Ponic, Pamela

Summary: "Unequal access to health care is a problem in Canada much studied by journalists, academics, and policy makers. There is a growing recognition that existing theories on, and approaches to, health inequities are limited in their ability to capture how these inequities are produced through changing, co-constituted, and intersecting effects of multiple forms of oppression. Intersectionality offers itself as a research paradigm capturing the complexities of illness and care, and this volume brings together Canadian activists, community-based researchers, and scholars from a range of disciplines to apply interpretations of intersectionality to cases in Indigenous health, mental health, migration health, community health, and organizational governance. By addressing specific health issues including cardiovascular disease, dementia, post-traumatic stress disorder, diabetes, and violence, this book advances methodological applications of intersectionality in health research, policy, and practice. The authors ultimately reveal how multiple variables are influencing health and healing in Canada -- not simply race, class, and gender but also age, religion, geography and place, and the state of the economy. Most importantly, it demonstrates that health inequities cannot be understood or addressed without the interrogation of power and diverse social locations and structures that shape lives and experiences of health."--Provided by publisher.

The social, psychological, and physical health benefits of participation in physical activity and other forms of recreation are well documented (Frankish, Milligan and Reid; Sallis and Owen; Reid and Dyck), and evidence suggests that low-income women view access to community recreation as an important dimension of their health and their communities (Weber; Frisby and Hoeber). Although many community recreation departments in Canada have a social mandate of providing services to all citizens to promote health and well being, consistent barriers to regular involvement persist for those who live on the margins and are unable to conform to dominant expectations inherent in modern forms of public recreation (Frisby, Crawford and Dorer; Lyons and Langille;Harvey). With its individualist ideology, classist notions of self-responsibility, and fees for service, we argue that community recreation has become a two-tiered system where only those with sufficient social, cultural, and financial resources can participate (Kidd). Consequently, insufficient subsidies, policies requiring "proof of poverty," and discrimina- tory practices exclude poor women from being actively involved in health-promoting forms of community recreation. The purposes of this paper are: i) to examine how low-income women see involvement in community recreation contributing to their health, and ii) to examine low-income women's experiences with exclusionary community recreation policies and practices. Hearing the voices of those who are marginalized from the knowledge production and policy development process is important when considering how public sector programs, policies, and practices can become more inclusive (Lord and Hutchison; Frisby and Hoeber). Through fostering inclusion rather than classist forms of service delivery, the community development and social justice mandates of many community recreation departments is advanced thus providing health-promoting resources for those living on the margins.

The chapter, "Living an ethical agreement: negotiating confidentiality and harm in feminist participatory action research" was written by the listed authors including Colleen Reid (Douglas College Faculty). Feminist community research is a collaborative, policy-oriented methodology that holds the promise of empowering the disadvantaged and building a more just society. But in the absence of critical analysis and the responsible use of power, this approach can lead to naive or even harmful practices. Grounded as they are in fieldwork, the interdisciplinary case studies in this volume acknowledge the real methodological and ethical issues that researchers can encounter as they negotiate contested research relationships. The authors discuss the strategies — successful and unsuccessful — that they have employed to overcome these challenges. The authors’ collective experiences working with diverse groups, from immigrant and Aboriginal women in Vancouver to poverty-reduction practitioners in Vietnam, reveal that truly equitable research projects require that we question core concepts and address crucial issues such as the promises and limits of reflexivity; the politics of place, time, and resources; ethical dilemmas and emotional responses; and the way issues of social justice, policy, and social change are embedded in research. ­-- From publisher description.

Feminist participatory action research integrates feminist theories and participatory action research methods, often with the explicit intention of building community-academic partnerships to create new forms of knowledge to inform women's health. Despite the current pro-partnership agenda in health research and policy settings, a lack of attention has been paid to how to cultivate effective partnerships given limited resources, competing agendas, and inherent power differences. Based on our 10+ years individually and collectively conducting women's health and feminist participatory action research, we suggest that it is imperative to intentionally develop power-with strategies in order to avoid replicating the power imbalances that such projects seek to redress. By drawing on examples from three of our recent feminist participatory action projects we reflect on some of the tensions and complexities of attempting to cultivate power-with research partnerships. We then offer skills and resources needed by academic researchers to effectively harness the collective resources, agendas, and knowledge that each partner brings to the table. We suggest that investing in the process of cultivating power-with research partnerships ultimately improves our collective ability to understand and address women's health issues.