Brann-Barrett, M.  Tanya

English

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The Alberta Journal of Educational Research Vol. 52, No. 3, Fall 2006, 203-205The Wounds of Exclusion: Poverty, Women’s Health and SocialJustice. Colleen Reid. Edmonton, AB: Qual Institute Press, 2004,277 pages.Reviewed by: M. Tanya Brann-BarrettCape Breton UniversityIn this insightful and informative book based on her doctoral dissertation, TheWounds of Exclusion: Poverty, Women’s Health, and Social Justice, Colleen Reidexplores how a group of women living in poverty understand and definehealth and how they participate in forms of social justice in relation to women’shealth. Winner of the 2002/2003 International Institute for Qualitative Method-ology Dissertation Award, Reid also engages in an ongoing critique of thefeminist action research model she adopted as a methodological framework forher study.Reid presents a solid interdisciplinary theoretical foundation for her re-search, drawing on health equity studies and feminist and social justice theo-ries. Using a social determinants-of-health perspective (one that claims thathealth is influenced by social factors such as race, sex, income, and class), sheargues that dominant discourses of health exclude people who live on themargins of society. She contends that people who live in poverty are lesshealthy than wealthier people, yet current health inequities research does notadequately investigate what causes the disparities. Moreover, it fails to addresswomen’s health and issues of poverty. Hence Reid asked the following ques-tions for her research.1) How did a group of women on low income understand and negotiate theirexperiences of poverty, exclusion, and health, both individually andcollectively?2) From the perspectives of a group of women on low income, what was theconnection between poverty and health?3) How did a group of women on low income collaboratively identify,organize, and enact action towards social change to address their sharedconcerns? (pp. 61-62).Reid’s choice of methodology for her study is well justified in her book.Whereas much of the current literature on poverty and health is based onquantitative studies, Reid notes that qualitative research provides a usefulmodel for exploring socio-environmental issues. Similarly, qualitative researchcreates spaces where women can discuss their experiences and views aboutwhat they need to improve their health. Subsequently, Reid chose a feministaction research (FAR) approach to her work. She defines FAR as: “a conceptualM. Tanya Brann-Barrett is an assistant professor in the Communication Department. Her currentresearch interests include the study of young people’s experiences and perceptions of sociallyand economically healthy communities and how their accounts may inform healthy communitydevelopment education programs. She is enrolled in the doctoral program in Educational Studiesat the University of British Columbia.203AJER journal fall 2006.indd   203 10/6/06   11:56:35 AMand methodological framework that enables a critical understanding ofwomen’s multiple perspectives and works towards inclusion, participation,action, and social change while confronting the underlying assumptions theresearcher brings into the research process” (p. 35).Reid conducted her research in an existing feminist action research projectin British Columbia known as Women Organizing Activities for Women(WOAW). The program developed out of a workshop for women living inpoverty that aimed to expose barriers that prevented their participation incommunity recreation. A doctoral student, Reid became involved in WOAW asproject manager. She helped to organize a subgroup (the Research Team)created as a place for women to discuss their experiences of health and povertyand to consider forms of collective action. All the participants in Reid’s projectwere WOAW members. Data were gathered from Research Team meetings’transcripts and field notes, one-on-one interviews, and participant observation.Throughout the book, Reid addresses the challenges of ensuring that the datacollection and analysis processes were collaborative with the women on theResearch Team, one of the goals of FAR.The women involved in the study are introduced through stories using theirown words to articulate their experiences. Some pieces are noticeably shorterthan others due to the amount of data collected and what the women werecomfortable disclosing and having presented. Although these stories may ap-pear incomplete, their inclusion is important. To discount them would havesilenced voices and perspectives that are a significant part of the research.Reid clearly articulates an analysis of the women’s experiences of exclusion.On a cultural level, the women experience exclusion in the form of stereotypesand labels. On an institutional level, exclusion takes the shape of degradationand disrespect as people, policies, and systems fail to understand and addresstheir issues and concern. On a material level, the women are excluded fromaccess to basic needs such as safe and affordable housing, transport, andresources for food and child care.As well as levels of exclusion, Reid presents the dynamic and sometimescontradictory discourses co-created by the women as they explored their expe-riences of health and living in poverty. Yet she emphasizes: “The followingdiscourses capture only partial moments of the women’s identities; they are notmeant to be seen as static or fixed representations” (p. 168). They include thepowerless victim discourse (“there is nothing that can be done to change mysituation”), the legitimacy and entitlement discourse (“my hardship is morelegitimate than someone else’s so I am more entitled to assistance and accep-tance”), and the individual work ethic discourse (“I am in control of my life andwill rise above this situation”). Reid argues that each discourse unwittinglyreinforces the dominant health discourse that creates the exclusion: in part bynot holding society accountable for the injustice of health inequities amongcitizens. However, she notes that in the discourses were examples of individualempowerment and action. Further, she also identifies a critical and collectivistdiscourse through which the women recognize how social conditions work todisadvantage and disempower them and how they may challenge thedominant stereotypes of women living in poverty.M.T. Brann-Barrett204AJER journal fall 2006.indd   204 10/6/06   11:56:36 AMIn her conclusion, Reid makes policy recommendations that include sup-port for programs such as WOAW, advocacy for more collaboration in policy-making, and politicizing social determinants of health. In the end, she argues,“We can only be healthy in a healthy society” (p. 244). Thus we need tounderstand health as a social justice issue with a goal to initiate individual andcollective change that aims for inclusion of all sectors of the population.Reid also offers reflective analyses of her role as a feminist action researcher.She points to challenges of FAR that include dealing with issues of power andprivilege between herself and the women, recognizing the limitations thatprevent the full participation of all involved, and challenging and acceptingperceptions of her roles and the roles of the women. She discusses her emotion-al response to the challenges faced and calls for more feminist action re-searchers to do the same. Finally, she struggles to determine whether the groupachieved social change, a struggle she does not resolve. Instead she questionswhat constitutes social change, recommending future work toward a theory ofaction and social change. Overall, Reid’s reflections support her claim thatalthough feminist action research is a valuable tool, the methodology needsfurther critique, analysis, and development to narrow the gap between theideal and what really happens once researchers are engaged in the practice.Reid’s book is theoretical, practical, and reflective. I recommend it to thoseconcerned with issues of health and inclusion, those interested in engaging inFAR and other forms of participatory research, and graduate students whowish to read an award-winning dissertation. Furthermore, this book providesvaluable insights for educators and researchers committed to the developmentof socially just, healthy community education programs. Particularly, it em-phasizes the importance of listening to the voices of the community memberswhose experiences and opinions are often unsolicited and unheard to ensurethat education programs address their needs and concerns. Although her writ-ing is steeped in theory, her voice and the voices of the women are clear in eachchapter in the form of direct quotations and examples, and her writing is rich,descriptive, and critically reflective. Colleen Reid has succeeded in writing awork that contributes to community health studies, social justice theories, andfeminist action research. Equally important, she has done so while honoringherself and the women with whom she worked.Book Review205AJER journal fall 2006.indd   205 10/6/06   11:56:36 AM

The Wounds of Exclusion: Poverty, Women’s Health and Social Justice by Colleen Reid

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