Childhood Anaphylaxis The negotiation of public spaces

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Childhood Anaphylaxis The negotiation of public
spaces

• Genevieve Clark (Health Geography)
• School of Geography and Earth Sciences, McMaster

March 17, 2006 3HH3 Geography and Health and
Health Care
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Childhood Anaphylaxis
Outline

• Clinical condition
• Social dimensions
• Implications for Policy
• My dissertation research
• Research gaps and opportunities

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What is Anaphylaxis?
A clinical condition

• Condition triggered by an allergen
• Massive and rapid immune system response
• Involves 2 body systems
• Life-threatening condition
• Theres no cure

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What is Anaphylaxis?
A clinical condition

• Treatable by injecting epinephrine

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Causes
A clinical condition

• Proteins
• Trace amounts
• Asthma is a risk factor
• A growing problem in youth
• 1.5 of children vs. 0.3 of adults
• North America and Australia

Problems Extent
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Respiratory allergy prevalence
Wjst et al. 2005
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Allergy Increase Hypotheses
A clinical condition

• Higher immune sensitivity in some children?
• Cross-sensitization from soy to peanuts?
• Baby lotions containing peanut oil?
• Early Childhood Vaccines?
• a. Peanut protein in breast milk during
  vaccinations
• b. Peanut oil used as an adjuvant in vaccines
• c. Immune system failure from multiple vaccines
• 5. Hygiene hypothesis?

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A social condition
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So, whats it like being allergic?
A social condition
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Living with a life-threatening allergy
A social condition

• Places and spaces matter
• Home is a safe place, everywhere else is
  questionable
• A safe place may not be safe the next time around

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Living with a life-threatening allergy
A social condition

• Psychosocial impacts
• Personality may change
• Anxiety
• Dependency on adults
• Segregation from peers
• Frustration from restrictions

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The Allergic Parent
A social condition

• Psychosocial impacts
• Stress x 4
• Sustained vigilance and anxiety
• Worry about the child fitting in
• Impacts on family cohesion

• Coping Skills
• Becoming an expert and an advocate
• Social support

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Transitioning from home to school
A social condition

• Experienced and better coping skills in the
  school-age years
• New risk factors
• - Lunches
• - Cross-contamination
• - Risky behaviours
• - Inattention
• The child needs cooperation to ensure safety and
  assistance to participate in normal childhood
  activities

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A multi-stakeholder effort
Social condition
A social condition

• Non-allergic parents roles
• Be aware and educated
• Respect allergen-free lunch guidelines
• Educate their children about the risks
• Students roles
• Be aware and educated
• Assist and act responsibly

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A multi-stakeholder effort
A social condition

• School Administrations roles
• Establish and uphold school policies and
  protocols
• Provide emergency training for staff
• Provide educational support
• Teachers roles
• Be trained, educated, and sensitized
• Ensure safety and cleanliness
• Monitor student interactions

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The peanut debate
A societal condition

• A peanut butter sandwich at school is as
  dangerous to my child as a loaded handgun is to
  yours. GM9
• VS.
• If your kid is so sensitive, put them in a
  special environment rather than asking everyone
  else in the world to comply with your needs.
  GM11

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An Anaphylaxis School Policy
Policy Implications

• Sabrinas Law in Ontario
• Goal To manage and minimize childhood
  anaphylaxis via preventive measures and emergency
  planning
• A multi-stakeholder effort
• - Public education
• - Staff training
• - Multi-stakeholder involvement

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A multi-scale investigation of anaphylaxis in the
school setting
Dissertation Research

• Research Questions
• How does anaphylaxis and its risk management
  policies impact the people sharing the school
  environment? Specifically,
• Whats it like being allergic and being labeled
  as such at school?
• How does the condition and the process of
  creating inclusive spaces impact on others
  sharing the school environment?

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Specific Objectives
Dissertation Research

• To explore respective perspectives of school
  stakeholders and how they interact.
• To understand the social and psychosocial impacts
  of anaphylaxis AND anaphylaxis policies
• To identify the differences between legislated
  and non-legislated spaces

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Multi-disciplinary lens
Dissertation Research

• Nursing
• Social work
• Sociology
• Childrens geographies
• Geographies of disability and chronic illness
• Policy Sciences Framework
• To understand how multiple stakeholder views and
  values interact and organize themselves

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Methodology
Dissertation Research

• Case study
• Ontario Elementary Schools (legislated)
• Quebec Ele. Schools (non-legislated)
• Qualitative methods
• Interviews with
• allergic families (6-9 yrs parents)
• non-allergic parents
• school staff (teaching and non-teaching)

• Document analysis

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Anticipated Contributions
Dissertation Research

• Provide a multi-stakeholder, multi-scale
  perspective on the regime of anaphylaxis
• (clinical condition social constructions)
• Knowledge for policy relevant to anaphylaxis
  prevention, emergency plans, and educational
  resources in schools

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Research opportunities in the geographies of
childhood anaphylaxis

• Spatial analysis Anaphylaxis distribution
• Place Space Lived experiences in different
  social settings, families, and ages
• Scale Influence of social support organizations
  on personal understandings of chronic illness
• Context Influence of different epistemologies on
  shaping the social construction of anaphylaxis

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For funding and research opportunities, visit
AllerGen-nce.ca
Contact info genclark_at_gmail.com