Language, gender and generation the social economy approach to health and the case of Estrie's English-speaking communities.

摘要

This study uses the case of Quebec's aging minority language communities living in the rural Estrie region as an occasion to think through the social economy approach to health widely implemented in recent years. Evidence gathered using qualitative and quantitative methods reveals the intersection of language, gender and generation to be a critical, yet largely neglected, indicator of the state of community---based care and associated health outcomes.;This claim is supported by the observation of excessively high levels of high intensity unpaid care by the women of middle and low-income minority language households; narrowing social support networks; intergenerational decline in the volunteer labor force of community-based organizations; the decreased capacity of households to pay for the increasingly mandatory solution of private care services; and the increased fragmentation of this group as participants in the new "partnership" arrangement between public health institutions and local communities. The extent to which the benefits of the social economy model rely upon the presence of the middle-generation, middle-income professional group notably reduced among this "left behind" minority population is underlined as contributing to the decline of their health status.;The study claims that even as Estrie's minority language communities hold community as a cherished value and demonstrate a long-standing history of exemplary community capacity, they have experienced the decline of their position with respect to key determinants of health during Quebec's era of third-sector development. While high levels of voluntarism and civic engagement, a history of reliance on community-based organizations and a tradition of unpaid family care for vulnerable groups suggests an ideal cultural fit, social policy promoting "community development" as a strategy towards improved health in fact undermines community in this instance and in so doing is itself a health risk.