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The implications of the COVID 19 pandemic signal both tragedy and possibility. This reflective paper considers the amplification of the concurrent pandemics of violence against women and children and anti-black racism during the responses to COVID 19 and renewed calls to action. The enforced 'pause' as a result of social isolation or distancing measures in response to COVID-19, has led many people to re-imagine a different world and ignited social movements across the globe. Education must inspire a vision of what our world could be and define what action is needed and the steps required to implement change. The critical reflection that characterizes most social work educational programs can provide opportunities to harness such imaginings in redefining 'the possible' in the quest for a more equitable and safer world. This article describes the potential of the pandemic to subvert the pervasive influence of neoliberalism by promoting collective notions of care.

This article will profile the innovative community engagement process initiated by the "Be the Peace, Make a Change" project to end gender-based violence in Lunenburg County, Nova Scotia, and conclude with lessons learned. These lessons were summarized as "headlines" to imagine a future with new narratives for interpersonal relationships. This project was a three-year grassroots initiative of Second Story Women's Centre, funded by Status of Women Canada. It engaged the rural communities of Lunenburg County to develop a coordinated response to violence against women and girls. It focused on the engagement of all genders, youth, and adults in exploring and implementing the visions, hopes and actions identified as priorities by the community within a peacebuilding framework. Community was broadly defined to include: survivors of relationship violence; professional service providers in healthcare, community services, policing and justice; municipal and provincial government; community-based services; educators and schools; clergy; and any interested citizens. The need to alter the cultural and social roots that sustain violence was recognized. A focus on building trusting partnerships both locally and provincially, inclusion of men and boys, engaging schools and youth and the justice systems, as well as survivors were hallmarks of the project.

Purpose
The purpose of this paper is to discuss the opportunities for future organizational and leadership research presented by positioning dialogue related to the #MeToo movement within a peacebuilding agenda. The #MeToo movement raised public consciousness about the pervasiveness of sexual assault and harassment in schools, workplaces and other institutions by an international social media campaign. However, subsequent discussions are often charged with hostility and outrage that result in divisiveness within workplaces and other settings that can further silence about these issues. The authors argue a community peacebuilding framework can create space to have difficult conversations to further the efforts of the #MeToo movement.


Design/methodology/approach
The authors will discuss the implications of a peacebuilding framework by the discussion of a case study in a rural setting to highlight the ways in which community conversations necessary to further the goals of the #MeToo movement.


Findings
A grassroots community peacebuilding framework can present opportunities for victims, offenders, family members and the community to voice expressions harms experienced and to enable processes of accountability. Promotion of a positive relational peace includes opportunities for education, skill development and conflict resolution that are healing and transformative for individuals and communities.


Research limitations/implications
The systemic social and cultural change required to prevent sexual harassment and sexual assault must happen within face-to-face relationships within community dialogue.


Practical implications
The authors argue a critical relational peace lens offers an emancipatory framework that can initiate change from the bottom up to facilitate social healing and further the efforts of the #MeToo movement.


Social implications
Grassroots peacebuilding invites a relational peace established by dialogue within communities. This dialogue is often not easy but is recognized as essential to establishing trust, resolving conflict and fostering community integrity.


Originality/value
In this paper, the authors offer a community peacebuilding framework to provide skill development and a vision necessary to host difficult conversations to inform the next wave of the #MeToo movement.

BACKGROUND: In the province of Québec, video lottery terminal (VLT) gambling has proliferated under government control since 1993. The aims of this study were to describe the spatial distribution of video lottery terminals (VLTs) in the municipalities of Montréal and Laval and to identify neighbourhood socio-economic conditions associated with their distribution. METHOD: Locations of all establishments holding VLT licences in Montréal and Laval (n=834) were geocoded by their street address. Boroughs (n=49) were characterized by socio-economic indicators (unemployment, educational attainment, lone parenthood), a neighbourhood distress index, and measures of VLT prevalence, VLT adoption and VLT density. RESULTS: VLT prevalence, adoption and density were strongly correlated (p<0.01) with lower borough socio-economic conditions. Although liquor establishments were also more likely to be located in poorer neighbourhoods, the adoption rate of VLT licences by bars in poorer neighbourhoods was systematically higher than in more affluent ones. CONCLUSIONS: The spatial distribution of VLTs in Montréal and Laval closely reflects local geographies of socio-economic disadvantage. Any public health effort to reduce the burden of gambling-related health and social problems must recognize the spatial distortion of gambling opportunities in the urban environment.

