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Major Research Papers - Health

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  • ItemOpen Access
    Climate Change Action versus Complacency: How Political Power and Influence Shape National Environmental Policy
    (2022-08) Flanagan, Erin
    The catastrophic effects of climate change are being felt around the world – in both developed and developing countries, with expeditious action needed to avoid a serious global crisis. There has been an array of political responses that have been developed with hopes of forestalling, or even completely eradicating, these impending environmental catastrophes. However, there exists large differences between the responses of countries, particularly amongst the Anglo-Saxon liberal welfare states (LWS) – Australia, Canada, UK, and USA – and the Nordic social democratic welfare states (SDWS) – Denmark, Finland, Norway, and Sweden. The SDWS have created policy that simultaneously responds to climate change while also promoting existing public policies that emphasize the economic and social security of the population. Alternatively, the LWS continue to emphasis non-governmental responses that serve to depoliticize and individualize the solutions towards the climate crisis. Using a political economy framework, I continue to explore the relevance of the “eco-social welfare state” literature and define how the robustness of a country’s welfare state is explicitly linked to the proactiveness of the environmental policies that are put forth. Furthermore, I provide evidence of five public discourses that demonstrate how public opinion and the resulting conceptualization and framing of the climate crisis may also be influenced by the political economy of a nation. Overall, I conclude that, currently, eco-social welfare state environmental policies are the most proactive, however despite their intentions, are unlikely to control climate change as even the world’s “best” policies are not contributing enough preventative action. Finally, I suggest that only a post-capitalist eco-socialist state can avert a global environmental catastrophe.
  • ItemOpen Access
    Neoliberalism and the Creation of ‘Obedient Bodies’ in Healthcare: Current Political Creeds and Their Impact Upon the Acute Care Sector in Canada
    (2023-08) Thompson, Corina R.; Raphael, Dennis; Falk-Rafael, Adeline
    Neoliberalism, described as a current hegemonic ideology and mode of governance that embraces individualism, market fundamentalism and subservient governments as its core tenets, has generated an increasingly fragmented society - with a deriving Darwinian culture where everybody tends to self, and only the strong and capable will survive. Constantly attacking the ‘commonplace’ and everything related to the idea of shared responsibility, while refusing to admit our ever-present interdependencies, neoliberalism has created a world-wide asphyxiation of care. This crisis of caring spreads into every sphere of society, from the polis to our natural resources, depleted more and more by neoliberal greed. Policies and measures designed to protect communities and populations are constantly removed or weakened, superseded by the worship of capital and the struggle to generate profit at any cost. Canada, like many of the Western capital-oriented nations, has, unfortunately, embraced the neoliberal agenda, too, since the late 1970s and early 1980s. Consequently, social protection strategies and publicly owned assets are relentlessly - and sometimes surreptitiously - assaulted. Common resources and their governing processes are under constant surveyance in the name of efficiency. Often, the result is tragic: what once belonged to all is now the possession of just a few. The Canadian healthcare system is, too, beneath the neoliberal talon. Yes, although under permanent criticism and tireless invigilation, our public healthcare system still stands, despite sabotaging discourses that claim unsustainability. For how long, though? Affected by partial removal of government coverages, fractional privatization, and relinquishment of certain services to the marketplace, our public capacities to care are weakened day after day. Efficiency is consistently dethroning quality, with numerous consequences that equally hurt receivers and providers of care. A downwards spiral is thus created, whilst privatization of healthcare services is presented as the only viable solution, a cure for all lesions and a remedy for all deficits. As one of the epitomes of care, as those who are ever-present at the patient’s bedside, regardless of resources, strategies, support, pandemic measures, or lack of thereof, this paper will argue that nurses are affected the most by this healthcare crisis. The existential encounters that the caring profession is so proud of, and so gratified with, become scarce. The very idea of quality of care needs to be restrained to a few fortunate moments or limited circumstances. After prolonged and unsupported compensatory efforts, a multitude of nurses - burnt out and disheartened - might consider alternate ways of regaining professional and living satisfaction, and leave the profession: a current post-pandemic, still unresolved, unfortunate reality. The proposed way forward that concludes my study is the constant resistance against neoliberalism, this present zeitgeist: defiance through contrasting ideology and counter-discourse, and confrontation by counteraction, from the smallest act occurring at the individual level, to the larger acts, initiated by communities and nation-states. The suggested alternative is the idea of common good, while promoting the restoration of a culture of care. Instead of promoting self-sufficiency, we need to point toward the incessant human need for one another. Instead of relentlessly competing with each other in a fragmented and disoriented world, we could allow others to win as well.
