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Jacqueline Cattanach uses an ecological approach to explore links between child development and health and cultural factors.
RESEARCH SUMMARY
* This paper asserts the importance of health visitors understanding the impact of wider health determinants, including social and cultural factors, on health behaviours, in order to improve community engagement, reduce health inequalities and develop practice.
* I t can provide a basis for the unique contribution they can make, as a profession, to the lives of children and families, including marginalised minority groups where reports of reduced cultural awareness can act as a barrier to improved child health outcomes.
* Bronfenbrenner's social-ecological model (Bronfenbrenner, 1977) is used as a framework to explore the link between health behaviours and factors at both person, family and community level.
* The impact of these wider contextual factors is emphasised with a particular focus on Gypsy Traveller families - among the most socially excluded and disadvantaged groups in society, which consistently report higher rates of infant mortality, stillbirth and lower immunisation rates, together with increased levels of hate crime and racial discrimination.
The social ecology concept or 'whole community' approach recognises and considers the wider social, cultural and environmental influences of health and is particularly helpful at understanding the 'person in context'. One example of this method is Bronfenbrenner's ecological model (described in Tudge et al, 2016), which has been used as a framework based on four contextual layers or systems - the individual child's microsystem, the mesosystem of relationships, the exosystem of environmental factors and the macrosystem of the surrounding society and culture.
Each system will now be considered in relation to child development, with a particular focus on Gypsy Traveller children and their families.
MICROSYSTEM: THE CHILD
The microsystem considers the immediate environment, activities and relationships as experienced by the child, including those with parents.
Gypsy Traveller children are highly valued family members and likely to have all their physical care needs met (Stokes, 2009). Moreover, nuclear family structures together with kinship support aids the development of positive attachments and heightened resilience.
However, Cromarty (2019) asserts that new mothers from the Gypsy Traveller community have an increased risk of maternal low mood and heightened anxiety, known to impact directly on the mother-baby bond and attachment. Emerging...