Making health public: a philosophy café in a disadvantaged neighbourhood.

Community Based Participatory Research (CBPR) provides important insights in how to mobilize a community for health promotion. This article explores the possibilities for shifting the frame from community to publics for building new forms of public health engagement in disadvantaged neighbourhoods. We present the results of an ethnographic research project on health and resilience in three low-income neighbourhoods in Maastricht, the Netherlands. In the context of a broader University-Citizens collaboration, citizens and researchers organized a monthly philosophy café to discuss subjects related to health and wellbeing. We analyse this in terms of public building and argue that shifting the perspective from community to publics strengthens the emancipatory tradition within CBPR. By creating an open setting, accommodating diversity and disagreements between its participants, the philosophy café constituted a local epistemic public, generating knowledge on health and wellbeing in disadvantaged neighbourhoods.

In this article, we present an analysis of how researchers and citizens in low-income neighbourhoods collaborated to improve health and resilience. Citizens and researchers together organized a monthly philosophy café to discuss subjects related to health and wellbeing. We analyse the philosophy café as the activities of a public rather than a community. The philosophy café was set up as an open setting in which strangers could meet and exchange ideas and experiences. This resulted in lively exchanges and disagreements on what a good life entails. By presenting the philosophy café as a local public, our paper stresses the desire of neighbourhood inhabitants to meet strangers and exchange ideas, rather than to form close attachments to a neighbourhood community.

Clean Spaces, Community Building, and Urban Stage: the Coproduction of Health and Parks in Low-Income Neighborhoods.

Green zones are potential contributors to health by mitigating disparities between low- and high-income neighborhoods. Against the background of different discourses about city parks-parks as restorative environments, parks as enabling places, and parks as sites for encounters between strangers-we ethnographically studied the coproduction of green spaces and health within low-income neighborhoods. We found three competing notions of urban green, each tied to different notions of neighborhood well-being. Parks as "clean spaces" create expectations of order and peace; parks as places of the community are related to play and activities; and parks as urban stage foster interactions between strangers. By generating experiences that encompass different conceptions of health, citizen-led events can contribute to a shift in the understanding of parks as sites of neighborhood decline to parks as places of hope and new beginnings.

Overcoming the tragedy of urban commons. Collective practices for a healthy city ecology in disadvantaged neighborhoods.

This paper provides insight into collective practices for promoting a healthy city ecology in disadvantaged neighborhoods. Using ethnography, we analyze the actions of a citizen collective to improve a park as 'urban commoning' and 'placemaking.' The analysis shows that first, the collective received ambivalent bureaucratic support; second, the open character of space commons enabled collective responsibility and democratic publics, but also made them vulnerable; and third, in providing informal security, the collective restrained itself to avoid stigma and retaliation. We conclude that open commons enable collective responsibility, but in disadvantaged city areas, they suffer from ongoing bureaucratic governance and accumulations of adversity.

Constructing democratic participation in welfare transitions: An analysis of narrative interactions.

OBJECTIVE: This article provides insights into the democratic character of local enactments of welfare reforms by analysing narrative interactions about changes in care. We analyse processes of storytelling that are part of the interactions between citizens giving, receiving and organizing care and the policymakers governing welfare reforms. We also study how narrative interactions shape understandings about changing care practices and what types of narrative interactions support democracy in care. BACKGROUND: Stories about recent welfare reforms include messages about citizens' care, citizen participation, citizens' powers and revitalization of democracy. However, researchers have cast doubt on their emancipatory and democratic character. RESEARCH SETTING AND METHODOLOGY: We conducted research of four initiatives and municipal policy settings in the city of Maastricht that organized social care in lifeworlds connected to arts, crafts, farming and entrepreneurship during welfare reforms. Using narrative ethnography, we analyse narrative interactions between the master narrative of welfare reforms about 'lifeworld care' and 'citizen powers', and small stories told by participants in new care practices. RESULTS: We identified two types of narrative interaction: idealizing and pragmatizing. Idealizing narrative interactions were strategic for care initiatives in finding support and for policymakers in proving that a so-called 'participation society' works. Pragmatizing narrative interactions gave expression to insights into the everyday practices of social care experiments and included a greater variety of stories. CONCLUSIONS: We conclude that pragmatizing narrative interactions adjust the master narrative about welfare reforms and replace ideals of independency with ideals of active participation in webs of dependency and care.

The making of new care spaces. How micropublic places mediate inclusion and exclusion in a Dutch city.

This paper provides insight into strategies used by social care initiatives to create caring environments for people with a variety of abilities and disabilities. The analysis is guided by the concept of 'micropublic places' and builds on research about changing spaces of care and three types of spatial, symbolic and public-private boundary logics. Using ethnographic methods, we map three hybridization strategies that challenged spatial separations of functions, professional diagnostic labels, and public-private distinctions While these hybridization strategies have been analyzed separately in literature about specific vulnerable groups like psychiatric patients, this analysis shows how they combined to form new spaces of care.

Engaging cultural resources to promote mental health in Dutch LSES neighborhoods: study of a community-based participatory media project.

Community-based participatory media projects form a promising new strategy for mental health promotion that can help address the mental health-gap identified by the World Health Organization. (2008b) mhGAP, Mental Health Gap Action Programme: Scaling Up Care for Mental, Neurological and Substance Use Disorders. World Health Organization, Geneva. In this article we present an ethnographic study about a participatory media project that was developed to promote mental health in selected Dutch low socio-economic status neighborhoods. Through narrowcastings (group film viewings), participant observation and interviews we mapped the ways in which the media project effected and facilitated the collective sense-making process of the audience with regard to sources of stress impacting mental health and opportunities for action. These determinants of mental health are shaped by cultural dimensions, since the cultural context shapes everyday experiences of stress as well as the resources and skills to manage them. Our analysis shows that the media project engaged cultural resources to challenge stressful social scripts. We conclude that more attention should be paid to cultural narratives in a community to understand how health promotion strategies can support social resilience.

Making sense of risk. Donor risk communication in families considering living liver donation to a child.

This paper contributes to the growing line of thought in bioethics that respect for autonomy should not be equated to the facilitation of individualistic self determination through standard requirements of informed consent in all healthcare contexts. The paper describes how in the context of donation for living related liver transplantation (LRLT) meaningful, responsible decision making is often embedded within family processes and its negotiation. We suggest that good donor risk communication in families promote "conscientious autonomy" and "reflective trust". From this, the paper offers the suggestion that transplant teams and other relevant professionals have to broaden their role and responsibility for risk communication beyond proper disclosure by addressing the impact of varied psychosocial conditions on risk interpretation and assessment for potential donors and family stakeholders. In conclusion, we suggest further research questions on how professional responsibility and role-taking in risk communication should be morally understood.