Positive Health and Social Resilience in Postwar Disadvantaged Neighborhoods: An Ethnographic Participatory Study

Dutch Summary Doel van dit project is inzicht verwerven in de dynamiek van burgerparticipatie, integraal beleid, sociale veerkracht en positieve gezondheid in sociaaleconomisch kwetsbare wijken met gezondheidsachterstanden. Het begrip positieve gezondheid verwijst naar de vermogens van mensen zich aan te passen aan chronische ziekte en wisselingen daarin, en zelf de regie te voeren. In dit onderzoek wordt positieve gezondheid gekoppeld aan sociale veerkracht omdat de sociale omgeving een grot rol speelt in zowel de ontwikkeling en het verlies van deze vermogens. Om inzicht te krijgen in de impact van burgerparticipatie en integraal beleid op positieve gezondheid en sociale veerkracht, doen we participatief etnografisch onderzoek in 3 lage inkomensbuurten in Maastricht Noord-West. Op die manier kunnen we zicht krijgen op alledaagse betekenissen en praktijken van positieve gezondheid in LSES buurten. Het onderzoek wordt participatief vormgegeven met burgers, professionals en beleidsmakers. Qua organisatie (buurtplatform in projectgroep, feedback meetings)en methodologie (veldwerk, veel informeel contact) is verzekerd dat het onderzoek niet over de buurt gaat maar van de buurt is. English summary This project aims to theorize, to empirically investigate and to stimulate the dynamics of citizen participation, intersectoral policies, and positive health and social resilience in 3 socio-economically disadvantaged neighborhoods in Maastricht Northwest. The concept positive health refers to the abilities of people to adapt to chronic, fluctuating conditions and to suffering. This concept captures the dynamics of life and health and articulates the agency of people. We will combine the concept positive health with the concept social resilience to assure that we grasp the social embedding and social production of these abilities. It is well known that health promotion as well as citizen participation are not easily achieved in disadvantaged neighborhoods. We will study how, in the three neighborhoods in Maastricht Northwest, a combination of two specific strategies affects social resilience and positive health: 1. citizen participation (running initiatives and new initiatives, for instance initiatives that followed a neighborhood Citizen Summit, that was organized in November 2015) 2. intersectoral policies and intersectoral professional networks (for instance the Social Team to address requests for care and the Community Savety Team) To study how these strategies affect positive health and social resilience we will conduct an in-depth ethnographic participatory research. This means that the research focuses on everyday real life practices of citizen participation, intersectoral policies, and promotion of positive health and social resilience, and the symbolic-narrative meanings of health, neighborhood life, participation and professional work. We do not consider the neighborhood as only a geographical zone, but also as cultural zone, with a narrative biography that mediates current health promotion activities as well as processes of citizen participation. Many studies in LSES communities suffer from problems with reach. Our experiences and relevant literature demonstrate that an ethnographic-participatory methodology is able to overcome problems of 'reach'. Data collection methods consist of field work and participant observation in relevant places and settings (e.g. social care team, safe-neighborhood-project, cooking-club, walking groups, neighborhood platforms cq networks, mosque), informal conversations and ca 30 interviews with inhabitants, professionals, civil servants and policymakers. Besides that we will use photo-voice as a method to elicit the perspectives of citizens, professionals and policy makers on obstacles and resources for positive health and social resilienceL this method is well suited for LSES neighborhoods. Furthermore we will make systematic use of available quantitative data like surveys of the municipality and of the local Public Health Organization, data about primary care services, the social care team etc. The analyzis of the data will be guided by the reserach question and the discourses about the central theoretical concepts, and will provide insights in the question wheher and how strategies of citizen participation and intersectoral work and Health-in-All-Policies help to improve positive health and social resilience in disadvantaged neighbiorhoods. The participatory ethnographic design enables to include different perspectives and narratives. We will discuss the process and the findings regularly, in different ways, with the project team and with people in the neighborhood, and we will organize dialogue about these findings to help articulate and clarify frictions and to find common ground. This way, the research process can inform the local evaluations of how intersectoral policies and citizen participation contribute to positive health and social resilience