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Managing challenging contexts : understanding children’s health Irwin, Lori Gayle

Abstract

We know that the social conditions in which children live exert a strong influence on their health; yet we do not know how children's experience of these conditions of daily life shape their health. This research examined how contexts of daily life influence children's perspectives of health. The children involved in this study all lived in a neighbourhood characterized as having a complex of mid to high range of neighbourhood factors associated with vulnerability. Factors that impede or enhance children's sense of agency in relation to their health were examined, as was the role that parents play in children's perspectives of health. Ethnographic methods were employed which involved the systematic exploration of the social or cultural setting. Fourteen first grade children (6-7 years old) and their parents participated in this study. The health ideas, beliefs, knowledge, and practices of these young children were examined through in-depth interviews, observations of the children in their after-school care programs, parent questionnaires, and informal conversations with the children, parents, and key informants. The findings demonstrate that the children were able to articulate the health requirements of physical activity, healthy eating, an awareness of social standards, and the scholastic competencies that support their health. There was a disparity between the children's health knowledge, their perceptions, and their contextual realities in relation to health. Children spoke of concerns for their physical safety within their schools and neighbourhoods; their lack of free range of play, and that they had few opportunities to play with or get to know neighbourhood friends. Most children spoke of a lack of familiarity with neighbours, while parents spoke of not belonging and echoed the children's concerns regarding safety and lack of neighbourhood cohesion. The children used a variety of resources to support their health and to compensate for their neighbourhood challenges. The findings of this research have implications for including children in our future research; the findings also support the need for ensuring quality after-school programming, and providing simple solutions for creating safer communities for children. Nurses and other health professionals in contact with children and families who live in challenging social conditions need to be aware of how these contexts shape children's understanding of their own health potential.

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