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Evolved Living PodcastOccupational Therapist, occupational scientist & open citizen science advocate co-creating liberatory, ecological, & collaborative solutions beyond institutional systems through art, wisdom & applied science. Author: Dr. Josie Jarvis OT
The Evolved Living Podcast with Dr. Josie Jarvis, PP-OTD, MA-OTR/L, BA, BS Hosted by occupational therapist, occupational scientist, and open citizen science advocate Dr. Josie Jarvis, The Evolved Living Podcast explores how we can bridge art, science, and wisdom to co-create more liberatory, ecological, and collaborative systems of care. Each episode invites critical yet compassionate dialogue across disciplinesconnecting practitioners, educators, researchers, and community members who are working toward holistic, trauma-informed, and life-affirming change. Together, we translate occupational science into real-world practice and collective wellbeing through honest, inclusive, and transformative conversations. josiejarvisot.substack.com Language: en Genres: Life Sciences, Science, Social Sciences Contact email: Get it Feed URL: Get it iTunes ID: Get it |
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Clinical Reflections on Occupational Apartheid: Ethics, Policy, and Systems Change in Occupational Therapy
Tuesday, 17 March, 2026
Why this Occupational Science series mattersIf you are an occupational therapy practitioner in the United States, chances are you are already using occupational science.You just might not have been given the words for it yet.That gap is part of why I created this Occupational Science Alphabet Series — a public learning series designed to make occupational science more accessible and more visible in everyday life and traditional practice settings.This first composite series begins with A for Occupational Apartheid.Recording Timestamps:00:00 “Occupational Apartheid Analysis”06:01 “Occupational Apartheid Challenges”16:11 “Systemic Barriers in OT”18:04 “Enhancing Accessibility through Advocacy”25:20 “Defining Occupational Apartheid”33:06 “Occupation and Systemic Inequality”39:23 “Advocating Equity in OT Practice”45:04 “Occupational Therapy for Healing”48:04 “Advancing Occupational Justice”54:55 “Occupational Ethics Evolution”58:50 “Occupational Apartheid Ethics”01:03:58 “Justice and Veracity”01:10:17 Healthcare Bias and Scientific Integrity01:15:59 “Addressing Maternal Health Disparities”The phrase can feel intense at first.It should.Because it names something real.It gives language to the ways people are systematically denied access to meaningful participation in everyday life — not simply because of individual impairment or diagnosis, but because of how social, economic, political, and cultural systems are organized.And that matters deeply for occupational therapy.Because when we only look at barriers inside individual bodies, we miss the wider context shaping participation.We miss the insurance policy.The school policy.The zoning code.The inaccessible architecture.The transportation gap.The labor condition.The funding cap.Occupational science helps us see those patterns clearly.And once we can see them, we can respond more ethically and more effectively.The Secret of OccupationOne of the most powerful insights of occupational science is that occupation always transcends the individual.Yes — participation includes personal capacity, motivation, and health status.But occupation is also shaped by:environmentculturepolicyhistoryeconomicssocial relationshipsWhen occupational therapists work with clients, we are rarely working with bodies alone.We are working with people in systems.Occupational science simply gives us a language to describe those systems more clearly.Why Occupational Apartheid MattersThe concept of occupational apartheid helps us name situations where social systems restrict access to meaningful participation in everyday life.Frank Kronenberg describes occupational apartheid as:“systematically enacted negations of humanity that divide and subjugate collectives of people to the benefit of some at the expense of others.”(Kronenberg, 2018) These restrictions can occur through intersecting social mechanisms such as:racismclassismsexismableismxenophobiaeconomic inequalityThese forces shape who has access to resources that sustain dignified living.They shape who can participate fully in everyday life.And they show up in everyday occupational therapy practice more often than we might initially realize.When Systems Become HabitOne of the most profound insights connected to occupational apartheid comes from the concept of occupational consciousness, developed by Elelwani Ramugondo.Occupational consciousness invites us to examine how systems of power become embedded in everyday activity.Because the truth is:Systems do not reproduce themselves automatically.They reproduce themselves through what people do every day.Policies become habits.Beliefs become routines.Social hierarchies become normalized through everyday actions.Over time, these patterns become so familiar that they operate below the level of conscious awareness.This is where occupation becomes incredibly important.Occupation is the point where ideas turn into action.And when those actions become automated habits, they can quietly reproduce systems of inequality — even after the laws that created them have been formally abolished.When Systems End but Patterns PersistHistory shows us that oppressive systems rarely disappear completely when policies change.Segregation in the United States was formally dismantled decades ago.Apartheid in South Africa was officially abolished in the 1990s.And yet racial disparities, inequities in access to housing, healthcare, education, and safety persist in both societies today.Why?Because systems do not only exist in policy.They exist in everyday occupations.They exist in patterns of:where people livewho receives serviceswho gets referred to carewhose needs are believedwho feels welcome in public spaceswho has access to transportation, education, and healthcareThese patterns often persist through habits and assumptions that operate subconsciously.Occupational consciousness asks us to notice those patterns.Occupational apartheid helps us name their structural origins.Rehumanizing the Collective After WarAnother important dimension of occupational apartheid is its relevance to collective recovery from war, violence, and social division.Many