LAUSR

Objectives The association between social status and health is well established, but the psychosocial factors and mechanisms underlying this association are not fully understood. This study aims to identify and describe social and psychosocial factors that may harm the health of low-income adults. Design Participatory qualitative research using a problem-posing method based on Freire’s pedagogy. Setting Community organisation in a low-income district in the metropolitan area of Montreal, in the province of Quebec, Canada. Participants Eight low-income adults using food bank services provided by the community organisation. Participants had to reside in the community organisation’s service area, have insufficient income to cover living expenses, be aged 18 years or older, and be able to participate in group sessions. Methods Eight weekly group sessions (average of 2.5 hours per session) were held using problem-posing method, which included activities such as presentation of representative stories or images and role-playing. Five additional sessions were held for thematic data analysis with participants. Results A main factor identified as harming the health of participants was the dissonance between perceived current circumstances and the ideal of circumstances conceived early in life. This dissonance follows a loss or a failure to achieve the ideal of circumstances and generates profound malaise. Other main factors identified were the current circumstances as a social trap and the lack of love and support from an early age. Conclusions This study identifies a new psychosocial factor, namely, the dissonance between perceived current circumstances and the ideal of circumstances conceived early in life. Larger studies should examine the influence of this factor on health.