Taking Action: Mobilizing Communities to Provide Recreation for Women on Low Incomes

Contextualizing Poverty, Health and Physical Activity for Women

A recent study reported that less than 25 per cent of the female population in Canada participates in sufficient physical activity to derive health benefits.1 Yet, research has clearly demonstrated that the risks associated with a number of serious health problems, including cardiovascular disease, obesity, diabetes, cancer and osteoporosis, can be reduced through regular physical activity. It is also well-known that women living below the poverty line are more likely to experience poor health2 and are less likely to be involved in physical activity and community recreation as a means of offsetting some of the health problems they encounter.3 Women living in poverty face a staggering number of challenges, such as poor housing, inadequate childcare, and insufficient financial resources for food and clothing, and access to community recreation is rarely considered a priority. Not only is poor women's access to community recreation not seen as a priority, but women on low income encounter multiple societal, community and personal barriers to participation in community recreation.

Evidence suggests mat the health and quality of life of women on low income and their families could be improved and that substantial savings to the health care system could be accrued if community recreation was seen as a preventative health promotion strategy for marginalized populations. Unfortunately, little has been done in the areas of policy development, program design or research to address the interconnected social problems of women's poverty, poor health and lack of involvement in and access to community recreation. It has been suggested that one reason for this omission is that health and sport policy are largely designed with little or no input from those who are encountering structural barriers to participation.

Background on the Kamloops Women's Action Project (KWAP)

The Kamloops Women's Action Project (KWAP), funded by the BC Health Research Foundation and completed in 1996, was a feminist action research project designed to address health issues of women living below the poverty line by encouraging increased involvement in community recreation. Women on low income in Kamloops identified a lack of access to community recreation as a major factor inhibiting the development of healthy lifestyles for themselves and their families. Women on low income, community partners and researchers collaboratively identified the research questions, collected data and developed actions, including the implementation of new recreation programs. Multi-level outcomes were achieved, including improvements in self-reported dimensions of physical and mental health for the women, changes in community recreation policy, program delivery and resource allocation and the formation of new community partnerships. A final outcome included a Leisure Access workbook written by the researchers to facilitate the identification of access issues for marginalized groups and the implementation of this kind of community planning for other communities.

Taking Action: Study Purpose and Methodology

Building on the knowledge and experiences gained in the Kamloops project, a second project was developed to share the knowledge gained. This project involved three communities in British Columbia and examined the factors that influenced whether action was taken in these communities to increase poor women's access to community recreation. The overall goal was to provide some tentative "lessons learned" for other individuals, organizations and communities interested in launching similar initiatives.

The methodology in the second study consisted of a full-day workshop intervention at each site by original members of the KWAP team using the Leisure Access workbook,4 two return visits to each site and 30 follow-up telephone interviews with workshop attendees over a 12-month time frame. In all three sites, women on low income, municipal recreation staff and representatives from a variety of community groups (i.e., public health units, family services, women's centres) attended the workshops and were subsequently asked questions during return visits or follow-up telephone interviews about the factors that enhanced or inhibited action being taken in their communities. Attendance at the workshops varied from 12 to 85 participants.

Findings

The response to the workshop interventions varied considerably in the three communities. In Community #1, initial plans were developed but were not subsequently implemented. In Community #2, women on low income assumed a major leadership role and initiated action plans outside of the existing municipal recreation system because the policies and practices of that department were not community-development oriented and presented a number of obstacles. In Community #3, partnerships emerged between a larger and more diverse group of women on low income, community representatives and municipal recreation staff, and more extensive action plans, both within and outside the municipal recreation systems, were developed and implemented.

The tracking of the three communities over time revealed a number of factors that influenced whether action was taken and the direction it took. The factors that enhanced or inhibited action were either internal to the working partnerships that were created to tackle the social problems identified (e.g., practitioners adopting a facilitator rather than "expert" role) or were external or more structural in nature (e.g., the daily experiences of living in poverty, restrictive policies of the local government).

Internal and external factors that enhanced the likelihood that action would be taken included: (1) the use of a community development approach that actively involved women on low income in leadership roles and decision-making, (2) the diversity of representation, (3) the use of a community development approach accompanied by a social justice discourse, (4) the shared responsibility for action, and (5) the acknowledgement of the structural dimensions of poverty. Factors that inhibited the likelihood that action would be taken included: (1) power imbalances among collaborators, (2) fragmented community services, (3) reliance on one "idea champion," and (4) the adoption of the traditional direct model of service delivery.

Discussion

This study demonstrates that the dissemination of successful local health promotion initiatives involving community recreation is more likely to occur when the experiences and resources of women on low income are pooled with intersectoral community partners around a shared vision of social justice. Canadian health policies and programs are frequently based on the assumption that individuals should be responsible for their own health, yet provide little or no opportunities for input from the growing number of women who live below the poverty line who are also the most likely to experience poor health. A community development approach helps to ensure that marginalized voices are heard and acted upon in ways that are relevant to them. At the same time, including community leaders and researchers in the process broadens the responsibility for social change. The guidelines for health promotion dissemination developed from this study are meant to serve as a starting point for discussions about the types of principles that should guide community involvement in health promotion for women, while pointing out some of the obstacles that may be encountered along the way. These findings may be useful to other women on low income, community groups, the public sector, and researchers embarking on similar initiatives across Canada.

A copy of the full report, Taking Action: Mobilizing Communities to Provide Recreation for Women on Low Incomes, can be downloaded at: www.bccewh.bc.ca/Pages/pubspdflist4.htm, or contact:

British Columbia Centre of Excellence for Women's Health

BC Women's Hospital and Health Centre

E311-4500 Oak Street

Vancouver, BC Canada V6H 3N1

www.bccewh.bc.ca

Tel: (604) 875-2633

Fax: (604) 875-3716

bccewh@cw.bc.ca

NOTES

1. Bruce MJ, Katzmarzyk PT. Canadian population trends in leisure-time physical activity levels, 1981-1998. Canadian Journal of Applied Physiology 2002;27(6):681-691.

2. Doyal L. What Makes Women Sick: Gender and the Political Economy of Health. London: Macmillan Press Ltd., 1995; Evans MG, Barber, ML and Marmore TR. Why Are Some People Healthy and Others Not? The Determinants of Health of Populations. New York: Aldine De Gruyter, 1996; Popay J, Jones G. Patterns of health and illness among lone parents. Journal of Social Policy 1990;19(4): 499-534.

3. Frisby W, Crawford S, and Dorer T. Reflections on participatory action research: The case of low-income women accessing local physical activity services. Journal of Sport Management 1997;11(8):8-28.

4. Frisby W, Fenton J. Leisure Access: Enhancing opportunities for those living in poverty. A workbook prepared for the BC Health Research Foundation and BC Centre of Excellence for Women's Health, 1998.

Wendy Frisby, Fearon Blair, Therese Dorer, Larena Hill, Jennifer Fenton, and Bryna Kopelow, British Columbia Centre of Excellence for Women's Health

Copyright Centres of Excellence for Women's Health Spring 2005
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