of the social systems that shape our institutions today were forged in contexts of conflict, colonial expansion, and geopolitical competition. Even when wars formally end, the habits, infrastructures, and relational patterns shaped by those conflicts often remain embedded in everyday life.Occupational apartheid helps illuminate how the aftermath of war can continue to shape participation in subtle ways — through segregation, displacement, institutional distrust, unequal resource distribution, and inherited patterns of fear or exclusion.If left unexamined, these patterns can reproduce division across generations.Occupation is where these patterns are maintained — but it is also where they can be transformed.Through shared activities, community participation, creative practice, caregiving, education, and everyday collaboration, people rebuild relational life.Occupational therapy historically emerged in part from this very context — helping individuals and communities reconstruct meaningful life after the disruptions of war and institutionalization.Engaging with occupational apartheid and occupational consciousness today invites us to continue that tradition.Not by reproducing new forms of division or tribal harm, but by helping cultivate conditions where people can participate in humanizing, compassionate, and sustainable forms of collective life.In this way, occupation becomes a pathway toward healing.Not only individual healing.But collective healing.Occupation as a Tool for LiberationIf occupation can reproduce systems of injustice, it can also help dismantle them.Because occupation is also the place where change becomes possible.When we change everyday patterns of doing, we change systems.This is why occupational therapy has always been connected to movements for human dignity and social participation.From the moral treatment movement to disability rights advocacy, occupational therapy has been concerned with helping people return to meaningful life within their communities.Occupational science expands that mission.It invites us to see how everyday activities can either reinforce systems of harm or help create environments where people can live with dignity, belonging, and agency.Why This Perspective Strengthens Occupational TherapyUnderstanding occupational apartheid and occupational consciousness does not weaken clinical practice.It strengthens it.When therapists understand the systemic barriers affecting participation, they can:design more realistic interventionsadvocate for appropriate equipmentcollaborate with community resourcesidentify policy barriersdocument environmental constraints clearlyIt also helps us articulate what makes occupational therapy distinctive.Our profession studies human beings as occupational beings.That means we look not only at physical function, but at how environments and systems shape the possibilities for everyday life.This perspective integrates insights from:health sciencessocial sciencescritical social sciencescommunity knowledgedecolonial scholarshipTogether, these perspectives create a robust and integrated understanding of participation.What This Series ExploresThis Occupational Science Alphabet Series explores concepts that help illuminate the broader context of occupation, including:occupational apartheidoccupational consciousnessoccupational justicecollective occupationsecological approaches to healthEach concept will be translated into examples from real-world practice contexts.The goal is simple:To help occupational therapists, students, and the public better understand the unique scientific foundation of our profession.Subscribe for OS 101If this conversation resonates with you, I invite you to subscribe to this Substack.Here I share:Occupational Science 101 explanationspodcast conversationsinterdisciplinary scholarshipreflections on ethics and policyexamples from everyday clinical practiceMy hope is to make occupational science more accessible so that occupational therapy can be better understood both within our profession and by the broader public.Stay tuned for the Forthcoming Learning CommunityI am also building a forthcoming Skool community where free OS 101 content will be hosted.This space will include:introductory occupational science coursesa journal and book clubcommunity discussion forumsreflection spaces for practitioners and learnersTogether we will explore how occupational science can support:collective liberationecological balanceoccupational wellbeinghumanizing care across the lifespanClosing ReflectionIf you have ever felt that occupational therapy is bigger than the narrow boxes it is often placed in, you are not imagining that.If you have sensed that participation barriers often arise from systems rather than symptoms, you are not imagining that either.Occupational science gives us the language to understand those realities.And occupational therapy gives us the tools to transform them.This series is an invitation to explore that together.Primary Sources📚 Ramugondo, E. L. (2015). Occupational consciousness. Journal of Occupational Science, 22(4), 488–501.https://doi.org/10.1080/14427591.2015.1042516https://www.tandfonline.com/doi/full/10.1080/14427591.2015.1042516📚 Kronenberg, F. (2018). Everyday enactments of humanity affirmations in post-1994 apartheid South Africa: A phronetic case study of being human as occupation and health (Doctoral dissertation, University of Cape Town).https://open.uct.ac.za/handle/11427/29441ReferencesHammell, K. W. (2019). Building globally relevant occupational therapy from the strength of our diversity. World Federation of Occupational Therapists Bulletin, 75(1), 13–26. https://doi.org/10.1080/14473828.2018.1529485Kronenberg, F. (2018). Everyday enactments of humanity affirmations in post-1994 apartheid South Africa: A phronetic case study of being human as occupation and health (Doctoral dissertation, University of Cape Town). https://open.uct.ac.za/handle/11427/29441Kronenberg, F., Pollard, N., & Sakellariou, D. (Eds.). (2011). Occupational therapies without borders: Towards an ecology of occupation-based practices (2nd ed.). Elsevier.Ramugondo, E. L. (2015). Occupational consciousness. Journal of Occupational Science, 22(4), 488–501. https://doi.org/10.1080/14427591.2015.1042516Wilcock, A. A., & Hocking, C. (2015). An occupational perspective of health (3rd ed.). SLACK Incorporated. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit josiejarvisot.substack.com
