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Jennifer Waite https://orcid.org/0000-0002-7335-2176

Michaela Sparringa https://orcid.org/0000-0002-1713-1862

Lenora Duhn https://orcid.org/0000-0002-0401-953X

Pilar Camargo-Plazas https://orcid.org/0000-0002-8349-7723

Abstract

Equitable access to health and social services is recognized as a fundamental right in Canada. Women living on a low income experience the harmful effects of structural inequalities when accessing health and social services. Some of those women belong to minority groups such as Indigenous, immigrants and refugees, LGTBQ2S, single mothers, older adults, and those living with chronic illnesses and disabilities. However, little we know about how gender and income as social determinants of health affect access to health and social services for women on a low income. Goals: Our purpose in this qualitative study was to explore how the SDH affect the experiences of Canadian women who live on a low income, with accessing health and social services. Methods: In keeping with a participatory research approach, we are partnering with a not-for-profit organization, and are using an art-based approach (photovoice), hermeneutic phenomenology, as well as one-to-one interviews to illuminate the experiences of women living on a low income. Results: Five women are participating. In our analysis to date we have found three themes:  1) I know what I'm feeling, I know what my body feels; 2) There’s a lack of empathy, lack of compassion; and 3) They didn't break me because I'm going to keep going. Conclusions: Although access to health and social services is considered a fundamental right for all Canadians; it is unfair and unjust how women in this study do not experience that right. This work aims to bring access issues to light and elevate the voices of women living on a low income to create sustainable solutions with them and other community members, including a more compassionate health system and inclusive society in Ontario, Canada.

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Section
Empirical Studies with Methodological Reflection

How to Cite

Jennifer Waite, Michaela Sparringa, Lenora Duhn, & Pilar Camargo-Plazas. (2022). They didn’t break me, because I’m going to keep going: A participatory study exploring access to health and social services for women living on a low income in Ontario, Canada. New Trends in Qualitative Research, 13, e674. https://doi.org/10.36367/ntqr.13.2022.e674
References

Anaut-Bravo, S., & Raya-Díez, E. (2020). The social reality of youth and social work: between visibility and invisibility. Social Work Education, 39(6), 737–749. https://doi.org/10.1080/02615479.2019.1682541

Benatar, S., Sullivan, T., & Brown, A. (2018). Why equity in health and in access to health care are elusive: Insights from Canada and South Africa. Global Public Health, 13(11), 1533–1557. https://doi.org/10.1080/17441692.2017.1407813

Camargo Plazas, M. d. P., Cameron, B. L., & Smith, D. G. (2012). Neoliberal-oriented health care system answer to global competition or a threat to health equality for people with chronic illness. Advances in Nursing Science, 35(2), 166-181. https://doi.org/10.1097/ANS.0b013e31825372a4

Camargo Plazas, P., Cameron, B. L., Milford, K., Hunt, L. R., Bourque-Bearskin, L., & Santos Salas, A. (2019). Engaging Indigenous youth through popular theatre: Knowledge mobilization of Indigenous peoples’ perspectives on access to healthcare services. Action Research, 17(4), 492-509. https://doi.org/10.1177/1476750318789468

Cameron, B.L., Camargo Plazas, M. del P., Salas, A. S., Bourque Bearskin, R. L., & Hungler, K. (2014). Understanding Inequalities in Access to Health Care Services for Aboriginal People: A Call for Nursing Action. Advances in Nursing Science, 37(3), E1–E16. https://doi.org/10.1097/ANS.0000000000000039

Canadian Women’s Foundation. (2022). The facts about women and poverty in Canada. Retrieved April 22, 2022 from https://canadianwomen.org/the-facts/womens-poverty/

Cohen, S. A., Kunicki, Z. J., Drohan, M. M., & Greaney, M. L. (2021). Exploring changes in caregiver burden and caregiving intensity due to COVID-19. Gerontology & Geriatric Medicine, 7, 2333721421999279. https://doi.org/10.1177/2333721421999279

