Tuesday, 16 January 2018 23:49

Ushering in the new Health Age

By: Shan Qiao in Toronto, ON

At the age of 60, quitting a well-paying job to refinance her townhouse and start an entrepreneurial venture was the last thing Helen Poon’s friends thought she would do. But Helen did just that, setting out to build a healthy eating and living co-op so she could hire people who would be compensated by becoming healthy. 

According to a 2017 study, over three ­quarters of Canadians aren't meeting the recommendations of Canada’s Food Guide for fruit and vegetable consumption, this results in an estimated economic burden to society of $4.39 billion annually. While dietary recommendations are made annually by the Canadian government, Poon recognized that a more hands-on approach would be necessary in order to affect more immediate change. The result, the Sprouts Co-Op in Toronto which focuses on specific neighborhoods across the GTA.

The thought of building a community-based healthy food and living co-op had been brewing in her mind for a couple of years, well before Poon decided to quit her job. “You are what you eat,” she continues. Hence the 2017 co-op which is steered by Poon but also receives support from a handful of people that have drawn influence from her. 

[quote align="center" color="#999999"]“I want to create diverse and connected communities that recognize, practice, and advocate for equitable and sustainable food and health systems.” -Helen Poon[/quote]

Poon has never been one to shy from a challenge, so when she learned of the difference sugar alternatives like honey could make, she immersed herself in the subject. Canadians consume an average of 26 teaspoons of it every day, which amounts to 21% of their total daily caloric intake, playing a huge role in many diseases and conditions that have become more prevalent in recent years. Despite her lack of experience in the subject, she has been able to incorporate the ingredient in several recipes without sacrificing taste in any way. 

“Helen was my supervisor at our previous organization we both worked for. At the end of last year, she told me she wanted to start a food and health co-op and hire people with disabilities,” says Daphne Au-Young who holds a Master’s degree in Clinical Psychology and joined Sprouts as a board member. 

“I thought it’s a great initiative to provide affordable healthy food for the community and meaningful employment for individuals with disabilities. I admire Helen’s determination to start an organization at the age of 60. It shows that one is never too old to turn a dream into a reality,” Au-Young explains. 

As an immigrant woman who came to this country after China’s 1989 political turmoil, Au-Young said her parents sacrificed their high paying jobs in Hong Kong for stability and freedom in Canada. The version of Sprouts’ “meaningful employment” makes her very happy to see clients moving past their traumas and living a normal life again. 

A major influence within the Asian community, Poon is also a mentor to young men like Dave Tran. A descendant of Vietnamese immigrants and high school English teacher, Tran is currently the Vice-Chair of Sprouts and considers Poon an inspiration. 

“There have been several important people in my life recently, demonstrating amazing leadership over the years, helping to build a greater diverse community for all. Helen is one of those people. She is quite an inspirational person who is a work horse; she always gives her 100% into anything she does and it can become infectious—in the best way,“ he explains. 

Rui Ping Chen came to Canada 10 years ago as a young girl who also met Helen in her previous job. After learning of Sprouts, she was intrigued. “What kind of dream was big enough for her to leave a management position? She talked to me about Sprouts with so much passion and wisdom that I immediately understood why she did what she did.”

“I believe in what Sprouts is trying to promote ‘we are what we eat’,” says Ping, behind a makeshift reception table that collects people’s membership fees and registration forms at Sprouts’ first product launch event in Markham last November. That night, Sprouts successfully attracted more than three dozen people to join as members, after a year-long endeavor by Helen and the people influenced by her.

As the Sprouts Co-op continues its steady growth, Poon hopes to extend her reach to an even more diverse range of members. And while the Co-op's Toronto base has limited its current operations to the GTA, it will be interesting to see what the future holds for this ambitious startup.


This piece is part of a series titled, "Ethnic Women as Active Participants in Ontario". Writers interested interested in participating are encouraged to join the NCM Collective for an opportunity.

Published in Health

By: Viji Sundaram in Mountainview, California

A much heralded push toward digital patient portals, commonly integrated with electronic health records, may be exacerbating health disparities between rich and poor, instead of reducing them, as they were intended to.

In fact, for a variety of reasons, “you could argue they increase disparities,” said Suneel Ratan, chief strategy officer of Community Health Center Network and the Alameda Health Consortium, who has researched the use of patient portals in Bay Area community health centers.

Last year, MayView Community Health Center’s three clinics – here in Mountain View, Palo Alto and Sunnyvale -- launched their patient portal tool to meet “meaningful use” requirements in order to receive federal incentive checks, a part of the Electronic Health Records Incentive Program. The program was designed to help health care providers move away from a paper-based system. A few mouse clicks allows a doctor to navigate the entire medical history of a patient.

