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On September 28, 2012, the postgraduate students of the Dalla Lana School of Public Health at the University of Toronto organized a conference on the theme of "Health, Austerity and Affluence." It brought together academics, health-care professionals and public policy makers in a forum to discuss effective health care delivery at a time when the gap between wealth and poverty appears to be increasing while, at the same time, governments are imposing austerity measures on public spending--not least in the field of public health. The remarks by Dr. Blake Poland are of direct importance not only to college students and teachers in Nursing and related health-care programs, but also to any educators who understand that education is an inherently moral and political practice: moral because it is deeply infused with values, and political because those values are essentially contested. Most obviously in vocational pursuits involving the creation and distribution of public services and private commercial enterprise, but even in the most instrumental and technical fields, education involves a continuing dialogue about what knowledge is "for" and how the use of knowledge adds to or detracts from the common good.

Reducing disease prevalence rather than promoting health has long been the objective of significant population health initiatives, such as the social determinants of health (SDH) framework. However, empirical evidence suggests that people with diagnosed diseases often answer the self-reported health (SRH) question positively. In pursuit of a better proxy to understand, measure and improve health, this scoping review of reviews examines the potential of SRH to be used as an outcome of interest in population health policies. Following PRISMA-ScR guidelines, it synthesizes findings from 77 review papers (published until 11 May 2022) and reports a robust association between SDH and SRH. It also investigates inconsistencies within and between reviews to reveal how variation in population health can be explained by studying the impact of contextual factors, such as cultural, social, economic and political elements, on structural determinants such as socioeconomic situation, gender and ethnicity. These insights provide informed hypotheses for deeper explorations of the role of SDH in improving SRH. The review detects several gaps in the literature. Notably, more evidence syntheses are required, in general, on the pathway from contextual elements to population SRH and, in particular, on the social determinants of adolescents' SRH. This study reports a disease-oriented mindset in collecting, analysing and reporting SRH across the included reviews. Future studies should utilize the capability of SRH in interconnecting social, psychological and biological dimensions of health to actualize its full potential as a central public health measure. [ABSTRACT FROM AUTHOR]

The lack of affordable housing in Canada affects a growing number of female heads of single-parent families, and the current political economy presents significant obstacles to develop more social housing in response. This paper seeks to understand the extent to which new housing programmes led by community providers comply with or resist neoliberalisation. We draw on feminist ethics of care to explore and deepen the ideas, interests, institutions, and networks involved in creating social housing for female heads of single-parent families in Montreal, Toronto, and Vancouver, Canada. The cases reveal that neoliberalisation is not eliminating care in the social housing sector. On the one hand, communities that embrace and engage with the principles of care comply with state rollback by stepping up to meet pressing needs despite the inadequacies or unavailability of public programmes. On the other hand, care ethics lead them to design programmes and spaces centred on family needs, which resist the climate that hampers social housing development and orients it toward market-driven solutions and neoliberal expectations. We conclude with a critical reflection on the inequalities in communities' capacity to create housing with care to meet the identified needs and thereby resist the neoliberalisation of social housing. [ABSTRACT FROM AUTHOR]

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1467-9566.2008.01119.x Byline: Rebecca J. Haines (1), Blake D. Poland (2), Joy L. Johnson (1) Keywords: substance use; tobacco; adolescence; cultural capital; Bourdieu Abstract: Abstract This paper draws from a qualitative study of tobacco use by young women in Toronto, Canada. Narrative interviews were used to understand the multiple roles and functions of smoking within the everyday lives of female adolescents. Guided by a Bourdieusian theoretical framework this study employed the core construct of cultural capital in order to position tobacco and other substance use as field-specific capital that young women accumulate while navigating the social worlds of adolescence. Departing from the psychosocial or peer-influence models that inform the majority of tobacco research with young people, this analysis provides a nuanced understanding of how smoking, drinking, using drugs are much more than simple forms of teenage experimentation or rebellion, but can also serve as key resources for defining the self, acquiring status and making social distinctions within adolescent social worlds. In this context it is also argued that initiation into substance use practices is a way that young women demonstrate and develop social and cultural competencies. Author Affiliation: (1)School of Nursing, University of British Columbia, Canada (2)Department of Public Health Sciences, University of Toronto, Canada Article note: Address for correspondence: Rebecca Haines, NAHBR, School of Nursing, 302-6190 Agronomy Road, University of British Columbia, Vancouver BC, Canada V6T 1Z3, e-mail: rebecca.haines@nursing.ubc.ca

The professional claims and struggles involved in the design of non-traditional health care places are rarely problematized in applied health research, perhaps because they tend to fade away once the new design is implemented. This paper offers insights into such professional tensions and their impact on health care delivery by examining the design of two dialysis service delivery models in Quebec, Canada. The satellite units were hosted in two small hospitals and staffed by recently trained nurses. The mobile unit was a bus fitted to accommodate five dialysis stations. It was staffed by experienced nurses and travelled back and forth between a university teaching hospital and two sites. In both projects, nephrologists supervised from a distance via a videoconferencing system. In this paper, we draw mainly from interviews with managers (mostly nurses) and physicians (n = 18), and from on-site observations. Nephrologists, medical internists, and managers all supported the goal of providing 'closer-to-patient' services. However, they held varying opinions on how to best materialize this goal. By comparing two models involving different clinical and spatial logics, we underscore the ways in which the design of non-traditional health care places opens up space for the re-negotiation of clinical norms. Instead of relatively straightforward conflicts between professions, we observed subtle but inexorable tensions within and beyond professional groups, who sought to measure up to 'ideal standards' while acknowledging the contingencies of health care places. Keywords: Design; Professionalization; Place; Health technology; Dialysis; Closer-to-patient services; Normativity; Canada