Gilbert P. (2021). Creating a Compassionate World: Addressing the Conflicts Between Sharing and Caring Versus Controlling and Holding Evolved Strategies. Frontiers in psychology, 11, 582090. https://doi.org/10.3389/fpsyg.2020.582090

Kwan, C. & Walsh, C. A. (2017). Seniors’ disaster resilience: A scoping review of the literature. International Journal of Disaster Risk Reduction, 25, 259–273. https://doi.org/10.1016/j.ijdrr.2017.09.010

Krumer-Nevo, M. (2008). From noise to voice: How social work can benefit from the knowledge of people living in poverty. International Social Work, 51(4), 556–565. https://doi.org/10.1177/0020872808090248

Le, Mylopoulos, M., Bearss, E., Geist, R., & Maunder, R. (2022). Multiple symptoms and health anxiety in primary care: a qualitative study of tensions and collaboration between patients and family physicians. BMJ Open, 12(4), e050716–e050716. https://doi.org/10.1136/bmjopen-2021-050716

Lincoln, Y. S., & Guba, E. A. (1985). Naturalistic inquiry. Sage.

Loignon, C., Hudon, C., Goulet, É., Boyer, S., de Laat, M., Fournier, N., Grabovschi, C., & Bush, P.L. (2015). Perceived barriers to healthcare for persons living in poverty in Quebec, Canada: the EQUIhealThY project. International Journal for Equity in Health, 14.

Lombardo, A. P., Angus, J. E., Lowndes, R., Cechetto, N., Khattak, S., Ahmad, F., & Bierman, A. S. (2014). Women's strategies to achieve access to healthcare in Ontario, Canada: A meta-synthesis. Health & Social Care in the Community, 22(6), 575-587. https://doi.org/10.1111/hsc.12093

Loppie-Reading, C., & Wien, F. (2013). Health inequalities and social determinants of Aboriginal people’s health. National Collaborating Centre for Aboriginal Health (NCCAH). Retrieved February 4, 2022 from https://www.nccih.ca/docs/determinants/RPT-HealthInequalities-Reading-Wien-EN.pdf

Lune, H., & Berg, B.L. (2017). A dramaturgical look at interviewing. In Qualitative Research Methods for the Social Sciences (9th ed.), (pp 55-71). United States, Pearson.

Lund-Nielsen, B., Midtgaard, J., Rørth, M., Gottrup, F., & Adamsen, L. (2011). An avalanche of ignoring-A qualitative study of health care avoidance in women with malignant breast cancer wounds. Cancer Nursing, 34(4), 277–285. https://doi.org/10.1097/NCC.0b013e3182025020

Moudatsou, M., Stavropoulou, A., Philalithis, A., & Koukouli, S. (2020). The Role of Empathy in Health and Social Care Professionals. Healthcare, 8(1), 26. https://doi.org/10.3390/healthcare8010026

Mumtaz, Z., Salway, S., Bhatti, A., & McIntyre, L. (2014). Addressing invisibility, inferiority, and powerlessness to achieve gains in maternal health for ultra-poor women. The Lancet (British Edition), 383(9922), 1095–1097. https://doi.org/10.1016/S0140-6736(13)61646-3

OECD. (2020). How’s life? 2020: Measuring well-being. Retrieved from https://www.oecd-ilibrary.org/sites/aa60ebdc-en/index.html?itemId=/content/component/aa60ebdc-en

Oetzel, J. G., Wallerstein, N., Duran, B., Sanchez-Youngman, S., Nguyen, T., Woo, K., Wang, J., Schulz, A., Keawe'aimoku Kaholokula, J., Israel, B., & Alegria, M. (2018). Impact of Participatory Health Research: A Test of the Community-Based Participatory Research Conceptual Model. BioMed research international, 7281405. https://doi.org/10.1155/2018/7281405

Ottewell-Watson, S. (2014). De-mythicizing art-based research: An art therapy student’s dance with a creative methodology (Démystifier la recherche par l’art?: Une étudiante en art thérapie utilise une méthodologie créative par la danse). Canadian Art Therapy Association Journal, 27(2), 9-12. https://doi.org/https://doi.org/10.1080/08322473.2014.11415595

