Positionality: Changing Perspectives: How My Experiences Shaped My Approach to Health Promotion
Updated: Sep 21
With over two decades in healthcare, I have seen how personal experiences shape how we perceive and understand our health, healthcare systems, and their impact on communities. While reading this week's resources, I have reflected on this through the lenses of positionality and reflexivity.
The video by UCLA Library (2021) describes positionality as the relationship between where we come from, our identities, our understanding of ourselves, and our relationships with others. Reflecting on my own positionality, I think back to my family's journey to Canada and how those experiences shaped my understanding of health equity, advocacy, and the impact of health literacy.
I am a Jewish immigrant woman raised by immigrant parents. We lived in various diverse communities across the Greater Toronto Area. When we first arrived in Canada, we were considered a lower-income family; my parents worked low-wage jobs and had limited English literacy. Through advancing their education their socioeconomic position improved, and by the 2000s they had built a successful business and supported my older siblings through post-secondary education. As a young child, I didn't fully understand the financial challenges my family faced, and listening to my siblings' experiences taught me that even within the same family, people have different lived experiences.
The experience that shaped me the most was watching my father navigate the healthcare system after his back injury. He didn't understand the language, didn't know what questions to ask, how to advocate for a referral, or who to call. These were real barriers that led to years of pain and years of inability to work. Reflecting on this, I understand that positive health outcomes depend on a person's ability to understand health information, access services, communicate with providers, and advocate for themselves.
During my undergraduate studies in Equity Studies, I learned how my identities as an immigrant and member of a religious minority group shaped my experiences, and I began to recognize parallels in other minority groups. This strengthened my belief that improving health literacy empowers individuals to make informed decisions that lead to better health outcomes.
This week's resources led me to think more about reflexivity in relation to my own positionality. Alexander et al. (2020) describe reflexivity as an ongoing process of examining how our experiences, values, assumptions, and social positions influence how we understand and respond to health issues. The focus on "ongoing" stood out to me as a process of evolution and improvement through reflection, rather than a one-time action. Connecting this to Nixon's (2019) Coin Model of Privilege helped me see my social position differently: as an immigrant and religious minority, limited language and health literacy were real barriers for my family. But our eventual shift in socioeconomic position gave me advantages that many other families and communities do not have. Both positions can be true and build on self-awareness and social impact.
In my experience, health promotion is the cause-and-effect between gaps and actions. Alexander et al. (2020) discuss this in terms of reflection during and after an action, as well as questioning the action taken. In my current role, this framework highlights the importance of learning in the moment, pivoting initiatives as needs change, and critically questioning whether actions were appropriate and what lessons can be learned.
Most importantly, health promotion requires a commitment to examining how my background and experiences shape my perspective, whose voices are prioritized, and how lived experience adds value. In my current role, I put this into practice by building real relationships within the communities I work with and ensuring program decisions are informed by anecdotal, qualitative, and quantitative data.
Alexander, S. A., Jones, C. M., Tremblay, M. C., Beaudet, N., Rod, M. H., & Wright, M. T. (2020). Reflexivity in health promotion: A typology for training . Health Promotion Practice, 21(4), 499-509.
UCLA Library. (2021 March 16). Positionality & research: How our identities shape inquiry. [Video]. YouTube. https://www.youtube.com/watch?v=fTHFud7fr8c
Nixon, S. A. (2019). The coin model of privilege and critical allyship: Implications for health. BMC Public Health, 19(1), 1637. https://doi.org/10.1186/s12889-019-7884-9
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