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Mothers Experiencing Homelessness: Social Exclusion, Resistance, and Health

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Mothers Experiencing Homelessness: Social Exclusion, Resistance, and Health Western University Scholarship@Western Electronic Thesis and Dissertation Repository 12-14-2015 12:00 AM Mothers Experiencing Homelessness: Social Exclusion, Resistance, and Health Sarah Benbow The University of Western Ontario Supervisor Dr. Cheryl Forchuk The University of Western Ontario Graduate Program in Nursing A thesis submitted in partial fulfillment of the equirr ements for the degree in Doctor of Philosophy © Sarah Benbow 2015 Follow this and additional works at: https://ir.lib.uwo.ca/etd Part of the Nursing Commons Recommended Citation Benbow, Sarah, "Mothers Experiencing Homelessness: Social Exclusion, Resistance, and Health" (2015). Electronic Thesis and Dissertation Repository. 3407. https://ir.lib.uwo.ca/etd/3407 This Dissertation/Thesis is brought to you for free and open access by Scholarship@Western. It has been accepted for inclusion in Electronic Thesis and Dissertation Repository by an authorized administrator of Scholarship@Western. For more information, please contact [email protected]. MOTHERS EXPERIENCING HOMELESSNESS: SOCIAL EXCLUSION, RESISTANCE, AND HEALTH (Thesis format: Integrated Article) by Sarah Benbow Graduate Program in School of Nursing A thesis submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy The School of Graduate and Postdoctoral Studies The University of Western Ontario London, Ontario, Canada ©Sarah Benbow 2015 ABSTRACT Background and Purpose: Mothers experiencing homelessness in Canada are faced with unique challenges in achieving health. The purpose of this two-phase study was to critically examine the socio-political context, health needs, exclusionary and inclusionary forces, and strategies of resistance demonstrated by mothers experiencing homelessness. Methodology: This study falls under the critical paradigm informed by the theoretical perspective of intersectionality. Methodologies employed included critical narrative and critical discourse analysis. Data were collected at various homeless shelters and programs that provide services for women and mothers who are homeless in Southern Ontario. A purposive sample of women experiencing homelessness, and service providers participated in the study. Participants chose between individual and group interviews, based on their preference and comfort. In phase two, a critical discourse analysis of Ontario’s Poverty Reduction Strategy was conducted. Phase two provided further context to research participants’ narratives and insight in the current political will to address their needs. Findings: Mothers (n=26) ranged from 18-58 years of age with an average age of 27.4 years. On average women had 1.6 children; the majority of children were under 5 years of age. Nineteen women self-identified as having or have had a mental illness. All service provider participants (n=15) were working with women who experienced homelessness. Based on study purpose and philosophical underpinnings, four overarching themes were identified: (a) exclusion from safety; (b) stigma: public surveillance and discrimination; (c) contradictory sources and systems of support; and (d) internal impacts of exclusion. Within phase two of the study, findings revealed that the needs of homeless mothers were not adequately represented or addressed in the policy, nor were their experiences of social ii exclusion. Instead gender invisibility, neoliberal, and individualistic approaches to poverty reduction were dominant with minimal identification of timelines, concrete plans, and evaluation strategies. Conclusions: The findings united individual realities with the macro structure of policy shaping the experiences of health, social exclusion, and homelessness for mothers. Implications for nursing practice, education, research, and policy with regards to the socio-political context of health, social exclusion, and resistance of mothers experiencing homelessness are identified. Keywords: homelessness, mothers, health promotion, nursing, critical narrative, critical discourse analysis, social exclusion, intersectionality iii CO-AUTHORSHIP STATEMENT Sarah Benbow completed the following work under the supervision of Dr. Cheryl Forchuk, Dr. Helene Berman, Dr. Carolyne Gorlick, and Dr. Cathy Ward-Griffin, who will be co-authors of publications resulting from Chapters Two, Four, and Five. iv ACKNOWLEDGEMENTS First and foremost, I would like to express my extreme gratitude to the mothers who participated in this work by sharing their stories with me. Thank you for letting me into your lives and trusting me with your words. I am incredibly moved by your strength and will be forever in awe of each of you. Thank you. I would like to extend my sincere appreciation to my academic committee—Drs. Cheryl Forchuk, Carolyne Gorlick, Helene Berman, and Cathy Ward-Griffin—for their help in this work and in their support of my growth as a nurse researcher. You have each become strong mentors in my work, and in my life. Thank you for your guidance in getting me to this point, and beyond. Your expertise, patience, flexibility, vision, and encouragement propelled me through this process. I am more grateful than you will ever know. I would also like to specifically thank my supervisor, Dr. Cheryl Forchuk. Thank you for introducing me to the world of nursing research well over a decade ago. My work with you as an undergraduate student inspired me to pursue mental health nursing, advanced practice nursing, and graduate studies. Thank you for ‘planting the seeds’ and showing me the power of nursing research and the importance of advocacy. To my closest friends who have shared this journey with me in so many forms, thank you. Thank you for your patience, understanding, and never-ending encouragement. To my family, thank you for instilling in me a commitment to higher learning, social justice, political awareness, independent and critical thought, as well as extreme empathy, care, and perseverance. v Lastly, I would like to extend my thanks to the following for financially supporting my doctoral education through scholarships and awards: Ontario Graduate Scholarship Program, Arthur Labatt Family School of Nursing, Western University, Canadian Nurses Association, Registered Nurses Association of Ontario, and the Registered Nurses’ Foundation of Ontario. vi TABLE OF CONTENTS ABSTRACT…. ................................................................................................................... ii CO-AUTHORSHIP STATEMENT .................................................................................. iv ACKNOWLEDGMENT......................................................................................................v TABLE OF CONTENTS .................................................................................................. vii LIST OF APPENDICES ......................................................................................................x CHAPTER ONE – INTRODUCTION ................................................................................1 Statement of Research Purpose ................................................................................2 Summary of Research Approach .............................................................................2 Positionality/Self Relexivity ....................................................................................3 Background ..............................................................................................................8 Homelessness in Canada: The Historical and Current Political Context .....8 Relevance ...............................................................................................................17 Dissertation Overview ...........................................................................................18 References ..............................................................................................................19 CHAPTER TWO – SOCIAL EXCLUSION AND HEALTH: DEVELOPMENT OF NURSING KNOWLEDGE...........................26 Introduction ............................................................................................................26 Conceptualization of Social Exclusion: Historical and Political Context .............27 Prevailing Perspectives and Conflicting Ideologies ..................................30 Research Exploring Social Exclusion and Health in Canada ................................34 Toward Improvements in Social Exclusion Research in Canada ..........................36 Conceptualization of Social Exclusion for Nursing Knowledge ...........................38 Nursing Research Implications and Future Directions ..........................................40 Concluding Comments...........................................................................................41 References ..............................................................................................................42 CHAPTER THREE – LITERATURE REVIEW AND RESEARCH DESIGN ...............47 Current Literature...................................................................................................47 Homelessness and Adverse Health Consequences ....................................47 Violence and Trauma: The Gendered Experience of Homelessness .........49 Unique Challenges for Mothers Experiencing Homelessness ...................52 Strengths and Acts of Resistance ...............................................................55 Social Exclusion and Health ......................................................................59 Summary
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