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Research in the area of collaboration between complementary and alternative medicine (CAM) and biomedical practitioners often describes their relationships as fraught with power struggles. This paper explores communication among the various stakeholders at an integrative health clinic for artists located in a university hospital. Qualitative research methods were used, in-depth interviews and semi-structured focus groups, to facilitate the gathering of information about patterns of communication among stakeholders involved at the clinic. The findings describe the challenges to communication and integration at the clinic. The lack of communication is described as a scheduling issue, or lack of consistent presence of CAM practitioners, and a lack of formal methods of communication (patient charting). The consequences of these gaps were felt mostly by the CAM practitioners, as their scope of practice was not well understood by other practitioners. CAM practitioners stated that this had a direct effect on their confidence levels. CAM practitioners were relegated to the periphery of the hospital in their role as part-time, contract employees. Their lack of consistent presence at the clinic lead to a lack of understanding of their scope of practice, hence, a lack of referrals from other health-care practitioners, particularly those who were biomedically-oriented. [ABSTRACT FROM AUTHOR]

This article compares experiences of social isolation and perceptions of belonging between lower-income and higher-income people. We conducted individual interviews with 60 higher-income and 59 lower-income study participants and six group interviews with 34 low-income participants from two Canadian cities. Subsequently, a representative sample of 1,671 lower- and higher-income participants was surveyed by telephone. Income was a consistent predictor of measures of isolation and sense of belonging to the community: lower-income people experienced greater isolation and a lower sense of belonging than did higher-income people. Poverty shaped low-income people's perceptions and experiences of stigmatization and isolation. [ABSTRACT FROM AUTHOR]

In this article, we report on qualitative findings pertaining to low-income people's perceptions of and responses to "poverty stigma," a key component of social exclusion with important implications for health and well-being. Our findings are drawn from a multimethod study designed to investigate experiences of social exclusion and social isolation among people living on low incomes. We conducted semistructured individual interviews (n = 59) and group interviews (total n = 34) with low-income residents of two large Canadian cities. Data were analyzed using thematic content analysis techniques. Participants overwhelmingly thought that other members of society tend to view them as a burden to society-as lazy, disregarding of opportunities, irresponsible, and opting for an easy life. Low-income people responded to perceived stigma with a variety of cognitive and behavioral strategies that reflected their efforts to reconcile their perceived "social" and "personal" identities. These strategies included confronting discrimination directly, disregarding responses from others, helping other low-income people, withdrawing and isolating themselves from others, engaging in processes of cognitive distancing, and concealing their financial situation. [ABSTRACT FROM AUTHOR]

The goal of this paper is to explore the experiences of exclusion and inclusion of both low and higher-income people within a 'social determinants of health framework'. In the first phase of this research, individual interviews with 60 high-income and 59 low-income participants, and group interviews with 34 low-income participants were conducted. During the second phase, 1671 higher and low-income participants were surveyed by telephone. The findings revealed that inadequate financial resources, ill-health, and unwelcoming behaviours inhibited participation in community activities among low-income respondents. Higher-income earners were more likely to engage in social and group civic activities. Participants in the low-income category were less able to participate in desired activities due to user fees and poor health. Data revealed significant relationships between self-rated health and measures of exclusion and inclusion. Based on the responses of participants, the paper concludes that structural rather than interpersonal change contributes significantly to increased levels of social inclusion, and ultimately, improvements in health outcomes. [ABSTRACT FROM AUTHOR]

This paper describes public attributions for poverty using data from telephone interviews conducted in 2002 with a random sample of adults from eight neighbourhoods in Toronto and Edmonton, supplemented with interview data. Multivariate logistic regression was used to predict support for structural, individualistic, intergenerational and fatalistic attributions for poverty by demographic and exposure-to-poverty variables. Participants were most likely to attribute poverty to structural causes and least likely to favour individualistic attributions. Income was negatively associated with individualistic, fatalistic and one of the structural attributions, and positively related to the intergenerational attribution. [ABSTRACT FROM AUTHOR]

Although there is a large body of research dedicated to exploring public attributions for poverty, considerably less attention has been directed to public understandings about the effects of poverty. In this paper, we describe lay understandings of the effects of poverty and the factors that potentially influence these perceptions, using data from a telephone survey conducted in 2002 on a random sample ( n = 1671) of adults from eight neighbourhoods in two large Canadian cities (Edmonton and Toronto). These data were supplemented with interview data obtained from 153 people living in these same neighbourhoods. Multivariate linear and logistic regressions were used to determine the effects of basic demographic variables, exposure to poverty and attribution for poverty on three dependent variables relating to the effects of poverty: participation in community life, the relationship between poverty and health and challenges facing low-income people. Ninety-one per cent of survey respondents agreed that poverty is linked to health, while 68% agreed that low-income people are less likely to participate in community life. Affordable housing was deemed especially difficult to obtain by 96%, but other resources (obtaining healthy food, giving children a good start in life, and engaging in healthy behaviours) were also viewed as challenging by at least 70% of respondents. The regression models revealed that when controlling for demographics, exposure to poverty explained some of the variance in recognising the effects of poverty. Media exposure positively influenced recognition of the poverty–health link, and attending formal talks was strongly related to understanding challenges of poverty. Attributions for poverty accounted for slightly more of the variance in the dependent variables. Specifically, structural and sociocultural attributions predicted greater recognition of the effects of poverty, in particular the challenges of poverty, while individualistic attributions predicted less recognition. Older and female respondents were more likely to acknowledge the effects of poverty. Income was positively associated with recognition of the poverty–health link, negatively associated with understanding the challenges of low-income people, and unrelated to perceptions of the negative effect of poverty on participation in community life. [ABSTRACT FROM AUTHOR]

An internationally influential model of population health was developed in Canada in the 1990s, shifting the research agenda beyond health care to the social and economic determinants of health. While agreeing that health has important social determinants, the authors believe that this model has serious shortcomings; they critique the model by focusing on its hidden assumptions. Assumptions about how knowledge is produced and an implicit interest group perspective exclude the sociopolitical and class contexts that shape interest group power and citizen health. Overly rationalist assumptions about change understate the role of agency. The authors review the policy and practice implications of the Canadian population health model and point to alternative ways of viewing the determinants of health. (Am J Public Health. 2003;93:392-396) [ABSTRACT FROM AUTHOR]

We examine children's perceptions of the strategies they would use to resolve community health problems. Qualitative analysis using a grounded theory approach showed that 9- and 10-year-old children could conceptualize a range of solutions to hypothetical community health problems. Children's responses reflected an egocentric perspective, one that was centered on self and peers acting on short-term solutions to the immediate problem. Less frequently, children conceptualized broader structural interventions aimed at removing the problem altogether. Children could name resource persons including their friends, family, school personnel and other people in the community. However, outside of their family and peers, their knowledge was non-specific, i.e. it is doubtful that they would actually be able to access the resources, In light of our findings we discuss several important implications for future research. We note that children are interested in changing community conditions that affect their health. However, their recognition of their marginalized position in adult society and their perception that adults do not take them seriously may be significant barriers to their participation. We suggest that society must rethink the position and roles that are assigned to children so that their valuable potential is not lost. [ABSTRACT FROM AUTHOR]