Becoming the Divas of SUS: the construction of a community of active women in a socially vulnerable context

ABSTRACT

Given the rapid growing number of the ageing population worldwide, it has been questioned how health and wellbeing in old age can be improved, especially for women in socially vulnerable contexts. Research have shown that social aspects are key determinants for older-age groups’ engagement in an active life. It is crucial to understand older people’s experiences with physical activity in order to develop interventions that contribute to health promotion beyond disease prevention. The study’s purpose was to explore the experiences of middle-aged and older socially vulnerable women with physical activity within a public-funded programme under the Sistema Único de Saúde – SUS [Brazilian public healthcare system]. The study involved a Health and Physical Education professional and 16 women (43–66y) who regularly attended the programme. Data were generated through condensed fieldwork, employing semi-structured interviews and non-participant observation of sessions. Drawing on salutogenesis theory and a critical gender perspective, a qualitative analysis was conducted using the constant comparative method. From the women’s experiences, a major finding was the construction of a community of active women, which served as a collective resource to support them in the process of health development. Relating to the emerging community, another three themes were developed. The first was dancing and challenging the gender order, referring to women’s experiences of negotiating a collective identity and disrupting the invisibility of their bodies. The second was the HPE professional’s dialogical pedagogies as emancipatory, revealing the ways in which the community was supported. The third was the empathetic relationships among the women as a way of coping, representing the women’s positive experiences of social support, connectedness and resilience. The findings supported the conclusion that there are promising possibilities for research and practice in socially vulnerable contexts to widen the contributions to health promotion that are not limited to exercise prescription.

KEYWORDS:

• Health promotion
• community-based programmes
• exercise
• gender
• older people

Acknowledgements

The authors would like to acknowledge the valuable contribution of the editor and reviewers to the development of the present article. We also extend our gratitude to the Federal Institute of Education, Science and Technology of South of Minas (IFSULDEMINAS) for allowing the first author's study leave and to the participants of the study who, despite the challenges and recent cuts of funding, have contributed enormously to evolving and defending the SUS public healthcare system.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 The term Health and Physical Education (HPE) professionals is used to refer to health workers whose speciality is physical education (bachelor and/or teacher education degree), whether they are teachers or instructors who work specifically with health-related physical activity in public health settings, such as primary healthcare centres, community-based programmes and others. In Brazil, physical education (PE) refers to the broad field of knowledge and professional practice related to human movement, including formal education and other areas such as sports, leisure and health. As such, HPE professionals training in Brazilian universities has a particular organisation, with two different degrees – teacher education (for working in schools) and bachelor (for working in non-school settings, including public health) – which are combined under a general denomination of PE undergraduate courses (Tani et al., 2020). These courses are currently organised into two stages: a first phase of generic training that is common to all undergraduate students regardless of the type of degree; and a second phase that is specific for each of the two degrees (Brasil, 2018). Thus, Brazilian students apply for a PE undergraduate course and throughout the course they choose to pursue a bachelor or a teacher education degree.

Additional information

Funding

This work was supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES): [grant number 88881.131900/2016-01, Finance Code 001]; São Paulo Research Foundation: [Grant Number 2019/05358-7].