  • ItemOpen Access
    Social Determinants of Perinatal Health: Perspectives on the Role of Midwifery
    (2023-08) Anderson, Sarah; Raphael, Dennis; Vorstermans, Jessica
    There exists an abundance of literature that connects adverse perinatal outcomes to certain social and structural determinants of health. Midwives, like many other community-based primary healthcare providers, are often aware of various social determinants of health (SDH). Ontario midwives champion continuity of care and building trusting relationships with clients as significant aspects of their philosophy of care. Some midwives are committed to working with vulnerable populations in their communities and believe that midwifery’s model places the profession in a unique position to offer personalized and comprehensive care to those in marginalized social locations, with the goal of producing the best health outcomes for women and newborns. This original qualitative research paper aims to explore if there exists a lack of knowledge or understanding among Ontario midwives regarding SDH and how they produce inequitable health outcomes; what epistemological barriers midwives may experience regarding health inequities; and what role (if any) midwives believe they have in addressing the issues faced by marginalized clients to mitigate adverse health outcomes.
  • ItemOpen Access
    The Impact of the COVID-19 Pandemic on the Mental Health of Nurses in Canada
    (2023-08) Kaur, Charandeep; Morrow, Marina; Ahmad, Farah
    Mental health stress and conditions have become key health issues, particularly for nurses working in Canada. Nurses for years have experienced psychological distress from their work environments, which have worsened since the onset of the Covid-19 pandemic. The consequences nurses are facing are dire and have placed them in vulnerable positions within the Canadian healthcare system. The vulnerability of nurses in society is associated with systemic factors including power relations within the political economy that undervalues this healthcare profession. This political and stereotypical view of nurses is problematic in promoting nurses’ wellness and mental health even in crises like Covid-19. Moreover, there is a lack of focus given by health organizations and the Canadian government on mental health and its associated symptoms on a long-term basis. This paper utilizes a feminist political economic and an intersectional framework to examine policymaking to understand how systematic factors influence the mental health state of nurses in Canada. Analyzing their experiences and the effects of the system at multiple dimensions offers insights on the need for more services and supports for nurses’ mental health for a robust health workforce now and under crises like the Covid-19 pandemic.
  • ItemOpen Access
    “Make No Mistake, People Are Dying”: A Literature Review of the Opioid Crisis in Canada
    (2023-08-08) Marrelli, Alyssa; Morrow, Marina; Reaume, Geoffrey
    Objective: Evidence has indicated that harm reduction practices aid in preventing drug overdose and provide social support for people who use drugs. However, less is known about the enablers and barriers to adopting such practices in public health policy. The purpose of this research is to investigate how social and political factors act as enablers or barriers to implementing harm reduction services, with a focus on the roles of activism and evidence-based research. Design: A policy and history analysis of the opioid crisis in Canada, with a focus on British Columbia and Ontario. Methods: I conducted a literature review of published literature, grey literature and Federal and Provincial government reports. Findings: My findings demonstrate that activism is a stronger enabler for harm reduction than evidence-based research in both Ontario and British Columbia. A common barrier in Ontario is the difference in political values between the provincial and Federal governments. Also, limited funding and poor resource distribution resulted in equity concerns for Northern communities like Sault Ste. Marie. Conclusions: My findings emphasize the need for a more equitable reallocation of Provincial funding for mental health and addictions health care. A shift in political values may enable Ontario to implement harm reduction services long-term. More research is needed to better understand the intersection of multiple social determinants of health.
