Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
This qualitative action research study explored the potential partnership of OT and social movements that work to end structural poverty. Limited research in OT provides neither an accurate analysis nor an effective intervention strategy for addressing and dismantling the structural causes of poverty in the United States. This research centers the narratives and expertise of social movements to provide an alternate analysis and path to ending structural poverty in the United States.
Primary Author and Speaker: Sabine Adler
Contributing Authors: Melinda Cozzolino, Alicia Swords
PURPOSE: In the United States (US), over 140 million people live in poverty (Institute for Policy Studies, 2018). Current theories of poverty and intervention practices in occupational therapy (OT) focus on individual behavior and health outcomes (Sofo & Wicks, 2017; Farias & Rudman, 2019). Occupational justice (OJ), critical occupational therapy, and social occupational therapy explore the need for an implementation of a structural understanding of poverty in OT practice (Hocking & Townsend, 2015). There is limited research in OT and OJ that provide a practical analysis and intervention strategy for addressing the structural causes of poverty in the United States. The purpose of this study was to explore the potential collaboration between OT and social movements that work to end structural poverty (SMWESP) by determining 1) how OT can contribute to SMWESP and 2) how OT practice can be informed by SMWESP.
DESIGN: This study utilized a qualitative action research design. Participants were recruited through a purposeful and snowball sampling and consisted of one occupational therapist working in a homeless clinic, two social workers involved in the Poor Peoples Campaign (PPC), and a leader of the PPC and Put People First Pennsylvania.
METHOD: Semi-structured in-depth in person or phone interviews were conducted once with each participant. Interview questions were developed with action research principles and multiple rounds of expert input. Data analysis involved several rounds of thematic coding by the primary researcher until themes emerged. Peer debriefing with contributing authors was implemented to strengthen the interpretation of data.
RESULTS: Two major themes emerged, analysis and application of SP, each with 3-4 subthemes. Analysis provides a framework for understanding SP and application describes the actions and practices of addressing SP. In relation to analysis, subthemes consisted of; the system isn’t broken; collaboration; and lived experience. These subthemes create a framework that explains how the current power system in the US is working the way it was designed to and power dynamics need to shift to center the expertise of those most affected by SP. The most significant implication for OT is the understanding that the fundamental mechanisms of the US power system were designed to produce poverty for wealth creation. In relation to application, subthemes consisted of; empowerment; collaboration; political education; and healthcare advocacy. These subthemes suggest actions and practices to address SP need to shift from individual blame and intervention to collective and community engagement led by a network of those most affected by SP. Healthcare advocacy must center the creation of universal healthcare and an end to a profit over people healthcare system, provide education on SP to colleagues and clients, advocate for changes to restrictive and harmful policies, provide health literacy training and programming, as well as become an active ally at community rallies and public forums.
CONCLUSION: The varying perspectives and expertise of the participants in this study suggest a potential shift in existing theories and intervention practices to a structural and collaborative approach to ending SP. This study centers the experience and expertise of those involved with social movements to end structural poverty to provide crucial narratives missing from OT and OJ literature in the US. The potential partnership of occupational therapy and social movements that work to end structural poverty may provide a path to ending structural poverty and achieving occupational justice in the United States.
References
Farias, L., Rudman, D. (2019). Practice analysis: Critical reflexivity on discourses constraining socially transformative occupational therapy practices. British Journal of Occupational Therapy, 82(11), 693–697. https://doi.org/10.1177/0308022619862111
Hocking, C.,Townsend, E. (2015). Driving social change: Occupational therapists’ contributions to occupational justice. World Federation of Occupational Therapists Bulletin, 71(2), 68–71. https://doi.org/10.1179/2056607715Y.0000000002
Institute For Policy Studies. (2018). The Souls of the Poor Folk. Retrieved from: https://www.poorpeoplescampaign.org/wp-content/uploads/2018/04/PPC-Audit-Full-410835a.pdf
Sofo, F., Wicks, A. (2017). An occupational perspective of poverty and poverty reduction. Journal of Occupational Science, 24(2), 244–249. https://doi.org/10.1080/14427591.2017.1314223