Sarlo, C. A. (2019). The Causes of poverty. Fraser Institute. http://www.fraserinstitute.org

Schwei, R. J., Johnson, T. T., Matthews, A. K., & Jacobs, E. A. (2017). Perceptions of negative health care experiences and self-reported health behavior change in 3 racial and ethnic groups. Ethnicity & Health, 22(2), 156–168. https://doi.org/10.1080/13557858.2016.1244621

Sinclair, S., Russell, L. B., Hack, T. F., Kondejewski, J., & Sawatzky, R. (2017). Measuring Compassion in Healthcare: A Comprehensive and Critical Review. The patient, 10(4), 389–405. https://doi.org/10.1007/s40271-016-0209-5

Statistics Canada. (2016). Health at a glance: Difficulty accessing health care services in Canada. Retrieved April 22 2022 from https://www150.statcan.gc.ca/n1/pub/82-624-x/2016001/article/14683-eng.htm

Statistics Canada. (2017a). Focus on Geography Series, 2016 Census. Statistics Canada Catalogue no. 98-404-X2016001. Data products, 2016 Census. Retrieved February 18, 2021, from https://www12.statcan.gc.ca/census-recensement/2016/as-sa/fogs-spg/Facts-cma-eng.cfm?LANG=Eng&GK=CMA&GC=521&TOPIC=1

Statistics Canada. (2017b). Kingston, CY [Census subdivision], Ontario and Canada [Country] (table). Census Profile. 2016 Census. Statistics Canada Catalogue no. 98-316-X2016001. Released November 29, 2017. Retrieved February 17, 2021, from https://www12.statcan.gc.ca/census-recensement/2016/dp-pd/prof/index.cfm?Lang=E

Statistics Canada (2019). Low income statistics by age, sex and economic family type [Internet]. Ottawa (ON): Statistics Canada; 2021. Table 11-10-0135-01. https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1110013501

Statistics Canada. (2022). Percentage of persons in low income by sex. Retrieved April 22, 2022 from https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1110013502

St. Vincent de Paul Society of Kingston (SVDP). (2020). Annual report 2019. Retrieved February 4, 2022 from http://www.svdpkingston.com/wp-content/uploads/2020/08/SVDP-annual-report-for-2019.pdf

Subramaniam, S., Camacho, L. M., Carolan, M. T., & López-Zerón, G. (2017). Resilience in low-income African American women living and aging with HIV. Journal of Women & Aging, 29(6), 543–550. https://doi.org/10.1080/08952841.2016.1256735

Taber, J.M., Leyva, B., & Persoskie, A. (2014). Why do People Avoid Medical Care? A Qualitative Study Using National Data. Journal of General Internal Medicine, 30(3), 290–297. https://doi.org/10.1007/s11606-014-3089-1

Tait, C.L. (2013). Resituating the ethical gaze: Government morality and the local worlds of impoverished Indigenous women. International Journal of Circumpolar Health, 72(1), 1-7. DOI: 10.3402/ijch.v72i0.21207

van Manen, M. (2016). Researching lived experience: Human science for an action sensitive pedagogy (2nd ed.). Routledge.

Villegas, P., & Blower, J. (2019). “Part of being Canadian is having access to healthcare”: Framing the boundaries of healthcare deservingness for non-citizens through the Interim Federal Health Benefits Program. Canadian Journal of Communication, 44(1), 69–88. https://doi.org/10.22230/cjc.2019V44n1a3280

Williamson, D. L., Stewart, M. J., Hayward, K., Letourneau, N., Makwarimba, E., Masuda, J., Raine, K., Reutter, L., Rootman, I., & Wilson, D. (2006). Low-income Canadians' experiences with health-related services: implications for health care reform. Health policy, 76(1), 106–121. https://doi.org/10.1016/j.healthpol.2005.05.005

WHO & The World Bank. (2021). Retrieved April 22, 2022 from: https://cdn.who.int/media/docs/default-source/world-health-data-platform/events/tracking-universal-health-coverage-2021-global-monitoring-report_uhc-day.pdf?sfvrsn=fd5c65c6_5&download=true