  • ItemOpen Access
    The Liberal Party of Canada’s Proposal for Nationwide Universal Pharmacare: Informing the Path Forward Via International Comparison
    (2021-11-12) Wadhawa, Sapna; Raphael, Dennis; Chaufan, Claudia
    In 2019, the Liberal Party of Canada (LPC) tabled the most recent proposal (Hoskins Report) for nationwide Pharmacare. It made sixty recommendations on how to achieve universal drug coverage in Canada. Since the 1943 draft proposal for public health insurance, several periodic proposals for nationwide Pharmacare have been put forward at the federal level. A narrative review of these proposals established nationwide Pharmacare is once againon the table federally. To inform the path forward, this study compared the Canadian approach to prescription drug coverage with that of the United Kingdom (UK). Canada and the UK were compared in three clusters: (a) the levels and sources of expenditures on prescription drugs; (b) the levels and distribution of pharmaceutical insurance associated with prescription drug spending; and (c) the health outcomes “produced.” Recommendations were then provided for implementation of nationwide Pharmacare. I argue that a rapidapproach is needed by the federal governmentto implement the service. The steps taken towardsa Pharmacare inclusive Medicare systemmust be fast-tracked. This type of system is observed to be the norm in high income countries. Several findings indicated poor trends in health system performance and production of health inequalities under the current system for prescription drug coverage. The Hoskins Report concretely places Pharmacare on the political agenda, creating a window of opportunity for the federal government to employ a rapidapproach.
  • ItemOpen Access
    Indigenous Youth Mental Health in Canada: A WPR Approach to Canada’s (In)Action in Response to Suicide Crises
    (2020-10) Victoria, Francavilla; Marrow, Marina; Hillier, Sean
    Across Canada, Indigenous Peoples have been resilient to active colonization for more than 400 years, all the while upholding their traditional values, systems, and ways of being. However, despite this resilience, Indigenous youth experience disproportionate and elevated rates of negative mental health outcomes, including elevated rates of suicides. Canadian mental health policy has not been responsive to the needs of Indigenous youth, often ignoring the specific needs of Indigenous communities in documents that are meant to guide programming and responses. In this Major Research Paper (MRP) I review one such key document -the Mental Health Commission of Canada's (MHCC) 2016 recommendations in its report titled The Mental Health Strategy for Canada: A Youth Perspective. This document is the broadest reaching and most current official document addressing the issue of First Nations, Inuit, and Métis (FNIM) youth mental health at a Federal level. By analysing the narrative used throughout this document one can learn how the solutions proposed may actually be failing to address the root causes of the issue at hand. Using Carol Bacchi’s WPR (What’s the Problem Represented to be?) approach, it will become evident as to why these responses are not wholly conducive to achieving better mental health outcomes for Indigenous youth. Following this discussion, I will highlight the progress that is being made in various Indigenous communities in a variety of culturally relevant, safe, and sensitive ways. Communities who are thriving and who are working towards positive change for youth are the experts in this case, as they have the knowledge and are taking up practices which are created from themselves, not for them. These practices have the potential to influence policy, as they are paving the way for a better response in cases of Indigenous youth suicide. When systems are put in place that truly benefit the community, this has a profound effect by influencing community members, researchers, academics, and policymakers alike, and also highlights the shortcomings of existing governmental action. As a non-Indigenous person, I engaged in reflexivity throughout my research and situate myself as an ally.