Summary Social workers are positioned to respond to clients with a history of trauma by practicing bio-psycho-social, trauma, and violence-informed care but frequently encounter systemic barriers to providing holistic care. The research presented in this article was initiated by a College of Social Work in Canada in response to concerns raised by social work providers that their practice was constrained by ideological, structural, and system limitations within publicly funded mental health and addiction services. Ideologically trauma-based social work care is defined by five principles of safety, trust, collaboration, choice, and empowerment and recognizes that what has happened to individuals, including early adversity, can influence their bio-psycho-social functioning across the lifespan. Structurally, trauma-based care recognizes the corrosive impact of poverty, systemic discrimination, and exclusion. Findings Our research included a literature review, an online survey (n = 115 completed surveys), individual interviews (n = 50), and three focus groups (n = 15). The findings consistently highlighted a dissonance between dominant bio-medical approaches and reliance on the Diagnostic Statistical Manual of Disorders and social justice–based practice. Primary themes included a recognition by social workers of the pervasive presence of trauma and its effects, including mental health and addiction challenges; intergenerational impacts of trauma; the limitations of the medical model; and the need to reposition social work practice. Applications Repositioning the role of social work within mental health and addiction settings to center social justice responses to trauma presents transformative opportunities to better meet the needs of service users and increase workplace satisfaction.

Background: Immigrants to Canada are less likely to report depression compared with the non-immigrant population. This healthy migrant effect has not so far been explained by demographic and socioeconomic determinants of health. Aim: The present study examined whether the psychological health advantage of immigrants varied across Canadian health regions and investigated the hypothesis of immigrant density as a determinant of immigrant mental health advantage. Methods: Data from the 2000—2001 Canadian Community Health Survey were used to build multi-level models estimating variation in depression within and between health regions by immigrant/visible minority status. Results: Immigrant and visible minority residents were less likely to experience depression compared with the general population. Depression varied across health regions and the extent of variation was greater for visible minorities. The likelihood of depression decreased with increasing percentage of immigrants in the region among visible minority participants but not among whites. Conclusions: The protection against depression afforded by immigrant and visible minority status in Canada appears to depend on contextual factors, notably the percentage of immigrants in the region. Future work should seek to better characterize the experiences of visible minorities in different settings.

BackgroundThe impacts of the built environment on health is a widely studied international area of research. One area of research is how urban morphology (e.g. active living environments, also known as neighbourhood walkability) may promote healthy behaviour within a population. However urban morphology and data relating to the built environment varies across different countries.
ObjectivesOne of the challenges in international studies is producing consistent, comparable measures of the built environment, in this case active living environments. As part of a study which compares the impact of neighbourhood environments on health outcomes for patients with type 2 diabetes (T2D), neighbourhood-level measures for walkable environments were derived for Canada and Wales using Geographic Information Systems (GIS).
MethodsUsing method based upon the Canadian Active Living Environments Database (Can-ALE) we created walkability indicators for Wales, UK. We created GIS models using OpenStreetMap and Office for National Statistics (ONS) Open Data to produce walkability metrics for each Lower Layer Super Output Area (LSOA) in Wales for linkage into the SAIL databank. We compared the GIS generated walkability metrics for Wales with those produced for Canada to evaluate whether the GIS methods are internationally transferable in the context of generating walkability indictors and associations with T2D.
FindingsThis work highlights the challenges in creating internationally comparable environmental exposure metrics. The differences in urban morphology and scale in Canada and Wales are significant, however this work demonstrates how with considered methodological choices these differences can be overcome to generate comparable built environment indicators.
ConclusionsThe generation of comparable walkability indicators for the built environment has allowed subsequent analysis into hospital admissions for people living with T2D in Caranda and Wales. This study has wider implications for international research into the impacts of the built environment on population health and are reproducible on future studies.

