$3.5-million gift to uncover hidden health impacts by expanding critical qualitative health research

Jul 7, 2022

A sign in a big glass window reads: Dalla Lana School of Public Health — *Photo by Johnny Guatto*

How do you visualize hidden health impacts?

A girl stands alone in the middle of an empty desert.

A woman looks directly at the viewer, her mouth covered with band-aids.

These artworks are helping public health researchers understand more about the lives of young mothers during COVID and the systemic barriers that reinforce health inequities. Qualitative research like this aims to see health matters in context, to get at aspects of health that are difficult to measure or are invisible, and to ask better research questions.

The study’s lead, Assistant Professor Clara Juando-Prats, is a member of the Centre for Critical Qualitative Health Research (CQ), a multi-disciplinary academic unit founded in 2009 in the University of Toronto’s Dalla Lana School of Public Health. Her arts-based methodology is only one of many different qualitative approaches to studying health. CQ’s adage, ‘doing science differently’, underlies the use of qualitative data and analysis and social science theory to understand matters of health and health care.

Now, Professor Emerita Joan Eakin and her husband Chris Hoffmann have made a $3.5-million gift to ensure the future development and vitality of CQ and its research education program.

Eight researchers who are members of the Centre for Critical Qualitative Health Research.

Critical qualitative health research conducts inquiries ‘against the grain’

The Dalla Lana School’s Centre for Critical Qualitative Health Research works as a community of practice — debating, developing, sharing, merging their philosophies of knowledge and method; inquiring ‘against the grain’ to develop new understandings of public health.

To learn about the impact of COVID on her study participants — young mothers who mostly speak English as a second language, have low support, and are racialized — Juando-Prats first considered that many of her participants didn’t have a safe place to stay, or access to Zoom. So she set out to create a welcoming and accessible space for them online, noting that “a primary goal was to eliminate some of the structural barriers that make it difficult for them to participate and have a say in research that is done on them, and change it to doing research with them”. She then began art workshops that enabled participants to express their experiences in a form that could be used for research.

Researchers associated with CQ have turned their qualitative lens onto power dynamics and the assumptions underpinning the policy and practices of health promotion and prevention, or have studied health-related practices in settings such as hospitals, long-term care homes, and workplaces. Other CQ researchers based at Canadian universities have focused on health care systems and decision-makers, or examined patient experiences in relation to specific health problems like childhood concussion, HIV, and dementia.

Social gerontologist and Associate Professor Pauli Gardner challenges assumptions about aging and disability by immersing herself in the lives of older adults. Assistant Professor Sarah Elton spent a summer working in a community garden alongside local residents for her study of human-plant interactions in the creation of an effective urban food ecosystem. DLSPH Assistant Professor Amaya Perez-Brumer is studying the power dynamics entangled in how we ‘do’ global public health research and policy-making.

Eakin and Hoffmann’s gift will create two permanent chairs

Eakin, a pioneer in the field of qualitative health research and founding director of CQ, has directed her gift to the endowment of two permanent Chairs, one a junior tenure-track faculty position in research methodology, and the other a senior level scholar and the next Centre director. The Chairs will work with the academic fellows of the centre and other researchers in its international networks to further develop the field of qualitative research methodology, and seed it with new generations of researchers at its most questioning and innovative edge.

“Academia does not easily recognize methodology as a topic we can and should study,” says CQ Director and Associate Professor Brenda Gladstone. “This gift will allow us to recruit an assistant professor focussed on methodology rather than subject-matter expertise. And we can hire a more senior academic to grow our already-exceptional graduate and continuing education programs, including our public seminars and regular workshops and symposia, and engage our local and global communities of practice.

We ran this from the corner of our desks, and now an assistant professor can dedicate their career to it. We don’t know of anywhere in the world a position like this exists.

Gladstone says she’s excited about finding scholars who want to experiment and innovate and produce ‘the next generation’ of new knowledge about methodologies.

The establishment of two permanent chairs “injects a new life into CQ and brings new possibilities that until now we couldn’t even consider,” says Associate Professor Denise Gastaldo, who co-founded CQ with Professor Eakin and has spearheaded much of its curriculum development. “We ran CQ from the corner of our desks, and now an assistant professor can dedicate their career to developing qualitative methodologies and methods for critical public health research. We don’t know of anywhere in the world a position like this exists.”