  • ItemOpen Access
    Critical Analysis of National Nutrition Policy and Strategies of India
    (2021-04-30) Sayeed, Shurovi; Chaufan, Claudia; Sridharan, Sanjeev
    Abstract Global malnutrition and food insecurity are rising. The root cause of both malnutrition and food insecurity is poverty. Despite a remarkable increase in food production, developing countries show alarming rates of child malnutrition. India is a good example of this dichotomy. The country that harbours one-third of the world’s malnourished children is also one of the world's largest food grain exporters. Moreover, India has had the world’s most extensive government funded nutrition intervention programs.A National Nutrition Policy (NNP) was enacted in 1993, one of the earliest submitted in response to the World Health Organization’s call for countries to develop a NNP. India’s poverty reduction strategy and food policy are also aligned with NNP. Nevertheless, despite these massive initiatives, India’s nutrition problem remains a major public health concern. India’s nutrition problems and national nutrition programmes are generalizable to other agro based South East Asian developing countries.This study’s objective was to explain why nutrition policy and strategies failed to address malnutrition in India. A critical discourse analysis approach was used to show textual and contextual dimensions of government policy documents in relation to the neoliberal policy and practice. A political economy lens was employed to illustrate the global food politics context perpetuating persistent hunger and child malnutrition. The study revealed that India’s recent National Nutrition Strategy and National Nutrition Mission does not adequately address the lack of quality protein, fruits and vegetables and that the heavy reliance on grain is due to the government's sole support of rice and wheat production. The study also revealed that transnational agro-industries, international banking and donor organizations heavily influence India’s food and agriculture policy. Finally, it identified a shift in the policy, from challenging neoliberal
  • ItemOpen Access
    The Politics of Family Policies: A Critical Discourse Analysis of Ontario’s Early Learning and Childcare Policy 2017-2020
    (2021-03-31) Sandhu, Navdeep; Raphael, Dennis; Chaufan, Claudia
    Justin Trudeau, the leader of the Liberal Party since 2013, released the Multilateral Early Learning and Child Care Framework in 2017 to encourage the delivery of early learning and child careservices on the principles of high quality, accessibility, affordability, flexibility, and inclusivity across Canada (Japel& Friendly, 2018). Following the Framework, the Federal Government of Canada signed 13 bilateral agreements with provinces and territories to financially support each of theirearly learning and child careservices (Japel & Friendly, 2018).Inactions are just as relevant to public policy decisions as are actions while the former retains the status quo the latter brings change (Bryant, 2015). Therefore, it was important to discuss whether Ontario’s Bilateral Agreement is an act of inaction or action in the realm of family policies, specifically early learning and child care. Ideas and institutions were the key factors in this paper’sanalysis of understanding policy change (Beland, 2005). Ideas and institutions are important to consider because former enacted policies and formal political institutions affect policy reform and policy change. To do this, the paper involves a political economy analysis, through Critical Discourse Analysis, guided by the Discursive Institutionalism framework, to assess whether Ontario’s Agreement contributes to the expansion or shrinkage of the provinces’ early learning and child caresystem. The policy analysis wassummarized into key findings, followed with its interpretation, and final concludes with recommendations.
  • ItemOpen Access
    The Impact of Islamophobia on the Mental Health of Muslim Post-Secondary Students 
    (2021-08-12) Khan, Khan, Zainab; Raphael, Dennis; Marrow, Marina
  • ItemOpen Access
    The Problem of Power in ADHD: A Scoping Review
    (2020-06-10) Joseph, Abraham; Marrow, Marina; Wiktorowicz, Mary
    Attention deficit hyperactivity disorder (ADHD) has become the most diagnosed mental health issue for children worldwide. There are substantive critiques of the psychiatric basis for the conceptualization, diagnosis, and treatment that dominate the ADHD context. ADHD discourse and practice are largely influenced by the biomedical framework of mental health and illness. The pervasive, continued acceptance of the dominant biomedical ADHD narrative is problematic in terms of addressing mental health care needs as well as illustrative of the influence and power that psychiatry wields with respect to the ADHD landscape. Further, there is a lack of focus on the concept of power within the ADHD literature. This paper presents a power framework that locates the influence of psychiatric power vis-à-vis instrumental power, structural power, and discursive power. Operationalizing the dimensions of psychiatric power highlights the access points for resistance efforts aiming to counter and disrupt the status quo in ADHD from research to practice.
