THE NATURAL ENVIRONMENT: A
SOCIAL DETERMINANT OF HEALTH?
Shawn-Renee Hordyk, PhD
Mary Shem: MA, BSW
March 16, 2015
Outline
1.
2.
3.
4.
5.
6.
Social determinants of health model
Review of the literature
The role of nature in the adaptation process of immigrant
children and families in Montreal
Canada’s Indigenous people: environmental
racism/environmental justice
Healing traditions in the Cree community
John’s healing journey
Social determinants of health: Causes of health inequalities
Lalonde report (1975): “The dark side of economic progress” includes environmental
pollution and city living.
Recommendations: Provide the Canadian population ready access to recreation
facilities such as nature trails, ski trails, bike paths and playing fields.
The restorative effects of nature
Urban centers:
• Positive correlation: health and access to greenspace (Stigsdotter et al., 2010).
• Increased problem-solving skills (Kuo, 2001)
• Decrease in urban crime and violence (Kuo & Sullivan, 2001)
• Immigrant adaptation (Wen et al. 2010)
Healing institutions
• Hospital settings (Said & Bakar 2006; Sternberg, 2009; Ulrich 1991)
• Rehabilitation centres and nursing homes (Ottosson, 2001; Ottosson, & Grahn,
2005),
Education centers:
• ADHD symptoms (Faber Taylor, & Kuo 2009 )
• Youth educational trajectories (Matsouka, 2010).
Theoretical explanations
• Stress response- heart rate, blood pressure, cortisol levels, immunity (Ulrich, 1991)
• Cognitive restoration (Kaplan, 1995)
• Biophilia (Wilson, 1984)
• Other (i.e. Blackstock, 2011)
Context: Doctoral study
Montreal population: 1.6 million, 20% born outside Canada
Greenspace (parks, playgrounds, gardens)
Area of study: .45 hectares /1000 people
Recommended: 2 hectares / 1000 people
Challenges (SDH factors) of immigrant children
and families:
social exclusion
 fragile family structures- serial migration
 parental depression and stress
 unrecognized cultural competency, domains of intelligence
 poor material conditions: housing, food, clothing
 pre-migration stressors
 behavioral & biological symptoms

(Beiser et al., 2011; Suárez-Orozco, 2000; Zhou, 1997)
How do Montreal immigrant family’s experiences of
nature shape their adaptation process?
a)
How do immigrant children interact with nature in urban camp settings and
in the context of their day-to-day lives?
b)
In what ways does direct contact with the natural world appear to shape
immigrant children and family experiences of social determinants of health?
Research Design
Child Photos
Camp
a,c
Parent &
Child
Drawings
a,b
Child
Drawings
Camp
a,b,c
Child
Dialogues
Camp
a,b,c
Method: hermeneutic phenomenology
Participant profile
• 18 children: urban nature camps (age 7-12)
• 7 parent-child interviews
• 2 focus groups
Regions represented: 6 (Central & South America,
North and West Africa, East Asia, Caribbean)
Recruitment: welcome classes, camp
Analysis: thematic
Focus Group
Interviews
a,c
Parent &
Child
Interviews
a,b,c
Child
Photos
a
Facilitator
Observations and
Photos
a,c
a) day to day nature interactions
b) nature’s impact on social determinants of health.
c) contexts and child research
Researcher
Participant
Observations and
Photos
a,c
Nature defined
Nature included material components of the cosmos: flora, fauna, geographical
features, aromas, sounds, tastes, tactile sensations.
Nature was perceived as scientifically measurable, as symbol, as refuge and as
relationship (as having traits of personhood and/or spirit) .
Urban greenspace and the SDH of immigrant families
Housing Conditions
Caregiver Health
 Crowded conditions
 Parenting stressors
 Poor sound insulation
“Cardboard walls”
 Immigration related
stressors- job, language,
financial barriers
 Outdoor air and noise
pollution
We lived in a small
apartment. But what
was it that turned things
around so that this is not
such problem? We
walked one block, two
blocks and we arrived at
a park. For us, this is
marvelous
With the different seasons, we
can see that everything has its
place… There is a time to do
something in life, there is a
time to rest.
I had just arrived with the
baby... The first winter I did
not go out... The third year I
began to understand how this
(winter) worked, so to speak.
Social Cohesion
 Social isolation, newcomer
status
 Language barriers
 Lack of familiarity with
local norms and customs
The process of adaptation is
not clear when you arrive in
the city. There are not a lot
of things to do outside of
programmed activities.
However nature is there. It’s
free. So it’s up to you to go
looking. It’s easy. Nature is
so beautiful here in Canada.
When nature nurtures: Nature as a holding
and containing space
Nature
holding
Child
relational and
identity development
Nature
containing
Holding (Winnicott, 1959)
Containment (Bion, 1965)
Families in Nature, Montreal
SOCIAL WORK WITH NEWCOMER PNS
Familles en Nature: 4 saisons de plaisir
•
•
•
•
•
•
Sensory/geographic orientation
Stress reduction
Interfamilial relationships
Intrafamilial relationships
Cultural bridging
Community networking: Les Amis de la Montagne, Redpath Museum, PROMIS,
Centre Communautaire CDN, CRAPAUD, McGill University, Parcs Canada
Managed urban greenspaces vs. Embedded
within nature: A Cree lens
Chicoutimi, 1996: The Saguenay Flood
• 488 homes destroyed, 16,000 persons evacuated
• 1.5 billion dollars in damage
• 20 persons died
Canada’s Indigenous communities and water contamination
Metal mining regulations: natural bodies of water reclassified into
“tailings impoundment areas” as a dumping grounds for byproducts.
“Claims by industry that they will “return the land we use- including
reclaiming tailing ponds- to a sustainable landscape… replanted with
the same trees and plants and formed into habitat for same species
are clearly greenwashing.”
(Rooney, R. C., Bayley, S. E., & Schindler, D. W. (2012).
Contamination and drinking water
INAC 2002
75% water treatment systems and 70% waste water treatment
systems posed medium to high risk (industrial waste and fertilizer
contamination, high maintenance costs)
CBC news, Oct 2015 headline: “Bad Water: Third World
conditions…”
400 out of 618 Indigenous communities had some kind of water
problem between 2004 and 2014, the longest drinking advisory
continues after 20 years.
Environmental racism
Environmental racism- a disproportionate exposure of marginalized
populations (usually low income, racialized) to environmental toxins or
hazards, pollutants
Justice Rouleau:
"I doubt that anyone can suggest that Phase II of the James Bay
project will not affect both the social and economic future of the
native peoples and will certainly interfere with wildlife and its habitat,
resulting in drastic changes to the traditional way of life."
See Grand Council of the Crees: http://www.gcc.ca/archive/article.php?id=37
Not just an Indigenous problem: Canada pipelines
CBC news:
March 14, 2016
Whapmagoostui Landscape
Nature and healing
Puberty ceremony
Walking out ceremony
John’s healing journey
https://www.facebook.com/Johns-Healing-Journey-186572565036143/?fref=ts
Further reading
Grand Council of the Crees. “The Cree Legal Struggle against the Great Whale Project”
Retrieved March 2016 at http://www.gcc.ca/archive/article.php?id=37
Hordyk, S., Hanley, J., Richard. E. (2015). “Urban Greenspace and the Social Determinants
of Health of Immigrant Families” Health and Place. 34(74-82)
Hordyk, S. R., Dulude, M., & Shem, M. (2015). When nature nurtures children: nature as a
containing and holding space. Children's Geographies, 13(5), 571-588.