A clear emphasis on the patient's view is discernible in the health services research literature of the past decades. Such a switch to patients' perspectives has been greatly facilitated by a wider acceptance and use of qualitative methods. In particular, focus groups are often used to uncover the range and depth of experiences of health services users and chronically ill individuals. Although this method contributes to a better understanding of patients' perspectives and practices, a number of analytical considerations have been overlooked. The aim of this paper is to consider how to conceptualise and analyse interactions in focus group research. We argue that focus groups are social spaces in which participants co-construct the 'patient's view' by sharing, contesting and acquiring knowledge. Focus groups conducted with home care patients in Quebec, Canada (on antibiotic intravenous therapy, parenteral nutrition, peritoneal dialysis and oxygen therapy) are used to illustrate three interactive processes at work in focus groups: (1) establishing oneself as experienced and knowledgeable; (2) establishing oneself as in search of information and advice; and (3) validating or challenging one another's knowledge claims. We develop an analytical template focused on the subtle dynamics underpinning the various and at times competing claims of patients. This template acknowledges the processes through which participants attribute authority to the claims of others, including the focus group moderator. We find that focus group research does not derive epistemological authority simply from the identity of its participants. Rather, an emerging consensus about what constitutes the patient's view is the result of context-dependent social interactions that need to be scrutinised. Keywords: Patient's perspectives; Focus group methodology; High-tech home care; Experiential knowledge; Canada

Social capital has been the focus of considerable academic and policy interest in recent years. Despite this interest, the concept remains undertheorized: there is an urgent need for a critical engagement with this literature that goes beyond summary. This paper lays a foundation for a critical dialogue between social capital and health promotion, by examining problematics in the conceptualization and practice of social capital building and linking these to models of community development, a cornerstone health promotion strategy. In so doing, the paper contributes to the existing literature by providing a theoretical exposition and critique of various threads in social capital discourse, and linking these threads explicitly to community development practice. Distinctions between communitarian, institutional and critical approaches to social capital are elaborated, and the relationships between these three approaches and three models of community development--social planning, locality development, and social action--are discussed. The existing social capital literature is then critically examined in relation to three key themes common to both literatures: community integration, public participation, and power relations. This examination suggests that social capital cannot be conceived in isolation from economic and political structures, since social connections are contingent on, and structured by, access to material resources. This runs counter to many current policy discourses, which focus on the importance of connection and cohesion without addressing fundamental inequities in access to resources. This paper posits that approaches to community development and social capital should emphasise the importance of a conscious concern with social justice. A construction of social capital which explicitly endorses the importance of transformative social engagement, while at the same time recognising the potential negative consequences of social capital development, could help community organizers build communities in ways that truly promote health. Keywords: Social capital; Health promotion; Community development

The rapid growth of the Internet is increasingly international with young people being the early adopters in most countries. However, the quality of Internet access looms as a major barrier hidden behind Internet use statistics. The goal of this study was to provide an in-depth evaluation of young people's perspectives on using the Internet to obtain health information and resources (e-health). Using an inductive qualitative research design, 27 focus groups were conducted in Ontario, Canada. The 210 young participants were selected to reflect diversity in age, sex, geographic location, cultural identity and risk. A major finding was how the quality of Internet access influenced young people's ability to obtain health information and resources. Quality of Internet access was affected by four key factors: 1. Privacy, 2. Gate-keeping, 3. Timeliness and 4. Functionality. Privacy was particularly relevant to these young people in getting access to sensitive health information (e.g. sexual activities). Variations in access quality also impacted participation in mutual support, fostering social networks and getting specific health questions answered. These results serve as a warning about using Internet penetration statistics alone as a measure of access. Concerted attention is needed on improving the quality of Internet access for achieving the potential of e-health. This is imperative for addressing the digital divide affecting populations both within countries and globally between countries. Keywords: Internet; Telemedicine; Health promotion; Young people; e-Health

In this commentary, we describe initial learnings from a community-based research project that explored how the relational space between residents and formal institutions in six marginalised communities in Toronto, Ontario, Canada impacted grassroots responses to the health and psycho-social stresses that were created and amplified by the coronavirus disease 2019 (COVID-19) pandemic. Our research found that grassroots community leaders stepped up to fill the gaps left by Toronto's formal public health and emergency management systems and were essential for mitigating the psycho-social and socioeconomic impacts of the pandemic that exacerbated pre-existing inequities and systemic failures. We suggest that building community resilience in marginalised communities in Toronto can embody health promotion in action where community members, organisational, institutional and government players create the social infrastructure necessary to build on local assets and work together to promote health by strengthening community action, advocating for healthy public policy and creating supportive environments. [ABSTRACT FROM AUTHOR]

Wellbeing in buildings is often approached by practitioners and researchers as the aggregate result of individual interactions between building occupants and building features. This sum-of-the-parts approach, however, ignores the ways in which broader social (i.e. sense of ownership and belonging) and symbolic (i.e. what it means to be 'well' in a specific culture at a particular place and time) components of wellbeing influence occupant experience of the built environment. A social practice perspective on wellbeing in buildings is proposed that accounts for these elements. Beginning with discussions of how wellbeing has been assessed and the foundations of social practice theory, it is suggested that occupant wellbeing is emergent not just from individual interactions with building features but also from broader social and symbolic elements. [ABSTRACT FROM AUTHOR]

Although speech is often the focus of qualitative research, what is not said may be as revealing as what is said, particularly since what is left out ordinarily far exceeds [...]