Email this article Considering culture and context when supporting the development of communities
Abstract
In order to improve population health, public health authorities in the province of Quebec (Canada) have integrated in 2003 a crosscutting health promotion strategy in their public health plans: "Support for the development of communities". Although it has been in the plans for several years, its implementation had not yet been documented. Using an ethnographic case study, the project aimed at answering the following question: How does the implementation of a community development initiative, as defined in the official documents of public health authorities in Quebec, actually occurs? After 32 months of participant observation and 14 semi-structured interviews with key informants, it was possible to describe how it happened in an inner-city neighborhood of Quebec City, chosen as an exemplary case to study. The results revealed that such an initiative is significantly conditioned by a neighborhood's culture and that the context in which the process occurs needs to be centrally taken into account. Authors advocate for a culturally sensitive strategy that focuses on the contexts where the action take place and considers the culture of place as a central element when wanting to improve population health and health equity.
References
Atkinson, P., Coffey, A., Delamont, S., Lofland, J., & Lofland, L. (2007). Editorial introduction, In P. Atkinson, A. Coffey, S. Delamont, J. Lofland, & L. Lofland (Eds.), Handbook of ethnography (pp. 1-8). London, England: Sage.
Aubry, F., & Potvin, L. (2012). Construire l'espace sociosanitaire: Expériences et pratiques de recherche dans la production locale de la santé. Montréal, Canada: Presses de l’Université de Montréal.
Baribeau, C. (2005). Le journal de bord du chercheur. Actes du colloque L'instrumentation dans la collecte des données de l’Association pour la recherche qualitative, Hors-Série, 2, 98-114.
Beck, U., & Beck-Gernsheim, E. (2002). Individualization: Institutionalized individualism and its social and political consequences. Los Angeles, CA: Sage.
Bernard, P., Charafeddine, R., Frohlich, K. L., Daniel, M., Kestens, Y., & Potvin, L. (2007). Health inequalities and place: A theoretical conception of neighbourhood. Social Science & Medicine, 65(9), 1839-1852.
Bilger, M., & Carrieri, V. (2013). Health in the cities: When the neighborhood matters more than income. Journal of Health Economics, 32(1), 1-11.
Blais, M., & Martineau, S. (2006). L'analyse inductive générale: Description d’une démarche visant à donner un sens à des données brutes. Recherches Qualitatives, 26(2), 1-18.
Burawoy, M., Blum, J. A., George, S., Gille, Z., Gowan, T., Haney, L.,… Thayer, M. (2000). Global ethnography: Forces, connections, and imaginations in a postmodern world. Los Angeles, CA: University of California Press.
Coffey, A. (2002). Ethnography and self: reflections and representations. In T. May (Ed.), Qualitative research in action (pp. 31-331). London, England: Sage.
Cohen, A. K., & Schuchter, J. W. (2012). Revitalizing communities together. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 90(2), 187-196.
Collins, P. A., Hayes, M. V., & Oliver, L. N. (2009). Neighborhood quality and self-rated health: A survey of eight suburban neighborhoods in the Vancouver Census Metropolitan Area. Health & Place, 15(1), 156-164.
De Leeuw, E., Duhl, L., & O’Neill, M. (2010). Healthy cities. In R. Hutchison (Ed.), Encyclopedia of urban studies (pp. 348-351). Thousand Oaks, CA: Sage.
Delisle, N. (2012). Définition des concepts et des principes d'intervention en développement des communautés. Longueuil, Direction de santé publique de la Montérégie, Agence de la santé et des services sociaux de la Montérégie.
Gore, D., & Kothari, A. (2012). Social determinants of health in Canada: Are healthy living initiatives there yet? A policy analysis. International Journal for Equity in Health, 11, 41. doi:10.1186/1475-9276-11-41
Kickbush, I. (2007). Health governance: The health society. In D. McQueen & I. Kickbush (Eds.), Health and modernity: The role of theory in health promotion (pp. 144-161). New York, NY: Springer.
Leroux, R., & Ninacs, W. A. (2002). La santé des communautés: Perspectives pour la contribution de la santé publique au développement social et au développement des communautés. Montréal, Canada: Institut national de santé publique.
Mannarini, T., Rochira, A., & Talò, C. (2014). Negative psychological sense of community: development of a measure and theoretical implications. Journal of Community Psychology, 42(6), 673-688.
Marmot, M. (2009). Closing the health gap in a generation: The work of the Commission on social determinants of health and its recommendations. Global Health Promotion, 1, 23-27. doi: 10.1177/1757975909103742.
