Mapping the social determinants of substance use for pregnant-involved young Aboriginal women

Sana Z Shahram,Joan L Bottorff,Nelly D Oelke,Donna L M Kurtz,Victoria Thomas,Patricia M Spittal,And For The Cedar Project Partnership

doi:10.1080/17482631.2016.1275155

Abstract

ABSTRACTThere is a dearth of knowledge about the social determinants of substance use among young pregnant-involved Indigenous women in Canada from their perspectives. As part of life history interviews, 17 young pregnant-involved Indigenous women with experiences with substances completed a participant-generated mapping activity CIRCLES (Charting Intersectional Relationships in the Context of Life Experiences with Substances). As women created their maps, they discussed how different social determinants impacted their experiences with pregnancy and substance use. The social determinants identified and used by women to explain determinants of their substance use were grouped into 10 themes: traumatic life histories; socioeconomic status; culture, identity and spirituality; shame and guilt; mental wellness; family connections; romantic and platonic relationships; strength and hope; mothering; and the intersections of determinants. We conclude that understanding the context and social determinants of substance use from a woman-informed perspective is paramount to informing effective and appropriate programs to support young Indigenous women who use substances.

Highlights

Social determinants of health are key considerations in understanding health inequities observed in society (Halseth, 2013; Reading & Wien, 2009)
The findings of this study provide one of the first detailed descriptions of Indigenous women’s perspectives on social determinants of their health
Asking young pregnant-involved Indigenous women to map social determinants of substance use based on their own experiences provided a more nuanced and complete understanding of social contextual factors contributing to substance use than current models of social determinants of health

Summary

Introduction

Social determinants of health are key considerations in understanding health inequities observed in society (Halseth, 2013; Reading & Wien, 2009). These determinants typically include early child development, education, income, employment, the nature of social and physical environments, personal health practices and coping skills, access to health services, racism and gender (Halseth, 2013; Reading & Wien, 2009). In a recent systematic literature review of peer-reviewed empirical research on the social determinants of substance use among Aboriginal women between 1999 and 2012, only 16 articles were identified (Shahram, 2016). Women’s perspectives on experiences that shape their substance use were largely missing from the literature

Methods

Results

Conclusion