“Around here, they roll up the sidewalks at night”: A qualitative study of youth living in a rural Canadian community
Introduction
People living in rural Canada experience numerous health and social disparities in comparison to their urban counterparts; although, the nature and extent of such disparities remains open to interpretation (Pampalon et al., 2006; The Canadian Institute for Health Information, 2006). In addition to rural/urban differences on crude health indicators (e.g., life expectancy), many rural places experience notable disparities related to more specific measures, including young people's sexual health outcomes.1 For example, most rural communities in British Columbia (BC) have higher teenage fertility rates than urban settings (British Columbia Vital Statistics Agency, 2004).2 Understanding the context of growing up in a rural community is important for expanding our conceptualisation of young people's development as sexual beings (Skatrud et al., 1998) and has implications for how we understand overall health and its emplaced production.
Place represents the intersection of social and physical spaces, manifesting as both spatial and material effects in youth's everyday lives. In rural places, youth may experience geographic isolation, which may affect their access to timely and youth-centred health and social services. Forms of health-care management (e.g., centralised versus community-based models) and what this means for the provision of services also varies according to place (Poland et al., 2005). Moreover, places expose youth to intrinsic social norms (e.g., gender norms; social mores; expectations about privacy) that contribute to their development as sexual beings (Power, 2005; Shoveller et al., 2004).
There is a growing body of literature examining questions pertaining to social capital and rural youth (Gray et al., 2006; Onyx et al., 2005; Shucksmith, 2004). Since Coleman's (1988) and Putnam's (1993) foundational work, discussions continue regarding definitional, measurement and analytical concerns, as do debates about the ideologies associated with social capital (e.g., “social capitalists” versus “neo-materialists”). However, the social capital literature provides a useful rubric through which to view many aspects of the potential connections between rural socio-cultural contexts and young people's sexual lives. For example, Gold et al. (2002) investigation of the ‘causal pathways’ associated with teen births in the USA showed that the effects of income inequality on teen births appear to be mediated by social capital. They posited that such effects may be expressed at the individual level (e.g., sexual health risk taking) as a result of socio-cultural influences at the macro-level (e.g., weakened informal social supports that lead adolescents to feel socially disconnected; social welfare policies that de-emphasise pregnancy prevention services; economic opportunities that exclude youth and thereby remove disincentives against early childbearing).
Social capital (or other forms of capital) also needs to be considered in conjunction with the power relations that play out in young people's lives. Wakefield and Poland (2005) highlight the work of Bordieu (1986) and Bordieu (1979) (particularly in relation to marginality, dominant discourses and distances between groups within social hierarchies), and point out how power relations within and across places both reflect and challenge the distribution of social capital. By examining how institutions and community members co-create social capital, they pose questions about (re)presentation and taking action to promote youth health (e.g., whose voice is considered legitimate? what decision-making mechanisms are used to solve problems?). Gatrell et al. (2004) also emphasise the importance of attending to power relations when examining the links between social capital and health, reminding the reader to concentrate on how “people see [emphasis in the original] themselves [and others] located in social space” (p. 256).
The interface between local environments and global forces also has been addressed in the social capital literature. Castro and Lindbladh's (2004) analysis of hegemonic discourse in relation to the ‘problematic area’ interrogates neo-liberalism as a contributor to profound health and social suffering in specific locales. While their research was situated in an urban poverty zone, they too point out that it is the intersection between social capital and power relations at the nexus of local and global that promote (or damage) young people's health and social well being. Work in social epidemiology also supports the notion that context and social relationships, including power relations, are recursively (re)produced in youth's lives and are expressed in terms of health and social inequalities (Frohlich et al., 2001).
While we attended to spatial and material constructs in our study, we also attempted to resist reductionist approaches that would limit our analysis of “place”, particularly this rural place, in purely spatial terms (i.e., a setting, location) or in terms of resource deprivation (Gatrell et al., 2004). Our analysis is informed by the view that human lives are essentially emplaced (Malpas, 2003) and so we tried to give proper attention to integrated notions of space and place, as they arise out of one another (Macintyre et al., 2002) and as they are formed through time (Massey, 2005).
Drawing on these theoretical suppositions, this qualitative study investigated one rural community's socio-spatial context. We gathered the perspectives of local residents (adults and youth) regarding the ways in which context affects everyday life for young people and we focused on perceptions regarding the ways in which young men and women attempt to situate their emergent sexual behaviour patterns within that context.
Section snippets
The community
“Prospect” began as a ‘roadhouse’ along the wagon trail to a major gold rush site during the 1860s. The region has a rich history of First Nations settlement and today includes three First Nations. Cattle ranching dominated the local economy until the 1960s, when the forestry and lumber industries surpassed it. However, Prospect has remained a ‘cattle town’ to a large extent, with numerous ranches in the surrounding areas (these were affected negatively by the discovery of ‘Mad Cow’ disease in
Study participants
Interspersed through our fieldwork, we formally interviewed 9 adults individually (7 women and 2 men) and conducted two group interviews with 6 other adults (5 women and 1 man). We interviewed teachers, social workers, outreach workers, a parole officer, public health workers, parents, and community leaders (e.g., mayor, town council members). We also interviewed 17 youth (13 young women and 4 young men who ranged in age from 12 to 24 years). Most respondents self-identified as “White”,
Discussion
In this paper, we attempted to illustrate how social processes (e.g., stigmatisation, gender and other forms of power relations) are emplaced in ways that affect youth health at the individual and community levels. Our data indicate that the complex relationships between place and young people's sexual health go beyond obvious spatial and materials explanations. Our data show that such explanations intersect with and are contingent upon broader social structures that can exacerbate the negative
Acknowledgements
The authors would like to acknowledge the generosity of the people of Prospect who openly engaged with us during our fieldwork. Thanks also to Wendy Davis for her assistance in preparing this manuscript. Funding for this research was provided through an operating grant from the Canadian Institutes of Health Research.
References (42)
- et al.
Place, discourse and vulnerability- a qualitative study of young adults living in a Swedish urban poverty zone
Health & Place
(2004) - et al.
Mapping the determinants of health inequalities in social space: can Bourdieu help us?
Health & Place
(2004) - et al.
Teen births, income inequality, and social capital: developing an understanding of the causal pathway
Health & Place
(2002) - et al.
Place effects of health: how can we conceptualise, operationalise and measure them?
Social Science and Medicine
(2002) - et al.
‘Everywhere and nowhere’: locating and understanding the ‘new’ public health
Health & Place
(2003) Bio-medical Topoi-the dominance of space, the recalcitrance of place, and the making of persons
Social Science & Medicine
(2003)- et al.
Does living in rural areas make a difference for health in Quebec?
Health & Place
(2006) - et al.
Socio-cultural influences on young people's development
Social Science & Medicine
(2004) - et al.
Family, friend or foe? Critical reflections on the relevance and role of social capital in health promotion and community development
Social Science & Medicine
(2005) Creating difference: neo-liberalism, neo-conservatism and the politics of educational reform
Educational Policy
(2004)
The forms of capital
Personal Experience Methods
Social capital in the creation of human capital
The American Journal of Sociology
Grounded theory method: procedures, canons, and evaluative criteria
Qualitative Sociology
Grounding Grounded Theory
On the idea of what constitutes good qualitative inquiry
Qualitative Health Research
A theoretical proposal for the relationship between context and disease
Sociology of Health & Illness
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