Martine Shareck

ISECN Researcher Spotlight

Martine is a 4th year PhD Candidate in Public Health, specializing in Health Promotion. She studies at the Université de Montréal and is also affiliated with the Institut de Recherche en Santé Publique de l’Université de Montréal (IRSPUM), the Léa Roback Research Center on Social Inequalities in Health, and the Centre de Recherche du CHUM (CRCHUM)

Could you give a brief sketch of what your current project is and how you started it? What encouraged you to get involved in research in this area?

My doctoral research project stems from a large study on neighbourhood effects on social inequalities in smoking among young adults in Montreal (the ISIS study). When I was reviewing the literature and trying to figure out what my own specific research topic could be, I kept on coming back to a single question that really bothered me: what exactly does “neighbourhood” mean? (As if not enough people had already tried to answer this!) I realized that although “neighbourhood effects” on social inequalities in health, in general, and in smoking as well, are widely acknowledged, we could use more research to better define what “neighbourhoods” actually refer to in different contexts. More specifically, my review of the literature suggested that most neighbourhood studies generally focus on exposure to a single, mainly residential, location. However, individuals are mobile and experience other health-influencing environments (such as education or work places, among others), a concept known as their activity space. Some researchers are increasingly suggesting that we should move beyond the “residential trap” and evaluate whether people’s activity space is a more valid representation of the environments, or “neighbourhoods,” they are exposed to and influence their health. It is in this context that I will be comparing exposure to environmental conditions thought to influence social inequalities in smoking measured at two different scales: the residential and activity space scales.

During the time that you began your project until now, how have your views of your target population of young adults changed?

I have come to find young adults, my target population, a fascinating group to study. Young adults (18 to 25 year-olds) are typically not widely studied as a group and many more studies can be found on youth and adolescents as a group, or on adults in general (usually 25 year-olds and up). I am starting to understand part of why this is so: young adulthood is a transition period during which many health determinants, including social determinants, are not yet established. This makes for an even more challenging research project!

What major challenges throughout the project have you faced?

The most important challenge I, and the entire research team, faced was to get the project funded and up and running. After almost 4 years, we have just recently started collecting the data which is very exciting! It is always quite difficult to deal with uncertainties along the research process, but I have learned to stay flexible and adapt to changing situations. Another challenge was to develop an activity space questionnaire starting (almost) from scratch. Not many studies have collected data on people’s activity space using questionnaires that can be administered to large groups of people, so I did not have extensive examples upon which to base the development of my own questionnaire.

Can you discuss some of your major discoveries?

Since I do not have my own primary data yet, I have started working with secondary data, which come from an Origin-Destination travel survey and Census data. Preliminary data analyses suggest that accounting for individual mobility between non-residential activity locations, such as work or study places, reduces the social inequalities observed in environmental exposures, such as exposure to social and material deprivation or unhealthy features of the physical environment, measured at the residential neighbourhood level.

How do you see your research impacting the lives of those impacted by your research? How do you see your work impacting the field of health promotion?

By the tradition of choosing to exclusively focus on the residential neighbourhood as providing health-influencing exposures, we might be diverting our attention from other health-relevant life environments which could be good targets for health promotion programs. I hope that by including a focus on activity spaces, my research will help nuance existing research on neighbourhoods and social inequalities in smoking or health more generally.

I believe my research project can impact the field of health promotion by adding to the body of knowledge concerning the creation of supportive environments for health. We are increasingly interested in identifying and acting upon health-promoting features encountered in daily life. I hope my research can help clarify whether taking into account multiple life settings when studying the environment’s impact on health and health behaviours adds something to the equation, or not.

What are your plans for future work?

In the future, I hope to pursue my research on healthy environments and settings and to touch upon issues related to environmental change, food security, and global health. Apart from this, I also love yoga, photography and travelling. I hope to have more time to do all of these once my thesis is done!

You can contact Martine or visit her webpage if you are interested in learning more about her work: Email: martine.shareck@umontreal.ca OR Website: www.martineshareck.weebly.com

Published: January 2012

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Martine Shareck est une candidate de 4e année au PhD en santé publique (option promotion de la santé) à l’Université de Montréal. Elle est également affiliée à l’Institut de recherche en santé publique de l’Université de Montréal (IRSPUM), au Centre de recherche sur les inégalités de santé Léa-Roback ainsi qu’au Centre de recherche du CHUM (CRCHUM). En dehors de ses intérêts académiques, Martine aime le yoga, la photographie et le voyage.

Son projet de thèse s’imbrique dans une grande étude examinant les effets des quartiers sur les inégalités sociales liées au tabagisme auprès des jeunes adultes de Montréal (l’étude ISIS). En effectuant une revue de littérature dans ce domaine, Martine s’aperçoit qu’elle revient toujours à cette même question : qu’est-ce qu’un quartier? Elle remarque alors que bien que les effets des quartiers sur les inégalités sociales de santé et le tabagisme sont bien documentés, d’autres efforts sont nécessaires afin de définir le concept de quartier. De façon plus spécifique, sa revue de littérature suggère que les études s’intéressant aux quartiers se concentrent généralement sur l’exposition unique au lieu de résidence. Toutefois, les individus sont mobiles et font l’expérience de plusieurs autres environnements (environnements de travail, d’étude, etc.) qui ont des impacts sur leur santé. On peut penser ce phénomène comme un espace d’activité. Plusieurs chercheurs suggèrent qu’il faut éviter le piège résidentiel et évaluer si les espaces d’activités constituent une représentation plus valide des environnements auxquels les individus sont exposés. C’est dans ce contexte que Martine se propose de comparer l’effet des conditions environnementales mesurées à deux niveaux, à l’échelle de la résidence et de l’espace d’activité, sur les inégalités sociales liées au tabagisme.

Un des principaux défis auquel Martine a du faire face durant son doctorat a été d’obtenir du financement pour démarrer le projet. Après 4 ans, ce n’est que récemment que la collecte de données a pu débuter. Martine remarque qu’il est toujours difficile de jongler avec l’incertitude au cours du processus de la recherche, mais qu’elle a appris à rester flexible et à s’adapter à des situations changeantes.

Les résultats préliminaires de Martine suggèrent que tenir compte de la mobilité des individus entre des destinations non résidentielles permet de réduire les inégalités sociales observées dans les expositions environnementales mesurées au niveau des quartiers résidentiels. Elle espère que les résultats de son étude permettront de nuancer les recherches existantes sur l’effet des quartiers sur les inégalités sociales de santé. Il est possible qu’en se concentrant uniquement sur les environnements résidentiels, nous passons à côté d’autres environnements pertinents qui ont également des effets sur la santé et qui pourraient être ciblés par les efforts de promotion de la santé.

Dans le futur, Martine souhaite poursuivre ses recherches sur les environnements sains et étendre son expertise aux changements environnementaux, ainsi qu’à la sécurité alimentaire internationale.

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