Arshi Shaikh

Food, health, and complexity: towards a conceptual understanding to guide collaborative public health action.

BackgroundWhat we eat simultaneously impacts our exposure to pathogens, allergens, and contaminants, our nutritional status and body composition, our risks for and the progression of chronic diseases, and other outcomes. Furthermore, what we eat is influenced by a complex web of drivers, including culture, politics, economics, and our built and natural environments. To date, public health initiatives aimed at improving food-related population health outcomes have primarily been developed within ‘practice silos’, and the potential for complex interactions among such initiatives is not well understood. Therefore, our objective was to develop a conceptual model depicting how infectious foodborne illness, food insecurity, dietary contaminants, obesity, and food allergy can be linked via shared drivers, to illustrate potential complex interactions and support future collaboration across public health practice silos.MethodsWe developed the conceptual model by first conducting a systematic literature search to identify review articles containing schematics that depicted relationships between drivers and the issues of interest. Next, we synthesized drivers into a common model using a modified thematic synthesis approach that combined an inductive thematic analysis and mapping to synthesize findings.ResultsThe literature search yielded 83 relevant references containing 101 schematics. The conceptual model contained 49 shared drivers and 227 interconnections. Each of the five issues was connected to all others. Obesity and food insecurity shared the most drivers (n = 28). Obesity shared several drivers with food allergy (n = 11), infectious foodborne illness (n = 7), and dietary contamination (n = 6). Food insecurity shared several drivers with infectious foodborne illness (n = 9) and dietary contamination (n = 9). Infectious foodborne illness shared drivers with dietary contamination (n = 8). Fewer drivers were shared between food allergy and: food insecurity (n = 4); infectious foodborne illness (n = 2); and dietary contamination (n = 1).ConclusionsOur model explicates potential interrelationships between five population health issues for which public health interventions have historically been siloed, suggesting that interventions targeted towards these issues have the potential to interact and produce unexpected consequences. Public health practitioners working in infectious foodborne illness, food insecurity, dietary contaminants, obesity, and food allergy should actively consider how their seemingly targeted public health actions may produce unintended positive or negative population health impacts.

Postpartum Depression: Deconstructing the Label Through a Social Constructionist Lens

There is an increasingly widespread utilization of the term postpartum depression (PPD) to describe the emotional and mental turbulence that occurs after childbirth in western society. This paper seeks to analyze the emergence of the label PPD through the application of a social constructionist perspective, to compare lay interpretations with professional explanations, and to situate varied interpretations within a broader social, political and economic context. In doing so, the paper seeks answers to the following questions: (i) how did the label PPD emerge? and (ii) how is it changing now? The processes involved in the social construction of PPD pertaining to the social discovery of PPD, diagnosis and experience of illness, and treatment and outcomes are described and analyzed. The findings reveal that the definitions, explanations and ever-changing constructions of PPD extend beyond biomedical criteria and involve historical, social, cultural and structural dimensions. The varied meanings and interpretations of PPD also reveal the embeddedness of race, class, ethnicity, and gender as they intersect with biomedical perspectives in the construction of PPD. PPD is an objective medical condition for some, while for others it is a social problem rooted in socioeconomic disadvantages, gender inequality and cultural ideals regarding motherhood. The label PPD precludes adherence to a particular intervention and requires social work practitioners to demonstrate flexibility and creativity in dealing with clients. Implications for social work practice, particularly a need to recognize how the disorder known as PPD is socially constructed in the western world, are provided to deal with the multiple realities embedded in the label PPD.

Interconnections among Homelessness, Family Separation, and Mental Health: Implications for Multi-Sectoral Social Services

Abstract This qualitative study explored the interconnections among the phenomena of homelessness, family separation, and mental health and substance abuse issues within the social services, geographic, and infrastructure context of northern Ontario. In-depth semi-structured interviews were conducted with thirteen participants. Findings revealed the effects of colonization in the form of poor and overcrowded housing conditions in the northern First Nations, difficulties in obtaining affordable and suitable housing in northern towns and cities, reliance on the scarce social services for survival, and valiant attempts to cope with the cold climate of northern Ontario. All participants reported multiple and intergenerational experiences of separation from family due to involvement of child welfare system, placement in residential schools, death of family member(s), flooding, and epidemics. Participants described their lifelong struggles with mental health and substance abuse issues. All three phenomena were tied together in various configurations of causes and consequences. The implications include the need for critical examination of the historical policies and practices, early intervention for mental health and substance abuse issues, greater support for youth transitioning out of care, creation of a continuum of housing options, collaboration across multiple social services sectors, and incorporation of Indigenous worldview and practices in the mainstream services.