  • ItemOpen Access
    Comparative Critical Policy Analysis of SARS and COVID-19 Policy Responses to PSW Mental Health
    (2021-11) Glockmann-Musto, Santina; Chaufan, Claudia; Syed, Iffath
    This Major Research Project (MRP)assesses policy responses to the impact of COVID-19 on the mental health of Personal Support Workers (PSWs), a segment of frontline workers, in Canada. Specifically, Iassess how the experience of the 2003 Severe Acute Respiratory Syndrome (SARS)epidemicis informing policy responses to the mental health challenges experienced by PSWs under COVID-19. Despite the magnitude of the COVID-19 pandemic, with Canada reporting over half a million cases and over 15,000 deaths due to COVID-19 as of December 31st, 2020, this is not the first emergency of its kind in Canada. In 2003, the outbreak of SARS led to close to 500 cases and 44 deaths, resulting in the establishment of the Public Health Agency of Canada. It was then reported that PSWs who provided care to SARS patients experienced poor mental health outcomes -anxiety, occupational burnout, depression, and Post-Traumatic Stress Disorder (PTSD), which persisted twoyears after the epidemic. COVID-19, substantially more impactful, poses a much greater challenge to the mental health of PSWs. Drawing from a Marxist Feminist perspective –most PSW are low-income and female -thiscritical comparative policy analysis appraises publicly available documents (e.g., Learning from SARS –Renewal of Public Health in Canada) that represent SARS and COVID-19 policy responses. Preliminary findings suggest that policy responses so far have almost entirely missed key lessons learned from the SARS experience. Myanalysis elaborates on these findings and their implications for practice, policy, and equity.
  • ItemOpen Access
    Applying a Health Justice Framework to Examine Visitation Policies in Canadian Federal Penitentiaries and Psychiatric Facilities During the COVID-19 Pandemic
    (2021-11) Bailey, Megan; van Dreumel, Lynda; Shnier, Adrienne
    The COVID-19 pandemic has illuminated inequities in policy development and implementation of emergency intervention strategies. This study addresses the equitable access to visitation in COVID-19 emergency intervention strategies between comparable total institutional settings. This multiple-case design encompassed two selected custodial environments and was compared using the implemented emergency policies surrounding visitation. In comparing the institutionalized settings of psychiatric hospitals and federal penitentiaries in Ontario, it draws appraisals for equity and health justice-based analysis. These emergency intervention policies focused on visitation vary based on institutional influence, interests, and ideas that are consequently highlighted within this study. The findings of this study reflect a lack of consistency in emergency responsesurrounding visitation policies across psychiatric facilities and federal penitentiaries located within Ontario and uncover discrepancies in policies within the various Ontario psychiatric facilities. These findings lead to an analysis rooted in the framework of human rights and social justice that propel a unique discussion surrounding health justice in the context of Canadian institutionalized settings. The study concluded by considering health justice as a framework in practical and theoretical policy development and implementation to promote health equity and the approach to social justice from a health and equity perspective.
  • ItemOpen Access
    The Impact of Islamophobia on the Mental Health of Muslim Post-Secondary Students 
    (2021-08) Khan, Zainab; Raphael, Dennis; Marrow, Marina
  • ItemOpen Access
    The Problem of Power in ADHD: A Scoping Review
    (2020-10) Joseph, Abraham; Marrow, Marina; Wiktorowicz, Mary
    Attention deficit hyperactivity disorder (ADHD) has become the most diagnosed mental health issue for children worldwide. There are substantive critiques of the psychiatric basis for the conceptualization, diagnosis, and treatment that dominate the ADHD context. ADHD discourse and practice are largely influenced by the biomedical framework of mental health and illness. The pervasive, continued acceptance of the dominant biomedical ADHD narrative is problematic in terms of addressing mental health care needs as well as illustrative of the influence and power that psychiatry wields with respect to the ADHD landscape. Further, there is a lack of focus on the concept of power within the ADHD literature. This paper presents a power framework that locates the influence of psychiatric power vis-à-vis instrumental power, structural power, and discursive power. Operationalizing the dimensions of psychiatric power highlights the access points for resistance efforts aiming to counter and disrupt the status quo in ADHD from research to practice.