We ran this from the corner of our desks, and now an assistant professor can dedicate their career to it. We don’t know of anywhere in the world a position like this exists.

A recent CQ publication, led by Assistant Professor Jay Shaw, considers the impact of critical qualitative research on policy, practice and on science. The authors provide a new framework to help qualitative researchers plan for impact when carrying out their studies. That focus on impact and the study of public health through the close integration of theory and practice is a major draw for students entering CQ’s interdisciplinary curriculum and for the researchers associated with CQ.

A key strength of critical qualitative research is its wide diversity of approaches to understanding health, its critical approach to the ideas and assumptions underpinning the study of health and health care, and its application of social science knowledge to the health field.

In the post-COVID era, we need thoughtful challenges to traditional ways of researching public health. This generous gift will generate new insight into the problems of human health for decades to come.

“By providing long-term resources for faculty leadership, scholarship and teaching in this distinctive approach to health research, the Eakin-Hoffmann donation will make a lasting and unique contribution to future knowledge, practice and policy in health,” says the Dean of the Dalla Lana School, Adalsteinn (Steini) Brown. “I believe that especially now, in the post-COVID era, we need thoughtful challenges to traditional ways of researching public health. CQ-affiliated scholars have much to offer our field, and I believe this generous gift will cement their ability to generate new insight into the problems of human health for decades to come.”

In the post-COVID era, we need thoughtful challenges to traditional ways of researching public health. This generous gift will generate new insight into the problems of human health for decades to come.

Migration stories, quilting, motherhood and mass incarceration, queer workers: explore critical qualitative health doctoral research

A cluster of doctoral students works with CQ to advance their research interests in a wide variety of public health topics.

Nicola Gailits set up story circles for Latinx immigrant women, in order to understand immigrant mental health outside of biomedical approaches. For her study, she developed a new way of approaching narrative inquiry that she calls Postcolonial Narrative Inquiry. It’s comprised of four elements: deep seeing, which counters epistemic injustice; deep hearing, which emphasizes using a plurality of methods of knowledge generation and self-expression; deep listening, which focuses on disrupting power imbalances and unlearning extractivist approaches; and deep feeling, which elevates the research process to the same level of importance as the outcome.

“Some of the women had never shared their migration story before and had felt very alone in their experience,” says Gailits. “I spent a lot of time getting to know them, listening, and building trust, which is important for all research, but particularly as a white, non-Latinx woman.”

Kristie Serota, is incorporating quilting among other creative ways to engage with Canadian families in bereavement following Medical Assistance in Dying. This novel form of post-structural narrative inquiry is helping her to understand disagreement, family conflict and differing understandings among relatives. “Families are complicated, and death is complicated,” says Serota. “I hope that if we have a more fulsome understanding of how disagreement impacts MAiD bereavement, we can ensure there are resources to support loved ones experiencing moral or ethical issues related to MAiD throughout the process.”

Tenzin Butsang is applying Indigenous feminisms and biopolitics in studying how colonialism and incarceration impacts Indigenous parents and their relationships with their children. “Approaching the mass incarceration of Indigenous people, and specifically Indigenous women, as a public health issue allows for a deepened analysis of the social determinants of incarceration in the settler colonial context,” says Butsang.

“I hope that this project enables our partners to better understand the needs of the individuals they serve and use the findings to advocate for their needs as organizations to continue to support individuals released from prison and their families. More broadly, I hope to contribute to a critical dialogue on mass incarceration in Canada and elucidate the multi-dimensional and interconnected notions of settler colonialism, carcerality, motherhood, health, power, and Indigeneity in the lives of Indigenous mothers, mother-figures, and Two-Spirit parents.”

David Kinitz deploys narrative inquiry through a critical social paradigm to study the stories that queer workers in Toronto tell about their experiences of low-wage and precarious employment. “2SLGBTQ+ people, a population I share an identity with, navigate a world structured for cisgender, heterosexual people, resulting in alarming rates of social exclusion, poverty, and suicide,” says Kinitz. “I hope that my research might illuminate how oppressive power relations stifle our ability to thrive; and begin to inform social policy and public health interventions that promote stable housing, social welfare for newcomers fleeing violence, safety and security in the labour market, and equity in all aspects of life.”

By the Dalla Lana School of Public Health