‘Welfare moms and welfare bums’: Revisiting poverty as a social determinant of health

Abstract

In the last two decades health researchers have paid increasing attention to the social determinants of health and health inequalities. Broadly, two hypotheses attempt to explain health inequalities – the materialist hypothesis and the psychosocial hypothesis. The purpose of this study was to examine the relationship between poverty and women’s health from the perspectives of a group of poor women. Our qualitative study with 20 diverse women on low-income included 32 one-on-one interviews, 15 group meetings, and 30 sets of field notes. We used the analysis program Atlas.ti to sort, code, and conduct a content analysis. Overall, our findings revealed that both hypotheses were deeply connected with the dominant ideology of poverty and the concomitant social construction of ‘welfare bum’ and ‘welfare mom’. Socioeconomic factors limited the women’s access to health promoting resources and influenced their health behaviours (such as what they ate and how much they exercised). Ideologies that promulgated negative stereotypes legitimized the systemic barriers the women faced, enforced their material scarcity, and limited their entitlements to health-promoting services and resources. Our findings also indicated that the stereotype led the women to feel shamed, stressed, and depressed, and to adopt negative health behaviors as a way of coping and finding comfort.

Key Words:

• Women’s health
• health inequalities
• social determinants of health
• poverty
• qualitative research
• sociology