One of the greatest social injustices is that people who are marginalized experience more illnesses, disability, and shorter lives than those who are more affluent (Benzeval, Judge, and Whitehead, 1995). In this dissertation I critique the notion that health is affected by poverty through primarily material factors. In fact, poor women are systematically excluded from resources and opportunities to pursue their health. This feminist action research project addressed how poverty and exclusion influenced poor women's health, examined how a group of women negotiated their experiences of poverty and health, and developed action strategies to address their shared concerns. For 1 V2 years I worked with a group of 30 poor women and gathered qualitative data from 15 meetings, 32 interviews, and 30 sets of fieldnotes. The women lived in material deprivation and could not afford the most basic living necessities. They felt stereotyped, excluded, and invisible in their every day lives. The stereotype of the "welfare recipient" fueled institutional stigmatization and surveillance. Welfare, health care, and community recreation workers were threatening, withheld important information, and limited the women's access to services through chscriminatory practices and policies. The women had limited access to health-promoting resources, and their interactions with authorities were shaming which negatively influenced their psychosocial health through stress, depression, low self-esteem, and anger. Services that were meant to help them labelled them as poor and hurniliated them. The women's shame, material scarcity, and limited access to resources engendered feelings of lack of control and hopelessness and influenced their health. The women's varied discourses of poverty and health reflected attempts at finding legitimacy in a society that systematically excluded and de-legitimized them. Through their conversations and our feminist action research work together, they uncovered legitimate identities within experiences of poverty and ill-health and advocated action and social change. They cited a "livable" income, accessible health-promoting resources, and redressing stigmatizing practices and policies as changes required to improve their health. These findings confirmed that the social determinants of health must be reframed to better understand the effects of exclusion on poor women's health and that inclusion, respect, and dignity are fundamental conditions for promoting health. / Graduate and Postdoctoral Studies / Graduate

Thesis (MA)--University of Stellenbosch, 2001. / ENGLISH ABSTRACT: This study reviews the literature regarding psychodynamic therapy with low-income women. Low-income women are at psychological risk for developing emotional distress as a result of their deprived living circumstances. They have, however, received little attention from psychological research and practice. This literature review explores what psychological interventions are available for low-income women. It is found that psychodynamic therapy is largely unavailable to low-income women for a variety of reasons, which range from classism, sexism and ignorance to the cogent feminist and cross cultural critiques. It is argued that psychodynamic therapy should be more available to low-income women as it provides a sophisticated understanding of how oppressive social ideologies are internalized in the unconscious, thus facilitating, through therapy, a process of deconstruction and political subversion. Suggestions are also offered as to how to make psychodynamic therapy more accessible to low-income women. / AFRIKAANSE OPSOMMING: Hierdie studie bied 'n oorsig van die beskikbare literatuur aangaande psigodinamiese terapie vir laer inkomste vrouens. Die groep is tot 'n meerdere mate blootgestel aan die ontwikkeling van emosionele stress trauma weens hul ontneemde lewensomstandighede. Laer inkomste vrouens het tot hede min aandag geniet met betrekking tot psigologiese navorsing en praktyk. Hierdie literatuur oorsig fokus op gepaste psigologiese ingryping wat beskikbaar is vir die spesifieke groep. Die ontoeganklikheid van psigodinamiese terapie beskikbaar, vir laer inkomste vrouens, kan toegeskryf word aan 'n verskeidenheid faktore: die strek van klassisme, seksisme en onkunde tot oortuigende feministiese en kruis kulturele beoordeling en debat. Hierdie verhandeling stel voor dat psigodinamiese terapie meer beskikbar moet wees tot laer inkomste vrouens, want dit stel 'n gesofisikeerde begrip, ten doel van hoe onderdrukkende sosiale ideologie geinternaliseer word in die onderbewussyn en die teenwerking daarvan. Die geskrif beredeneer hoe terapie kan fasiliteer in die proses van de-konstruksie en politieke subversie. Dit word ook voorgestel hoe om psigodinamiese terapie toeganklik to maak vir laer inkomste vrouens.

Low-income women in an Oregon city of approximately 35,000 inhabitants have limited access to prenatal care services during their pregnancies. The purpose of this study was to uncover the impacts of several factors on the experiences of twenty-seven health department clients with public health department prenatal care practitioners and with local private obstetricians. Ethnographic interviews were conducted with the clients, two health department practitioners, two local obstetricians, and one local direct-entry midwife. The focal finding that emerged from the research was that the clients preferred the care of the health department practitioners to that of obstetricians, even though the health department providers could not deliver the women's babies. The major impacts on the clients' experiences included fragmented service delivery and availability, economic and social restrictions on prenatal care options, biomedical constructs of a healthy pregnancy, and provider role constructions and attitudes towards Medicaid recipients and uninsured pregnant women. Local physicians' mechanistic philosophy, professional dominance and profit orientation afforded them a narrow understanding of the needs and identities of low-income women. Local public health workers are less professionally autonomous than medical doctors but their service orientation allowed them the potential to better serve low-income clients. Based on the twenty-seven clients' perceptions of their care providers and the services available to them, recommendations are made for more empowering, comprehensive prenatal care services in this county. Recommended changes to the public health system entail expanded funding for more appropriate programs and to establish continuity of care for health department clients from pregnancy through the postpartum period. The incorporation of direct-entry midwives into the prenatal and birthing care options open to low-income women is also recommended. Senate Bill 1063, which creates a process for direct-entry midwives to become state-licensed in order to be reimbursed by the Office of Medical Assistance Programs for perinatal services, is considered in terms of its implications for low-income women, the Oregon community of direct-entry midwives, and the texture of Oregon reproductive health care. / Graduation date: 1994

This dissertation is an ethnography of U.S. women negotiating the shifting terrain of reforms to federal welfare policies. Chapter one reviews literature relevant to the dissertation themes. I discuss the work of anthropologists relevant to understanding U.S. welfare reform and gender, public policy and kinship, as well as the concepts of neoliberalism and neoconservativism which frame my analysis of the ethnographic material. In chapter two, I introduce a context for understanding everyday life in San Antonio for low-income women. After providing a brief historical context for understanding the public housing and urban poverty in San Antonio, I parse out events and themes related to public housing that punctuate and constrain the lives women, including the disparities among different City neighborhoods and significance of public housing in women's lives. Chapter three critiques flexibility as a strategy to meet the requirements of welfare reform and attain economic self-sufficiency. I describe gendered and classed perspectives on the marriage promotion component of welfare reform and contextualize these programs with women's lives and relationship choices. In chapter four, I look at marriage and marriage promotion as a component of welfare reform. I review complications and obstacles that women associated with marriage, such as blended families, domestic violence, and barriers to continued public assistance. These factors all affect women's considerations about marriage as a timely and appropriate choice or a way to improve their social and economic situation. Chapter five explores child care dilemmas encountered by women receiving and leaving welfare for employment. While subsidized child care is an option for some women, the employment opportunities available to them require a high degree of individual flexibility are frequently inconsistent with the surprisingly inflexible available formal and informal child care arrangements. Without subsidies, women are often unable to secure and maintain low-wage jobs that are available to them. I understand this predicament in the broader context of the gendered aspects of neoliberalism and welfare reform.

Project (M.P.P.) - Simon Fraser University, 2006. / Theses (Master of Public Policy Program) / Simon Fraser University.

Thesis (M.S.)--University of Michigan, 1995.

Thesis (M.S.)--University of Michigan, 1996. / Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 1995.

Thesis (M.S.)--University of Michigan, 1995.

Thesis (M.S.)--University of Michigan, 1995.