Interrogating play as a strategy to foster child health equity and counteract racism and racialization

KEYWORDS:

• Occupational science
• Racism
• Decolonizing
• Postcolonial
• Feminist
• Play
• Policy

In our 2014 article, ‘A Critical Reframing of Play in Relation to Indigenous Children in Canada,’ we interrogated play in the historical and ongoing settler-colonial context of Canada by employing postcolonial feminist and Indigenous postcolonial critical theoretical perspectives. From this stance, we advocated for framing play as an occupational determinant of health to draw attention to how this occupation, in the context of Indigenous children in Canada, is shaped by historical, political, cultural, and socio-economic factors. Moreover, when employed uncritically in occupational therapy practice, play can be a site for the inadvertent reproduction of stigmatizing, racialized, and colonial stereotypes of Indigenous children and parenting (Chief Public Health Officer of Canada, 2019).

Although the consensus in the health, social, and biological sciences is clear that ‘race’ is a social construct, not a biological attribute, research continues to show the extent to which persistent assumptions about race as a social category, and racism as a social process, have profoundly harmful effects on health and quality of life (Bailey et al., 2017; Henry et al., 2010; Krieger, 2020; Williams et al., 2019). Systemic and interpersonal forms of racism, and other forms of discrimination, continue to shape the health and well-being of people in Canada and globally, with significant consequences for Indigenous populations (Browne, 2017). Racism and racialization are inter-related social processes that operate to legitimize and reproduce the status quo and systems of power. Racialization refers to a process whereby racial identities are assigned to an individual or population groups based on mistaken assumptions about peoples’ genetic, physical, or biological characteristics, who are then, importantly, treated in accordance with those beliefs or labels (Agnew, 2007; Fanon, 1961). In the field of occupational science, “racialized stereotypes often become so pervasive that they become unquestioned, taken-for-granted truths that influence how various population groups are viewed within society” (Gerlach, 2016, p. 95). As highlighted in our 2014 article, racialized stereotypes can have profound consequences for Indigenous children.

On reflection, our motives for and theorizing in our article are well aligned with growing internationals call to decolonize occupation-focused practice, education, and research in order to advance occupational justice (Adams, 2018; Emery-Whittington, 2018; Magalhães et al., 2019). A review of subsequent citations of our article indicate that our critical theorizing about this taken-for-granted occupation has contributed towards advancing a critical orientation to occupational science (Farias et al., 2016; Gerlach et al., 2017) and a rights-based approach to occupational therapy (Crawford, 2017). Citations also indicate that our article has contributed towards further questioning and broadening how play is conceptualized and used in occupational therapy practice with children (Bundy & Du Toit, 2019; Moore & Lynch, 2018).

In our article, we also critiqued neoliberal public health campaigns in the Canadian context which employ play as a child health promotion strategy, and tacitly assume that all families and children have equitable access to this occupation and share similar views on what constitutes ‘play’. The ongoing politicization of play in Canada, underpinned by assumptions of universality and neutrality, largely fail to attend to the lived realties of Indigenous and non-Indigenous families and children who experience social and structural inequities, including racism and racialization, in their everyday occupations and environments (Giles et al., 2018).

In building on and responding to our original critique, Gerlach and colleagues (2019) undertook research to examine and disrupt a decontextualized public health discourse that promotes ‘risky’ outdoor play (Brussoni et al., 2015). Findings from this community-engaged study in a structurally-marginalized urban neighborhood in Western Canada highlight how children’s play in this community is significantly constrained by multifaceted factors, including opioid and housing crises, the downstream effects of socioeconomic disadvantages on children’s play and recreational opportunities, and unkempt and unsafe public play spaces. These social and structural factors expose children in this neighborhood to real risks when playing outdoors and create parental concerns to the extent that many children do not have any unsupervised outdoor play.

For parents raising children in often-socially difficult circumstances, ‘risk’ can also be associated with increased involvement with the child protection system. Notably, parents in this study, who were already under surveillance by this system, expressed their reluctance to let their children play in local parks or school playgrounds after hours for fear that something would happen to them; resulting in further intervention by the state (Gerlach et al., 2019). These findings highlight the importance of occupational science researchers and occupational therapists taking the time to spend time in communities and with families so that they develop a nuanced understanding of the contextually embedded nature of play in families and children’s everyday lives. Further critically-informed research is needed to continue to challenge how play can, albeit inadvertently, act as a site of oppression and ‘reproduction of the social order’ (Angell, 2012). This research needs to be grounded in the perspectives and lived experiences of families, children, and youth who experience systemic and interpersonal racism, and other forms of discrimination, and the effects of health and social inequities in their everyday lives.

The primary author, Dr. Alison Gerlach, welcomes dialogue on the original article or this commentary and can be contacted at: [email protected]

Disclosure Statement

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