Rethinking Health Inequities: The Case of Lone Mothers in Atlantic Canada Christine Saulnier, PhD Director, Canadian Centre for Policy Alternatives-Nova Scotia & Adjunct Assistant Professor, School of Health and Human Performance, Dalhousie University Presented at the CPHA, June 3, 2008, Halifax, NS

Redefining and Responding to Lone Mother Families’ Needs What about somebody suggesting that there be an extenuating circumstances box that can be checked off (Participant, Social Assistance Recipient, Nova Scotia).

SEI as a determinant of health all citizens should have an ability to make informed choices and participate in society in a meaningful way to them Understand the interactions among the determinants of health and specifically forefronts the health impacts of being excluded that determine access to society’s resources and by extension, health status (Public Health Agency of Canada, Social inclusion as a Determinant of Health, Ottawa: PHAC, 2003).

Indicators of Exclusion/Inclusion 1.Symbolic/subjective aspects of social inclusion/exclusion 2.Material income and resources 3.Labour market inclusion/exclusion 4.Physical environments 5.Service exclusion/inclusion 6.Social relations/social support 7.Civil Society Engagement 8.Personal health and coping skills

Service Exclusion: “a single mother don’t need a phone” “My husband was threatening to kill me, they put him up on charges, and he was going to kill himself and kill me but I didn’t need a phone. A single mother don’t need a phone.” “if you are going to look for a job, how can you apply for a job without some kind of a phone?.” “Really most of us need that phone, we take that out of my grocery money because it’s not accounted for.”

The Food Budget: the only source of ‘discretionary’ funds ““If you need anything extra or cough medicine or anything, everything comes out of your grocery money because that’s all that’s there. If your kids need sneakers, it comes out of your grocery money.” “there were times when I’ve had to keep my kids home from field trips because I didn’t have the money with a three day notice to come up with X amount of dollars. …

Smiling: A luxury for some “So I am in a position where I can’t smile at anybody because they won’t pay for that because it’s a front tooth [that was pulled]. This matters to me mentally. I can’t smile. Like that lowers your self-esteem and lowers everything. And it lowers your ability to be capable in the real world.”

“she’s got herself into a mess now”: Stigma and Discrimination “I’ve come up against that attitude of (...) the reason why your kids are acting and behaving the way they are is because you’re on your own…” “It’s like these people when you are in trouble, they don’t want to hear that. And you can hear in the back of their head say, ‘she’s got herself into a mess now’....

“my body is tired, my mind is stressed, and my spirit is walked on.” “When it doesn’t work, the consequences can be dire - more fear and insecurity, more health disparities, more exclusion.” Breaking Dependency: at what costs?

Advantages to SEI Integrates social and economic Relational Concept Focus on Process as well as the Outcome Focus on the solution

Thanks to all the women who shared their stories with us. Project Funded by CIHR and hosted by the Atlantic Centre of Excellence for Women’s Health. Thanks to all the Project Team Members For more information on this project: