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Home arrow Geography arrow Global Perspectives on Human Capital in Early Childhood Education: Reconceptualizing Theory, Policy, and Practice


Case Study: Sunny Acres Backstretch

Theories are abstractions that are often difficult to understand. In order to consider the value and force of the explanations providing divergent viewpoints, let us consider an early childhood case scenario created for a peer-education public health curriculum. Public Health 101 (Murray, Angeloponlos, Bloyd, Clark, Durica, Isfan, Porter, & Zanoni, 2012) was created by the Cook County Department of Public Health to enable all levels of staff to learn from each other about particular populations and conditions with a mission to understand and address health equity to maximize health and wellness for all. The case study we will consider in a sequence of extracts is called Sunny Acres Backstrech and describes the health conditions of a young family of immigrant animal-care workers that live and work at a horse racetrack (Opacich & Lizer, 2007).

The backstrech of a horse-racing track is the area of the stables and grounds where animals are fed, walked, and bathed and where the animal caregivers live. This family is a composite of many specific families presented here as a case for the public health workers to consider for their thought and action; all the names are pseudonyms and do not reflect a particular family. The approach will be to consider the story of Maria Ramos and her sons from the view of public health actors within a public system of health support and care. It could equally apply to early childhood educators and programs. I use the lenses of Foucault, Gramsci, and Bakhtin to ask questions or to reflect on the individual, public, and private stakes, agency, and actions in the lives of Maria Ramos, her sons Luis and Danny, and Mae, the public health nurse based upon their currere of lived experience.

Maria Ramos, age 21 works as a seasonal migrant worker at the Sunny Acres Racetrack. She lives with her two sons Luis, age 5 months and Danny age 4. Maria’s mother Rosa came to live with them to help take care of the children. Baby Luis was born five weeks premature at the John H. Stroger Jr. Hospital in Illinois.

Knowing, doing, and being are all part of Maria’s life; she is a mother of two young boys, both of whom are experiencing early childhood with her. She is working at the racetrack as a seasonal migrant worker earning a living to support her family. In mothering her children Maria uses social resources and solidarity that shows the positive aspects of Gramsci’s social bonding. Her activity may be a way for her to provide for her family and learn how to raise two boys. It will depend upon how Maria is positioned and if she may have success in what Gramsci called the “war of position” where she may demonstrate a lifeworld that shows how she can organize resources to support herself and her family. Through this possibility, Maria is also forming her own self-regulating knowledge about work and motherhood following Foucault. In listening to the voice of Rosa about how to care for and raise her boys, she is also developing her identity supported by Bakhtin’s notions of dialogue.

One surveillance system in the state of Illinois is a perinatal tracking system for high risk infants. It is called the Adverse Pregnancy Outcome Reporting System or APORS for short. When an infant is born with a complex medical diagnosis, the neonatal unit of the hospital is required to report the birth to the Illinois Department of Public Health (IDPH) Division of Epidemiological Studies. The program links the infant with a public health nurse and offers home visits for two years. During the two years, the mother, the infant, and the nurse work together to help the infant get a good start in life.

Luis has been identified by Illinois public health officials as a high- risk infant. This medical identity has many impacts for him and Maria. His identity resonates with public health workers who are trained to recognize how the risks to children result in developmental challenges documented through epidemiology. The scene is painted in hopes that the public health workers will see the writing on the wall. There are high stakes for Maria, Luis, and Mae based upon potential risk factors countered by potential resources offered to the family. Depending on how this narrative is theorized, it could be seen in a number of different ways.

One could look at this narrative using the framework of govern- mentality. Two years of home visits are offered to, and not expected from the family. Through the voices of both Rosa and Mae, Maria may take on practices of self-regulation to enable her to meet Luis’s emerging needs and possible challenges to his growth. The public health nurse may develop a relationship where she and Rosa could engage in Gramsci’s praxis, learning practices, and knowledge to maximize Luis’s development and possibly overcome the initial challenges of Luis’s premature birth.

The critical theoretical insights provided by Gramsci and others can give directions for interpreting social practice. Cultural humility will come into play since trust may predict the success of the relationship that Maria and Rosa form with the public heath nurse with consequences for Luis (Tervalon & Murray-Garda, 1998). Maria and Rosa could also potentially view these home visits as a form of disciplinary enforcement and intrusion from the government in their lives, and they may not be familiar with these nurses and what they may offer to them and their children.

Maria may also use the distance and self-inquiry of governmen- tality to hold Mae and her offers at bay for considering actions and responses. Maria may be judged negatively by other workers or her employer and be a suspect for bringing outsider eyes and ears into the backstretch world. An equally viable alternative is for Maria to consider what Mae has to offer but refuse due to the fear of social sanctions outweighing the potential benefits of her relationship. Foucault’s governmentality allow us to see that what may be viewed from a middle-class perspective as being positive help may also be seen as unwelcome intrusion by working class.

