Elsevier

Health & Place

Volume 16, Issue 3, May 2010, Pages 523-530
Health & Place

Culture as a problem in linking material inequality to health: On residential crowding in the Arctic

https://doi.org/10.1016/j.healthplace.2009.12.010Get rights and content

Abstract

Two problems are noted in the process of measuring material inequality and linking it to health across cultural boundaries. First, comparative measurements may be used as the basis for policy making, which ends up disciplining cultural minorities. In this way, policies intended to relieve disparities can actually have the effect of extending the power of the dominant group to define appropriate cultural understanding of the world for the minority group. Second, comparative measurements may inaccurately inform theories of how inequality works to influence health and well-being. To the extent that culture mediates the relationship between inequality and outcomes of interest to researchers, those ignoring cultural differences will fail to adequately assess the impact and significance of material inequality. In this paper we discuss and illustrate these problems with reference to the study and measurement of overcrowding and its effects on health and well-being for Inuit communities in Nunavut, Canada.

Introduction

The documentation of inequality and its consequences is a particularly important task for social researchers. Establishing comparative measurements of material living conditions, especially living conditions understood to be linked to health, is crucial for this task. Comparative measurements create a baseline by which we can document material inequality across various populations. At the same time, comparative measures allow us to test whether evidence supports hypotheses linking material inequalities to social and health outcomes of interest. However, cultural difference presents a real challenge for the judicious application of comparative measures. Culture predisposes people to understand and interact with the material world differently. This creates two problems. First, the application of comparative measurements of material inequality may push policy towards the disciplining of minority communities, extending the power of the dominant culture to define appropriate relationships to the material world. In effect, measures used to gauge material inequality may further promote the cultural marginalization of minorities, both by design and as an unintended consequence of their application. Second, comparative measures often fail to take into account the cultural mediation of relationships between health and material circumstances, resulting in poor theory when they are used in analysis of the determinants of health. Together these problems also suggest that poor health resulting from cultural marginalization may be mistaken as resulting from material inequality.

In this paper, we consider these two problems with reference to two comparative measures of residential overcrowding as developed in the United States and Canada. First we consider how the concepts of residential crowding and overcrowding are meant to reflect objective measures of material circumstances. We discuss two specific measures in depth, detailing how a consideration of culture creates problems in their application. Finally, we provide a case study of the application of overcrowding measures to Inuit communities in the Canadian Arctic, illustrating the problems discussed.

Section snippets

Measuring residential overcrowding

As a concept, residential crowding seems intuitively clear. Residential crowding relates individuals to the other people sharing the spatial environment of their living quarters. High levels of crowding mean that many people share the same, limited set of living quarters. The related concept of residential overcrowding implies that there is a threshold across which residential crowding becomes problematic and somehow pathological, inducing stress, reducing health, or otherwise poisoning the

Problems with measuring residential crowding

Unfortunately, using either PPR or CNOS as a comparative measure of overcrowding creates two problems rooted in the ignorance of culture. First, these measures of crowding can easily be transformed into standards used to discipline minorities into forming proper households, as defined by dominant cultural standards. In particular, apartment managers can and do use crowding standards to set maximum occupancy rules. Households violating maximum occupancy for a unit face the possibility of

Illustration—measuring overcrowding in the Eastern Arctic

In the sections that follow, we attempt to illustrate the problems associated with the comparative measurement of overcrowding as applied to the case of Inuit households in the Eastern Arctic. Methodologically, we draw on data from a variety of sources to understand how policy has been applied in the Eastern Arctic, including fieldwork from over 30 years of visiting the Arctic, qualitative interviews with dozens of policy makers and service providers, and the study of archival materials housed

Discussion

In the foregoing sections, we have illustrated the two problems we see as stemming from the application of comparative measures of inequality without careful consideration of culture. First, comparative measurements may be used as the basis for policy making, which ends up disciplining cultural minorities. Assumptions about proper relationships to the material world arising in one cultural context become applied to the policies governing another. Attempts to educate Inuit in proper hygiene and

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