Risk as a relational phenomenon: a cross-cultural analysis of parents’ understandings of child food allergy and risk management

Abstract

Western culture can be seen as permeated by risk-consciousness. In particular, parents are under scrutiny in their roles as risk managers. In this article, we address parental experiences of children more at risk than others, children with food allergy, and the management of allergy risk in everyday life. Drawing on a notion of risk as 'situated' in local everyday life, we argue that a further exploration of parental understandings of child food allergy risk would benefit from an analysis of studies across different local contexts. In this article we draw on a secondary qualitative cross-cultural analysis of interview data from several studies of parents in Sweden and Scotland through 2006-10, which focussed on parents' understandings of the nature of food allergy and the children's management of the allergy risk. We found some common themes in the different data sets. First, food allergy was depicted as life-threatening, a 'death risk' lurking in the background, more or less constantly present in different everyday situations, amounting to an existential condition in parenting. Second, food allergy risk was seen as a relational phenomenon, meaning that the risk emerged in the encounter between the young person's individual competence to manage allergy risk and the understandings of allergy risk in others ─ thus depending on contexts and interaction between several actors. These aspects of food allergy were discussed in terms of unpredictability and risk in constant flux, the ways risk and trust were related as well as how the involvement of others could be seen as a risk and a safeguard.

Interventions for caregivers of children with food allergy: A systematic review

“…Some caregivers have stated that the 'invisibility' of the FA can result in others not recognizing the importance of management plans or responding to requested accommodations for the child with hostility (eg accusing parents of being neurotic). 3,5 Parents have reported that these negative social interactions increase anxiety and fear of 'handing over' care to others. 3 Numerous studies have reported that although burdensome, parents often feel safer managing the ever-present threat of anaphylaxis alone.…”

“…In an analysis of parental understanding of allergy risk and management, Stjerna et al found that parents feel the need to manage a 'death risk', which depends both on context and on those who are interacting with their child. 5 As this risk is easier to manage when both aspects are familiar, caregivers may actively avoid uncertain environments, even when the overall risk of fatal anaphylaxis is low. 12 Given these challenges, it is perhaps unsurprising that caregivers regularly report poorer mental health, lower self-confidence and impaired quality of life (QoL).…”

“…Firstly, children are generally asymptomatic in the absence of the allergen. Some caregivers have stated that the ‘invisibility’ of the FA can result in others not recognizing the importance of management plans or responding to requested accommodations for the child with hostility (eg accusing parents of being neurotic) 3,5 . Parents have reported that these negative social interactions increase anxiety and fear of ‘handing over’ care to others 3 .…”

“…Finally, the unpredictability of FA reactions can provoke negative beliefs around ambiguity among parents. In an analysis of parental understanding of allergy risk and management, Stjerna et al found that parents feel the need to manage a ‘death risk’, which depends both on context and on those who are interacting with their child 5 . As this risk is easier to manage when both aspects are familiar, caregivers may actively avoid uncertain environments, even when the overall risk of fatal anaphylaxis is low 12 .…”

Health regulations and social experiences of ‘high-risk’ pregnancies among young working-class women in Brazil

“…These tensions between medical definitions and 'lay' definitions teach us two things in particular. First, the importance of understanding the former in and of themselves as vectors of values and social norms that build labels such as 'high-risk mothers'; second, the need to analyse risk not only in its 'cultural' dimension but also its relational dimension (Stjerna, Worth, Harden, & Lauritzen, 2017). Rather than being rigid, perceptions are constantly updated through interactions.…”