Tom, Allison

In this dissertation I critique the notion that health is affected by poverty through primarily material factors. In fact, poor women are systematically excluded from resources and opportunities to pursue their health. This feminist action research project addressed how poverty and exclusion influenced poor women's health, examined how a group of women negotiated their experiences of poverty and health, and developed action strategies to address their shared concerns ... The women lived in material deprivation and could not afford the most basic living necessities. They felt stereotyped, excluded, and invisible in their every day lives ... The women had limited access to health-promoting resources, and their interactions with authorities were shaming which negatively influenced their psycho-social health through stress, depression, low self-esteem, and anger ... The women's shame, material scarcity, and limited access to resources engendered feelings of lack of control and hopelessness and influenced their health. The women's varied discourses of poverty and health reflected attempts at finding legitimacy in a society that systematically excluded and de-legitimized them. Through their conversations and our feminist action research work together, they uncovered legitimate identities within experiences of poverty and ill-health and advocated action and social change. They cited a 'livable' income, accessible health-promoting resources, and redressing stigmatizing practices and policies as changes required to improve their health. These findings confirmed that the social determinants of health must be re-framed to better understand the effects of exclusion on poor women's health and that inclusion, respect, and dignity are fundamental conditions for promoting health.

Although feminist researchers have increasingly called for participatory and action-oriented research, there have been few analyses of the diverse actions that can occur. We theorized the actions considered and implemented in a feminist participatory action research project (FPAR). For three years we collaborated intensively with a group of diverse women on low income who were involved in a FPAR project designed to reduce social isolation and other self-identified health problems. Our data set included tape recordings of 32 one-on-one interviews, 15 research meetings, and extensive fieldnotes. Our findings indicated that actions occurred on both individual and collective levels; some had been enacted prior to the project and were shared to promote ongoing or new actions, while others arose as a consequence of the women's involvement in the project. Additionally, some actions were implemented and actualized while others, though discussed at length, remained hopes for the future. While the research participants reported the benefits of being involved in such projects, they also spoke of the potential risks. Our findings revealed the complexities of taking action in FPAR and highlight important considerations for others wishing to engage in this type of research. [ABSTRACT FROM AUTHOR]

In this study, we sought a better understanding of how poor women made meaning of their poverty and health. Twenty research participants used varied, multiple, and at times contradictory discourses that shaped their identities as both legitimate and powerful and illegitimate and powerless. We identified four discourses in the women's talk - illegitimate dependencies, legitimate dependencies, overwhelming odds, and critique and collectivism. These four discourses revealed complexes of meanings and networks of interpretation that subverted, accommodated, and reinterpreted dominant discourses of poverty and health. This examination is relevant for feminist researchers attempting to understand the impact of dominant discourses in the lives of socially marginalized women who continually struggle to establish and strengthen claims to legitimacy and moral worth. -- From publisher description.