SummaryThe focus of this scoping review was to understand the overall state of research activity related to pro-arrest, pro-charge, and pro-prosecution policies in Canada. The review identified 295 articles, academic (47.5%) and gray literature (52.5%) published between 1983 and 2018 that reported on these policies as a response to domestic violence in Canada.FindingsThe findings acknowledged growing concerns over the ineffectiveness of these policies as a response to domestic violence. In fact, over half of the articles (57.6%) either failed to support these policies or recommended significant revisions; only a small number of articles (1.0%) favored these policies in their current form. Themes related to the effectiveness of these policies included criminalization and public awareness, survivor satisfaction, standardized police response, removal of burden from survivor to charge, and better than nothing. Themes related to the ineffectiveness included disconnect between policy and practice, revictimizes survivors, one-size fits all approach, have not adequately reduced domestic violence in Canada, lack of understanding training and education for all, failure to address structural and systemic factors, lack of trust in the criminal justice system, and success has been difficult to measure.ApplicationsThe deconstruction of these policies in this review points to the need for future research to address identified gaps in the literature and to explore alternatives that serve their intended emancipatory effect.

IntroductionWhile some comparative work has provided evidence for a universally positive impact of built environment features that promote physical activity, less is known about chronic diseases and hospitalization among different social contexts and health care systems. Parallel international linkage efforts present an opportunity to study health impacts of the built environment.
Objectives and ApproachThis study compares the impact of neighbourhood environments on health outcomes for patients with type 2 diabetes (T2D) in two countries. Neighborhood-level measures for walkable environments were derived for Canada and Wales using Geographic Information Systems. Hospitalization admissions from routine data sources and linked survey data responses (from the Welsh Health Survey and Canadian Community Health Survey) allow for the generation of population-based descriptive statistics on socio-demographic information, self-reported health, diagnostic patterns, and health care use. We examine the feasibility of investigating contextual differences in walkable environments, T2D, and hospitalization between Wales and Canada.
ResultsData linkage in respective privacy protecting safe havens in the Canada Research Data Centre Network (CRDCN) and the Wales Secure Anonymised Information Linkage (SAIL) Databank show promise for a comparative study, enabling parallel modelling of environmental and socio-demographic factors with hospitalization data. Both the Canadian and Welsh surveys ask respondents about their current diabetes status, allowing us to compare hospitalization rates and neighborhood effects of those who report having diabetes with the those who do not. Moreover, the linking of survey responses and similarity in geographic scale permitted consistent measurement of walkable environments across countries. Key administrative variables have been identified relating to health and behaviors, such as socio-demographic information, smoking status, and body mass index, and hospitalization metrics in both countries are commensurable.
Conclusion/ImplicationsThe generation of comparable linked datasets, built environment indicators and comparative research for T2D patients will have wider implications for international assessment of the impacts of environment on chronic diseases, and the hospital burden associated with these conditions.

IntroductionHospital utilization varies across socioeconomic and demographic strata in Canada, which has a universal health care system that grants essential services to everyone. Rates of adverse birth outcomes are known to differ among high and low SES women, but less is known of the excess burden attached to those outcomes across Canadian provinces.
ObjectiveTo examine length of stay for childbirth relative to women's socio-demographic characteristics, in the context of the Canadian universal health care system.
MethodsA population-based record linkage between the Canadian Community Health Survey (CCHS) cycles 3.1 (2005) and 4.1 (2007/8), and the Discharge Abstract Database (DAD) allowed the tracking of hospital utilization for linked survey respondents between 2005 and 2009. Hourly length of stay for delivery was modeled by socio-demographic factors, controlling for other clinical and individual-level characteristics.
ResultsThere were 7,166 complete delivery records from 5,570 female CCHS respondents who agreed to link and share their information. Women with the lowest income had on average, four-hour longer stays for vaginal delivery as compared to high-income women (IRR 1.07, 95% CI 1.02-1.13, p=0.01), and eight-hour longer stays for Caesarian delivery (IRR 1.08, 95% CI 0.95-1.22, p=0.23). A greater proportion of teenage pregnancy was seen for Aboriginal girls. Aboriginal status and rural area of residence were co-determinants of elevated length of stay.
ConclusionThe absence of egregious socio-demographic differences regarding childbirth is reassuring for the Canadian health care system. However, the persistence of marginally longer, and in turn, costlier visits for low-income and rural Aboriginal women is suggestive that policies of cash transfers during the prenatal period might be highly cost-effective if they achieve population-wide reductions in length of stay.