  • ItemOpen Access
    Comparative Critical Policy Analysis of SARS and COVID-19 Policy Responses to PSW Mental Health
    (2021-11) Glockmann-Musto, Santina; Chaufan, Claudia; Syed, Iffath
    This Major Research Project (MRP)assesses policy responses to the impact of COVID-19 on the mental health of Personal Support Workers (PSWs), a segment of frontline workers, in Canada. Specifically, Iassess how the experience of the 2003 Severe Acute Respiratory Syndrome (SARS)epidemicis informing policy responses to the mental health challenges experienced by PSWs under COVID-19. Despite the magnitude of the COVID-19 pandemic, with Canada reporting over half a million cases and over 15,000 deaths due to COVID-19 as of December 31st, 2020, this is not the first emergency of its kind in Canada. In 2003, the outbreak of SARS led to close to 500 cases and 44 deaths, resulting in the establishment of the Public Health Agency of Canada. It was then reported that PSWs who provided care to SARS patients experienced poor mental health outcomes -anxiety, occupational burnout, depression, and Post-Traumatic Stress Disorder (PTSD), which persisted twoyears after the epidemic. COVID-19, substantially more impactful, poses a much greater challenge to the mental health of PSWs. Drawing from a Marxist Feminist perspective –most PSW are low-income and female -thiscritical comparative policy analysis appraises publicly available documents (e.g., Learning from SARS –Renewal of Public Health in Canada) that represent SARS and COVID-19 policy responses. Preliminary findings suggest that policy responses so far have almost entirely missed key lessons learned from the SARS experience. Myanalysis elaborates on these findings and their implications for practice, policy, and equity.
  • ItemOpen Access
    Applying a Health Justice Framework to Examine Visitation Policies in Canadian Federal Penitentiaries and Psychiatric Facilities During the COVID-19 Pandemic
    (2021-11) Bailey, Megan; van Dreumel, Lynda; Shnier, Adrienne
    The COVID-19 pandemic has illuminated inequities in policy development and implementation of emergency intervention strategies. This study addresses the equitable access to visitation in COVID-19 emergency intervention strategies between comparable total institutional settings. This multiple-case design encompassed two selected custodial environments and was compared using the implemented emergency policies surrounding visitation. In comparing the institutionalized settings of psychiatric hospitals and federal penitentiaries in Ontario, it draws appraisals for equity and health justice-based analysis. These emergency intervention policies focused on visitation vary based on institutional influence, interests, and ideas that are consequently highlighted within this study. The findings of this study reflect a lack of consistency in emergency responsesurrounding visitation policies across psychiatric facilities and federal penitentiaries located within Ontario and uncover discrepancies in policies within the various Ontario psychiatric facilities. These findings lead to an analysis rooted in the framework of human rights and social justice that propel a unique discussion surrounding health justice in the context of Canadian institutionalized settings. The study concluded by considering health justice as a framework in practical and theoretical policy development and implementation to promote health equity and the approach to social justice from a health and equity perspective.
