1. Contextualizing: One Neighborhood at a Time to Enable Structural Changes Andrea Chircop, RN, MN, PhD(c) School of Nursing, Dalhousie University CPHA Conference, Halifax, June 2008

2. Distribution of Canada’s Population Source: Canadian Institute for Health Information (2006). Improving the Health of Canadians: An Introduction to Health in Urban Places. Pp.8.

3. Pattern of Health Between Neighborhoods Source: Canadian Institute for Health Information (2006). Improving the Health of Canadians: An Introduction to Health in Urban Places. Pp.49

4. We know that…. Residents of Canada’s cities are not equally healthy Health outcomes among neighborhoods within the same cities vary This raises implications for policy makers BUT The mechanisms are not clear! CIHI 2006

5. Contextualizing: Magnifying the fine print of neighborhoods For social policy to be relevant and responsive to the daily challenges of people’s lives, contextualized knowledge is necessary.

6. Low-Income Mothers’ Systematic Oppression Urban Neighborhood Physical and Social Environments Mothers’ Local Knowledge Mothers’ Health Decisions in Low-Income Urban Neighborhoods An urban ethnography guided by an ecofeminist framework

8. Research Objectives To provide a forum for low-income mothers to articulate how they experience and negotiate their own and their families’ health in an urban environment To influence public policy relevant to low-income mothers living in urban environments

9. Method Ethnographic data collection over 12 months time period including: Individual (at time repeated) semi-structured interviews Photovoice Participant Observation Document Analysis

10. Preliminary Themes Negotiating Urban Infrastructure Negotiating Childcare Negotiating Nutrition Goals and Aspirations Personal Skills & Resources

11. Negotiating Urban Infrastructure Affordable housing Public Transportation Safety Playgrounds &Parks Services Geographic Isolation

13. Negotiating Childcare Lack of Daycare Centers Long Waiting Lists Early Childhood Education Mothers ability to work outside the home

14. Negotiating Nutrition Looking for Deals Transportation Food bank Borrowing Money Hunting & Fishing

15. Goals and Aspirations Motivation for Change Getting back into routine Wanting it better for their children

16. Personal Skills & Resources Formal Education Parenting Creativity Problem Solving

17. What next? Continue the dialogue with policy decision-makers Responsibility of the researcher Ongoing productive relationships with a MUTUL goal of reducing health inequities