre-adolescents, their households and their neighbourhoods across Quebec, Canada. Results show a significant geographical area variation in youth smoking initiation. The variation is explained not only by individual characteristics (parents’ smoking status, parents’’ education and pre-adolescents’ age), but also by aspects of the social structure at the neighbourhood level. When both the individual level and territory level predictors are entered in the model, only 2.66% of the between-territory variance in smoking initiation remain unexplained. [Copyright &y& Elsevier]