  • ItemOpen Access
    Indigenous Youth Mental Health in Canada: A WPR Approach to Canada's (In) Action in Response to Suicide Crises
    (2020-10-02) Francavilla, Victoria; Hillier, Sean; Morrow, Marina
    Across Canada, Indigenous Peoples have been resilient to active colonization for more than 400 years, all the while upholding their traditional values, systems, and ways of being. However, despite this resilience, Indigenous youth experience disproportionate and elevated rates of negative mental health outcomes, including elevated rates of suicides. Canadian mental health policy has not been responsive to the needs of Indigenous youth, often ignoring the specific needs of Indigenous communities in documents that are meant to guide programming and responses. In this Major Research Paper (MRP) I review one such key document - the Mental Health Commission of Canada's (MHCC) 2016 recommendations in its report titled The Mental Health Strategy for Canada: A Youth Perspective. This document is the broadest reaching and most current official document addressing the issue of First Nations, Inuit, and Métis (FNIM) youth mental health at a Federal level. By analysing the narrative used throughout this document one can learn how the solutions proposed may actually be failing to address the root causes of the issue at hand. Using Carol Bacchi’s WPR (What’s the Problem Represented to be?) approach, it will become evident as to why these responses are not wholly conducive to achieving better mental health outcomes for Indigenous youth. Following this discussion, I will highlight the progress that is being made in various Indigenous communities in a variety of culturally relevant, safe, and sensitive ways. Communities who are thriving and who are working towards positive change for youth are the experts in this case, as they have the knowledge and are taking up practices which are created from themselves, not for them. These practices have the potential to influence policy, as they are paving the way for a better response in cases of Indigenous youth suicide. When systems are put in place that truly benefit the community, this has a profound effect by influencing community members, researchers, academics, and policymakers alike, and also highlights the shortcomings of existing governmental action. As a non-Indigenous person, I engaged in reflexivity throughout my research and situate myself as an ally.
  • ItemOpen Access
    The Problem of Power in ADHD: A Scoping Review
    (2020-06-10) Joseph, Abraham; Morrow, Marina; Wiktorowicz, Mary
    Attention deficit hyperactivity disorder (ADHD) has become the most diagnosed mental health issue for children worldwide. There are substantive critiques of the psychiatric basis for the conceptualization, diagnosis, and treatment that dominate the ADHD context. ADHD discourse and practice are largely influenced by the biomedical framework of mental health and illness. The pervasive, continued acceptance of the dominant biomedical ADHD narrative is problematic in terms of addressing mental health care needs as well as illustrative of the influence and power that psychiatry wields with respect to the ADHD landscape. Further, there is a lack of focus on the concept of power within the ADHD literature. This paper presents a power framework that locates the influence of psychiatric power vis-à-vis instrumental power, structural power, and discursive power. Operationalizing the dimensions of psychiatric power highlights the access points for resistance efforts aiming to counter and disrupt the status quo in ADHD from research to practice.
  • ItemOpen Access
    Towards an Orthodox Marxist Critique of Critical Health Policy
    (2020-08-31) Torrence, Ryan; Chaufan, Claudia; Pilon, Dennis
    Critical health policy researchers have, over the past few decades, shown beyond doubt the connection between socioeconomic inequalities and disparities in health and disease outcomes. The evidence is strong enough that mainstream outlets like the World Health Organization now acknowledge the centrality of the social determinants of health. However, researchers and activists have largely been frustrated in their attempts to mobilize this knowledge into practice. By most accounts, social health inequalities are increasing on intranational and global scales, especially following the 2008 economic crisis (Cash-Gibson, et al., 2018). The present Covid-19 pandemic – which has caused unemployment levels to rise to historic heights in most advanced economies – has made understanding the connection between socioeconomics and individual health even more urgent. The concept of health inequality as a field of study emerged alongside the pioneers of the socialist tradition; Frederick Engels’ 1845 The Condition of the Working Class in England is a seminal work in the field, and his lifelong collaborator Karl Marx elaborated at length the deleterious (physical, psychological, and spiritual) effects of capitalism on the lower classes. However, a properly Marxist tradition is largely absent even in more radical circles of health research today. To the extent that it is present, it is “neo-Marxist” – that is, it comes from a second generation of Marxists who took influence from Marx, but use fundamentally different methodological and theoretical assumptions. I argue that this is because, for the past century, a mathematical inconsistency (the “transformation problem”) in Marx’s original political economy was thought to make it internally incoherent, and as a result it has been excluded from serious academic consideration. However, in recent years, a school of Marxist economists have disproven the inconsistency, and in doing so paved the way for the possibility of a reclamation of the Marxist tradition in the social sciences. In this paper I argue that a Marxist political economy could serve as a superior methodological basis for the study of social health inequities.