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HOW DO YOUTH IMAGINE A HEALTHY LIFE? UNDERSTANDING HEALTH THROUGH POSTMODERNISM AND CRITICAL RACE FEMINIST THEORY by Clare Margaret Amoako-Parks Dissertation Committee: Professor Charles Basch, Sponsor Professor Yolanda Sealey-Ruiz Approved by the Committee on the Degree of Doctor of Education Date 12 February 2020 Submitted in partial fulfillment of the requirements for the Degree of Doctor of Education in Teachers College, Columbia University 2020 ABSTRACT HOW DO YOUTH IMAGINE A HEALTHY LIFE? UNDERSTANDING HEALTH THROUGH POSTMODERNISM AND CRITICAL RACE FEMINIST THEORY Clare Margaret Amoako-Parks Enormous racial wealth and health disparities persist throughout the United States. There is evidence that health outcomes are a result of historical and contemporary forms of institutional racism (e.g., Roberts, 2012), but they are often framed as a result of individual behaviors in mainstream discourse (Fitzpatrick & Tinning, 2014b). Health education is one tool that can play a role in alleviating health disparities among adolescents, but traditional health and educational research tends to frame entire groups of young people as a monolith, categorized by their racial background, their family’s income, and/or their sexual orientation. This framing positions youth who are placed in these categories as “at-risk,” further pathologizing marginalized groups instead of attending to the role of the social structures that have created these disparities. Combining postmodern tenets and critical race feminist theory (Evans-Winters & Esposito, 2010), this study employed a culture-centered approach (Dutta, 2007, 2010) to disrupt this framework by presenting the socio-historical context of health inequities, and by exploring the voices of youth who happen to belong to communities that are typically pathologized in the literature (Dagkas, 2014). I conducted one-on-one interviews with 24 individuals who attend or attended public schools in New York City, and 2 students who attended parochial schools, in order to understand how individuals imagine health in the context of our social categorizations. Student-participants in this study shared stories with common themes, including the performativity of health (Webb & Quennerstedt, 2010), low school investment in health education, discourses of fear, risk, and shame in health class, and desires for openness and honesty from caring adults. Student-participants also shared unique or uncommon responses, including their ideas about health as an internal process, and the barriers that American cultural norms place on both individual and collective well-being. Additionally, some contradictions arose in the interview texts: between the importance of reaching out to community and focusing on oneself, and between students’ desires for structural versus individual changes in their imagination for a healthy life. This study showed how challenging deficit lenses and consulting youth about their understandings and imaginations can shape health education research, policy, and programming. © Copyright Clare Margaret Amoako-Parks 2020 All Rights Reserved ii ACKNOWLEDGMENTS I would like to start by thanking the students that I have had the immense privilege of working with over the years, before and during this study. When I first met many of you, I was a different person than I am now, and I cherish the ways we have all grown together. The opportunity to learn alongside you has shaped me in ways I never imagined. Thank you for sharing pieces of your lives with me and for allowing me to present some small part of your stories. I hope we never stop learning. I thank my advisor, Dr. Charles Basch, for his belief in me, his teaching, his care, and his mentoring over the last seven years. I am grateful for every meeting we had where I arrived nervous, but left empowered and inspired, without fail. I am grateful for every opportunity he provided me with and every new text and mentor he exposed me to. His care and commitment to his students, the larger community, and to a life of learning have played a large role in my willingness to see this degree and this document through to the end, and will continue to serve as inspiration for any future work I pursue. Thank you as well to Evelyn Quiñones, who always helped me and answered my questions with love and care. I would also like to thank my dissertation committee. Dr. Stephanie McCall gave me time, guidance, and support that she was not obligated to provide, and that allowed me to move forward in my stickiest moments. Her original research on discourses of success in all-girls’ schools was a significant inspiration and support to this document. Dr. Yolanda Sealey-Ruiz provided insight, honesty, and meaningful feedback with her characteristic dose of loving-kindness. My classes with both of these professors took place at the same time, and the combination of their work and their care both in and outside the classroom transformed my writing process, my worldview, and my navigation of the world. Learning from both of these women consistently inspired me to continue iii when I saw the contributions they made to their students, to their communities, and to the work. I have so much gratitude for so many faculty and staff in a variety of departments at Teachers College. I must first thank former postdoctoral fellow Dr. Monique Lane, whose class I took during the summer of 2015: it changed the entire trajectory of my research, my pedagogy, and my ways of being. I would also like to thank Dr. Christopher Emdin, who allowed me to take two of his courses so that I could continue to learn from his innovative methods to highlight students’ genius. Dr. Michael Carrera is an incredible example of someone who was born to teach and to mentor, whose genuine care for the people around him and for his work in health education has an immeasurable impact. His demonstration of love through his teaching practices and his continued curiosity about his students’ lives is an example I hope to follow. Dr. Sonali Rajan, Dr. Robert Fullilove, and Dr. Barbara Wallace are two professors whose classes I took many years ago, but from whom I gained so much wisdom. I am also in debt and gratitude to Dr. Wenimo Okoya—always three steps ahead of me, and always willing to reach back to lift me up. Her constant sharing of resources, advice, and time taught me how to be a better student, writer, educator, and friend. I am grateful for the ongoing support of my colleagues-turned-friends that I gained throughout my time in this degree and writing this paper. Even though they weren’t in classes with me, they listened patiently to my tirades about the things I learned and the ways we needed to apply it to our work, even when it didn’t always make sense. I won’t name their names here, to protect the anonymity of our students, but I needed to put my gratitude for them in writing. I can hardly describe in words the ways Nnemoma, Kylie, Kaitlyn, and Luke supported me in these last few months of writing and transforming, in more ways than one. Thank you for your unconditional friendship and support throughout the ups and downs of this entire process; thank you for listening and cheering me on. iv It’s hard to put into words the gratitude I have for my family, especially my parents. Mom and Dad—thank you for your unconditional love and support, even when my tendency toward critique was pointed in your direction. Thank you for listening to me and for loving me anyways. Thank you to my sister, who makes the combination of love and hard work look like no big deal, and to my brother, who taught me it was okay to change. Finally, thank you to my favorite person and partner, Kingsley, for supporting me in unimaginable ways throughout the completion of this paper, with a love and care for me the person first, and me the writer second, that allowed me to take care of both myself and our emerging child in ways that have transformed me. Thank you to Eva, Doris, Madalein, and Josh for your love and kindness. Grace – I can’t wait! C. A.-P. v TABLE OF CONTENTS Page FOREWORD ............................................................................................................... xi Chapter I—INTRODUCTION ......................................................................................1 Intentionality Statement and Research Questions..............................................2 A Note on Language ..........................................................................................3 Significance........................................................................................................4 Why Health Education? ............................................................................6 Why Students’ Perceptions? .....................................................................9 Gaps in Current Knowledge....................................................................11 Connection Between Aims and Long-Term Goals .................................12 Chapter II—LITERATURE REVIEW ........................................................................15 Attending to Discourse in Health Education ...................................................15 Rationale for Disrupting “Risk” Discourse in Adolescent Health ...................16 Introduction .............................................................................................17 Neoliberalism and Health .......................................................................19 Body Politics ...........................................................................................21