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"We don’t count, we’re just not there" : using feminist action research to explore the relationship between exclusion, poverty and women’s health Reid, Colleen

Abstract

One of the greatest social injustices is that people who are marginalized experience more illnesses, disability, and shorter lives than those who are more affluent (Benzeval, Judge, and Whitehead, 1995). 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. For 1 V2 years I worked with a group of 30 poor women and gathered qualitative data from 15 meetings, 32 interviews, and 30 sets of fieldnotes. 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 stereotype of the "welfare recipient" fueled institutional stigmatization and surveillance. Welfare, health care, and community recreation workers were threatening, withheld important information, and limited the women's access to services through chscriminatory practices and policies. The women had limited access to health-promoting resources, and their interactions with authorities were shaming which negatively influenced their psychosocial health through stress, depression, low self-esteem, and anger. Services that were meant to help them labelled them as poor and hurniliated them. 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 reframed to better understand the effects of exclusion on poor women's health and that inclusion, respect, and dignity are fundamental conditions for promoting health.

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