Massé, R. (1995). Culture et santé publique: Les contributions de l'anthropologie à la prévention et à la promotion de la santé. Montréal, Canada: Gaëtan Morin Éditeur.
McQueen, D. (2007). Critical issues in theory for health promotion. In D. McQueen & I. Kickbush (Eds.), Health and modernity: The role of theory in health promotion (pp. 21-42). New York, NY: Springer.
MSSS (2008). Programme national de santé publique 2003-2012. Ministère de la Santé et des Services Sociaux, Direction Générale de la Santé Publique, Gouvernement du Québec.
Navarro, V. (2009). What we mean by social determinants of health. International Journal of Health Services, 39(3), 423-441.
O’Connor, B. (2013). From isolation to community: Exploratory study of a sense-of-community intervention. Journal of Community Psychology, 41(8), 973-991.
O’Campo, P. (2012). Are we producing the right kind of actionable evidence for the social determinants of health? Journal of Urban Health: Bulletin of the New York Academy of Medicine, 89(6), 881-893.
O’Neill, M., Rootman, I., Dupéré, S., & Pederson, A. (2012). The evolution of health promotion in Canada. In I. Rootman, S. Dupéré, M. O’Neill, & A. Pederson (Eds.), Health promotion in Canada: Critical perspectives on practice (pp. 3-17). Toronto, Canada: Canadian Scholars' Press.
Parent, A.-A. (2014). New public health actors in Quebec, Canada. Perspectives in Public Health, 134(5), 249-250.
Parent, A.-A., O’Neill, M., Roy, B., & Simard, P. (2012). Entre santé publique et organisation communautaire: Points de convergence et de divergence autour du développement des communautés au Québec. Revue de l'Université de Moncton, 43(1-2), 67-90.
Poland, B., Frohlich, K., & Cargo, M. (2008). Context as a fundamental dimension of health promotion program evaluation. In L. Potvin & D. McQueen (Eds.), Health promotion Evaluation Practice in the Americas: Values and Research (pp. 299-318). New York, NY: Springer.
Poland, B., Lehoux, P., Holmes, D., & Andrews, G. (2005). How place matters: Unpacking technology and power in health and social care. Health and Social Care in the Community, 13(2), 170-180.
Potvin, L., Ginot, L., & Moquet, M.-J. (2010). La réduction des inégalités: Un objectif prioritaire des systèmes de santé. In L. Potvin, M.-J. Moquet & C. Jones (Eds.), Réduire les inégalités sociales en santé (pp. 52-61). Saint-Denis, France: INPES.
Ridde, V., Guichard, A., & Houeto, D. (2007). Social inequalities in health from Ottawa to Vancouver: Action for fair equality of opportunity. Promotion & Education, 14, 12-16. doi: 10.1177/10253823070140020601x
Robinson, Jr., J.W., & Green, G.P. (2011). Developing communities. In J.W. Robinson, Jr. and G.P. Green (Eds.), Introduction to Community Development (pp. 1-10). Thousand Oaks, CA: Sage.
Robinson, R. G. (2005). Community development model for public health applications: overview of a model to eliminate population disparities. Health Promotion Practice, 6(3), 338-346.
Roth, W. M. (2005). Doing qualitative research: Praxis of method. Rotterdam. The Netherlands: Sense Publishers.
Rothman, J., Erlich, J. L., & Tropman, J. E. (2001). Strategies of community intervention, 6th Ed. Itasca, IL: F. E. Peacock Publishers.
Sacker, A., Wiggins, R. D., & Bartley, M. (2006). Time and place: Putting individual health into context. A multilevel analysis of the British household panel survey, 1991-2001. Health & Place, 12(3), 279-290.
Saldana, J. (2011). Fundamentals of qualitative research. New York, NY: Oxford University Press.
Thomas, D. R. (2006). A general inductive approach for analyzing qualitative evaluation data. American Journal of Evaluation, 27(2), 237-246.
Walter Rasugu Omariba, D. (2010). Neighbourhood characteristics, individual attributes and self-rated health among older Canadians. Health & Place, 16(5), 986-995.
Welzer-Lang, D., & Filiod, J. P. (1993). Les hommes à la conquête de l’espace domestique: Du propre et du rangé. Montréal, Canada: VLB.
WHO (1986). Ottawa Charter for Health Promotion. Retrieved from http://www.phac-aspc.gc.ca/ph-sp/docs/charter-chartre/pdf/charter.pdf.
Wilson, K., Eyles, J., Elliott, S., & Keller-Olaman, S. (2009). Health in Hamilton neighbourhoods: Exploring the determinants of health at the local level. Health & Place, 15(1), 374-382.
Full Text: PDF
Refbacks
- There are currently no refbacks.