The last sentence is very telling: the mother is offered a primary role to be engaged with resources and practices so her infant could “have a good start on life.” The scenario projects that Maria will use the practices that she developed caring for Luis with the coaching of the nurse. Mae is seen as getting to know Maria and her family to provide her support to develop her own forms of self-regulation, also suspending middle-class expectations for the position of a young mother with two children.

The hospital sent mandatory paperwork on baby Luis to IDPH’s APORS program. The State forwarded the paperwork to Cook County Public Health Department. Public health nurse Mae Finder received the paperwork and made a courtesy phone call to Maria to inquire if she was interested in follow-up home visits as part of the APORS program. Maria was interested in the program. The day of the home visit Maria met Nurse Finder at the main gate of Sunny Acres Racetrack.

As they were walking to Maria’s dorm room they passed the communal shower area where Maria stopped and introduced her mother Rosa who was washing the family dishes in the bathroom sink. Maria explained that some units have showers but they did not have one. They shared the communal shower/bathroom with 13 other families in the building. They wash their dishes and soiled hands and sometimes clothing in the communal sinks.

We can only imagine the contrast between the gate of the racetrack and the backstretch where the dorms and showers are. Maria in her role as mother is presenting her family to Mae who is observing how they are performing their activities of daily living. These are their common practices given what they are offered. The primary intent of this description is not only to see if the public health workers can spot the potential cross contamination in a nonjudgmental way, but is also presented as an opening for public health workers to generate ideas about possibilities for Maria’s self-regulation. The conditions Maria has to live in and her proximity to horse stalls blurs the distinction between the way she lives and the way the animals live. While these practices may be commonplace in rural settings, there is a shock value here for conditions in the backstretch. The curriculum provides a gap here that the public health workers can project into to see how they can construct both knowing and doing to support Maria to create a self-regulating rationale for having her family experience these conditions and impact the early childhood experiences of both Luis and Danny. The meeting of Maria and Mae is opening a window to both possibility and fear based on how we interpret the actions and actors here.

On entering Maria’s unit the nurse noticed that Baby Luis was sleeping on his stomach in a crib placed in front of a window. The cord for the blinds was touching the crib. The ceiling paint over the crib was peeling. There was an aroma of cooked beans in the room. Beans were bubbling in a Mexican clay bean pot on a portable burner. Maria showed the nurse baby Luis’s immunization record. He was missing his two-month immunizations.

As we enter Maria’s home public health workers see a picture of both comfort and danger. There is comfort in the infant sleeping with the smell of nourishing beans filling the air. Maria and Rosa acted to provide for the two young boys and themselves. Maria was resourceful enough to have a portable burner, making a kitchen in her sleeping unit, and having the immunization record available for inspection. Public health workers have to project themselves into the mind and agency of Mae to discuss how she will document, communicate, and provide resources to Maria and Rosa. Immediate actions need to take place to prevent potential long-term negative consequences through this critical early childhood period to both Luis and Danny. How they consider their course of action and how they approach the family can be influenced by the theoretical views here. The challenges relate to how much the public health actors will allow the family to reflect and consider alternative conditions and practices and how they work to solve or resolve conditions that may pose risk to developing children.

Two months later Nurse Finder received a report from the state Lead program. Danny, Maria’s four year old son had a lead level of 20pg/dl, twice the level at which the CDC recommends public health actions be initiated. On a return visit the family had left Sunny Acres Backstretch.

While we have not heard much about Danny, our fears for his health are confirmed. Lead is a major neurotoxin and can significantly negatively impact children’s cognitive abilities. We do not know how Danny was assessed for this lead exposure, but it is understandable given the conditions described that he may be exposed to lead. With these results we can imagine that Danny’s life may be forever changed given his early childhood exposure to lead. Mae is motivated to renew her contact with Maria and her family.

The final sentence is chilling in its inevitability. We simply learn that Maria and her family, being migrants, have left Sunny Acres. We are left wondering what may have happened to Maria and Rosa, but especially to Luis and Danny. Through the being and doing of both Maria and Mae there may have been an impact on their knowing and future self-regulation. Mae is left with considering her actions for other families and children at Sunny Acres—other families who are living and acting in that setting with the potential for similar impacts on their children’s early childhood experiences. The silence is an apo- ria that stimulates our use of social theory to describe and analyze the discourses that construct the contemporary social experience of early childhood and to offer alternatives and possibilities.

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