Patient portals, which have been in use for more than a decade in larger hospitals nationwide, are commonly integrated with electronic health records. They are secure online websites that give patients 24-hour access to their personal health information from anywhere with an Internet connection. It’s a way of patients being engaged with their care team and on their own time, with the hope that it will lead to better health outcomes.

Among other functionalities, patient portals typically include online appointment scheduling, bill pay, prescription renewals and the ability to accept patient-generated data on allergies and other health issues. Patients also have access to lab results.

MayView, a federally qualified health center (FQHC), spent about $30,000 in staff time to build its portal, the clinic’s Executive Director Kelvin Quan said, noting that the tool was not only to meet the federal “meaningful use” standard by tethering it to electronic health records, but also to “meet a standard in adopting the patient care model known as ‘Patient Centered Health Home,’” a kind of one-stop shop for patient care.

Soon after MayView launched the tool, many patients enrolled, but enthusiasm seemed to wane after a few weeks, when the program became something like “white noise,” [a collection of sounds that are a mere distraction] as MayView’s Medical Director Dr. Aarti Gupta described it.

Enrollment figures in MayView’s program show that of the clinic’s approximately 6,600 patients, only 600 are currently enrolled. Of them, only 200 are active users.

Quan believes the tool’s low patient penetration is because “technology doesn’t work for our population,” a good percentage of whom are Hispanic and Asian and Pacific Islanders. That could be the reason why East Palo Alto-based Ravenswood Family Health Center, also an FQHC and with a similar patient demographic, has low usage of its patient portal – 10 to 15 percent -- according to Chief Executive Director Luisa Buada.

"The majority of our patients are Spanish-speaking with lower literacy (including health literacy, reading literacy and computer literacy) rates," said Dr. Justin Wu, Ravenswood's Clinical Informatics Officer. "Add to that the current political climate with mistrust around immigration issues and a general hesitancy to give out information or have health information online, and I think it helps explain some of the problems we've been having with patients in using our patient portal." The two clinics reflect a national usage trend that showed that Asian Americans, Latino Americans and African Americans were 23 percent, 55 percent and 62 percent less likely to register for digital personal health record access, respectively, compared to non-Hispanic whites.

First off, “many of our patients can’t afford computers. If they can, their [technology literacy level] makes it difficult for them to navigate the information,” Quan said.

For those who have the app on their cell phone, the font is so small, they can’t read it, he said.

David Lindeman, director, Center for Innovation and Technology in Public Health and the CITRIS program at UC Berkeley, believes that if some of the text were taken out of patient portals and replaced with images and videos the tool could possibly be embraced by more patients.

A study done two years ago by five academics shows why the patient portal program has been relatively successful at Kaiser Permanente, a large grouping of hospital and practices, as well as the nation’s second-largest insurer. By 2015, Kaiser had registered 70 percent of their 5.2 million patients on their portal, well above the health care industry expectation of 50 percent, according to Quan.

The bulk of Kaiser’s patient portal education material – not entirely simply written -- is geared toward white, middle-class people, who are better educated. Patients with a post-graduate education are more likely to register than adults with a high school education or less on to My Health Manager.

“You have to meet the patients where they are coming from,” said Quan.

My Health Manager enrollees can email their care team members with health questions and expect a response within 48 hours.

Most of MayView’s patients are on Medi-Cal (the federal-state health insurance program for low-income people, known as Medicaid in the rest of the nation). Some are undocumented. Care providers at the clinic are already stretched thin, Gupta said, one of the reasons why MayView’s patient portal lacks the e-mail communication functionality.

“If they had to respond to queries from their patients on the computer, it would take time away from attending to patients” who prefer face time with their providers, Gupta said.

Besides, “Medi-Cal will not reimburse them” for computer time, Quan said. 

Ratan said most FQHCs don’t have the resources to implement robust functionality in their patient portals. But at least one he has worked with has deployed a patient portal that includes medical records, in addition to appointment schedules and refills.


Republished in partnership with New America Media.

Published in Health

By Belen Febres-Cordero in Vancouver

Upon arrival, immigrant populations in Canada tend to present less allergies than their Canadian-born counterparts, but prevalence increases with time, a national study finds. However, exposing them to ethnic foods and cultural practices that they were accustomed to may help reduce allergies in this population, according to the researchers. 

