Edward Makwarimba

“Who Do They Think We Are, Anyway?”: Perceptions of and Responses to Poverty Stigma

In this article, we report on qualitative findings pertaining to low-income peoples 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.

Poverty, Sense of Belonging and Experiences of Social Isolation

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 peoples perceptions and experiences of stigmatization and isolation.

A Support Intervention to Promote Health and Coping Among Homeless Youths

Homeless youths are often vulnerable to limited support resources and loneliness. Peers are a potent source of social support. A support intervention for homeless youths was designed to optimize peer influence and was pilot tested. The intervention was based on an initial assessment of support needs and intervention preferences from the perspective of 36 homeless youths and 27 service providers. Based on the results, a 20-week pilot intervention program was designed, consisting of 4 support groups, optional one-on-one support, group recreational activities, and meals. Support was provided by professional and peer mentors, including formerly homeless youths. A total of 56 homeless youths aged 16 to 24 took part. Participants completed pre-, mid-, and post-test quantitative measures and qualitative interviews. In spite of challenges due primarily to attrition, the youths reported enhanced health behaviours, improved mental well-being, decreased loneliness, expanded social network, increased coping skills, enhanced self-efficacy, and diminished use of drugs and alcohol. Further research could focus on replication at other sites with a larger sample.

Challenges and barriers to services for immigrant seniors in Canada: "you are among others but you feel alone"

Purpose – This paper seeks to explore varied interrelated challenges and barriers experienced by immigrant seniors.Design/methodology/approach – Senior immigrants representing diverse ethnicities (Chinese, Afro Caribbean, Former Yugoslavian, Spanish) described their challenges, support needs, and barriers to service access. Service providers and policy makers from organizations serving immigrant seniors were interviewed to elicit their views on barriers to access and appropriateness of services for immigrant seniors. Qualitative methods were employed to enhance understanding of meanings, perceptions, beliefs, values, and behaviors of immigrant seniors, and investigate sensitive issues experienced by vulnerable groups. The qualitative data were subjected to thematic content analysis.Findings – Seniors reported financial and language difficulties, health problems, discrimination, family conflicts, and social isolation. Although most immigrant seniors appreciated the standard of living in Canada and the serv...

Left Out: Perspectives on Social Exclusion and Inclusion across Income Groups

Abstract 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.

Supporting Homeless Youth: Perspectives and Preferences

Homelessness among adolescents and young adults is a growing concern in Canada and other countries, yet little is known about their support needs and support intervention preferences from the perspectives of homeless youth or youth at risk of homelessness. The authors assessed these needs and preferences through individual and group interviews with homeless adolescents and young adults (n = 35) and their service providers (n = 27). The unique perspectives of service providers and homeless youth converged on some issues. Key challenges faced by these youth included social isolation, alienation, low self-worth, lack of resources, and substance abuse. Although some services were available, they did not fully meet existing needs. Participants indicated that interventions should focus on emotional and affirmational support. They recommended face-to-face support that was accessible, flexible, participatory, long-term, and offered choice.

Narratives of "dissonance" and "repositioning" through the lens of critical humanism: exploring the influences on immigrants' and refugees' health and well-being.

The focus of this article is on narratives of “starting over,” and the embedded processes, conceptualized as “dissonance”—between what people had expected to find in Canada and their actual experiences, and “repositioning”—how they subsequently restructured their lives and redefined their identities. This narrative analysis is one way of illuminating the complex ways in which social support networks influence dissonance and repositioning, and subsequently influence health and well-being.

Impacts of a social support intervention for Somali and Sudanese refugees in Canada

Purpose – The aim of this paper is to design and pilot test a culturally tailored intervention that meets the support needs and preferences of two refugee groups.Design/methodology/approach – The study employed a multi‐method participatory research design and was conducted in two urban centres in western and central Canada. Support was delivered to Sudanese and Somali refugees (n=58), by trained peer and professional helpers, in face‐to‐face groups matched by gender and ethnicity and in telephone dyads. Participants completed three quantitative measures before (pre‐test) and following (post‐test) the intervention. Group interviews with refugee participants and individual interviews with peer and professional helpers conducted at post‐test, elicited qualitative data on perceived impacts and factors influencing impacts of the intervention. Service providers and policy influencers (n=22) were interviewed in groups about the implications of this intervention study for services, programs and policies.Findings ...

Workforce utilization in three continuing care facilities

Abstract The recent commitment to investment in continuing care services demands a sound grasp of workforce utilization in continuing care facilities. This article examines workforce utilization in continuing care as a key component of effective service delivery. We used a case study design with three continuing care facilities in Alberta, Canada. Data were collected over one year through interviews, group discussions and observations. The data revealed workforce issues around staff mix, responsibilities and role clarity that negatively affect staff and residents. Using an ecological framework, we developed ‘upstream workforce strategies targeting barriers that can be influenced by the three facilities. Limited research exists on how regulated and unregulated healthcare providers are organized and deployed in different continuing care environments. In our sociological analysis of workforce utilization at three continuing care facilities, we illuminated the relations between staff and the contextual elements surrounding them.

Social support needs of Sudanese and Zimbabwean refugee new parents in Canada

Purpose The purpose of this paper is to examine support needs of African refugee new parents in Canada, and identifies support preferences that may enhance the mental health of refugee parents and children. Design/methodology/approach In all, 72 refugee new parents from Zimbabwe (n=36) and Sudan (n=36) participated in individual interviews. All had a child aged four months to five years born in Canada. Refugee new parents completed standardized measures on social support resources and support seeking as a coping strategy. Four group interviews (n=30) with refugee new parents were subsequently conducted. In addition, two group interviews (n=30) were held with service providers and policy influencers. Findings Separated from their traditional family and cultural supports, refugee new parents reported isolation and loneliness. They lacked support during pregnancy, birth, and postpartum and had limited interactions with people from similar cultural backgrounds. Refugees required support to access services and overcome barriers such as language, complex systems, and limited financial resources. Support preferences included emotional and information support from peers from their cultural community and culturally sensitive service providers. Research limitations/implications Psychometric evaluation of the quantitative measures with the two specific populations included in this study had not been conducted, although these measures have been used with ethnically diverse populations by other researchers. Practical implications The study findings can inform culturally appropriate health professional practice, program and policy development. Originality/value The study bridges gaps in research examining support needs and support intervention preferences of African refugee new parents.