There is no definitive answer as to the cause(s) of the definitely noted increase in allergies in immigrant populations when they move to Western countries such as Canada. However, the pattern is real and needs to be analyzed”, says Dr. David Fischer, President of the Canadian Society of Allergy and Clinical Immunology (CSACI).

As first-generation immigrants to Canada, Dr. Hind Sbihi (picture below), Research Associate at the University of British Columbia, and Jiayun Angela Yao, PhD candidate at the same institution, became intrigued by allergy rates among newcomers and conducted a study to understand the role that genetics and environmental factors play in the development of non-food allergies, such as hay fever.

[quote align="center" color="#999999"]“Our best hope to curb the increasing trend in allergic disorders is to prevent it.”[/quote]

The researchers explain that in the past decade, the media, public and researchers have mainly focused on food allergies “It’s critical to raise awareness for non-food allergies given their high prevalence in our population, and posing a big burden to our health care system,” they add.

Canada has some of the highest allergy rates

This is particularly true because Canada has some of the highest allergy rates in the world. According to the American Academy of Allergy Asthma & Immunology, approximately 10-30% of the global population has hay fever. While in the United States roughly 7.8% of people 18 and over has this allergy, almost 20% of the population in Canada is affected by it. Considering these statistics, Sbihi and Yao wanted to understand if immigrants in the country would also display an increase in allergies.

“Our study highlighted the unique opportunity to investigate allergies in migrant populations, who are going through a natural experiment, in which the environment around them changes dramatically in a relatively short period of time,” they explain.   

To conduct the study, the scholars used the data collected in the Canadian Community Health Survey, which gathered information about the health status, lifestyle habits and basic demographics of a large and representative sample of Canadians. In the survey, respondents were asked whether they had non-food allergies – diagnosed by a physician-, and whether they were immigrants to Canada and if so, their time since arrival. “We took the responses to these questions, and assessed the statistical association between non-food allergies and immigration status”, they say.Photo Credit:Hind Sbihi Linkedin

Following this method, the study found that only 14.3% immigrants who had lived in Canada for less than 10 years had non-food allergies, while the rates for immigrants over 10 years and non-immigrants were 23.9% and 29.6%, respectively.

These results suggest that environmental factors, such as pollution, levels of sanitization and dietary choices, carry more weight in the development of allergic conditions in Canada, Dr. Fischer explains, while Dr. Sbihi and Yao add that more research is needed to pinpoint what those factors are, and to better understand how allergies arise by country of origin.

They also highlight the need for undertaking multicultural strategies to improve newcomers’ health.

Ethnic foods may help

Dr. Sbihi and Yao add that it is also important to understand that allergies are symptoms of a loss of internal balance that results from a dysfunction of the immune system. “Providing immigrants with means to access food or cultural practice that are ethnically-friendly may help them transition smoothly into the new environment without perturbing their natural balance,” they suggest.  

“Our best hope to curb the increasing trend in allergic disorders is to prevent it. Prevention can only happen when there is a good understanding of risk factors that come to play in the development of these disorders.” For these reasons, they suggest that raising awareness among health practitioners about the link between immigration, environment and allergies might help in their patients’ management.

“The main role for medical practitioners is to work with patients to recognize if they have allergies, to manage them acutely with their patients and if necessary refer them allergist if there is some doubt about the diagnosis or for more definitive management,” says Dr. Fischer.

Published in Health
Wednesday, 06 July 2016 22:29

Canadian Pharma: Know Your Patient

Commentary by Rohit Phillips in Aurora, Ontario

The fast-growing multicultural consumer segment of Canada represents a potential opportunity for pharmaceutical companies, especially if they can improve patient outcomes on a national scale.

For a small or mid-tier drug company battling to make headway in the general market, capturing a large portion of the multicultural market may be the path to improved profitability and growth. 

Ethnic (or “Diversity”) Healthcare is all about the ‘culturally sensitive connection’ to effectively address ‘health and healthcare disparities’ that result from cultural differences. These differences influence the health and well-being of Canada’s growing visible ethnic minority population, which made up to 20 per cent of the total population in 2013 and is projected to grow to 32 per cent by 2031.  

Fifteen years from now, it’s projected that visible minorities will make up 63 per cent of Toronto, 59 per cent of Vancouver, 31 per cent of Montreal.  Together, these three areas will account for 70 per cent of Canadian GDP.

Genetic, Environmental and Cultural Factors 

The factors contributing to varied drug responses are complex and inter-related. Differences in drug response among racial and ethnic groups are determined by genetic, environmental, and cultural factors. These factors may operate independently of one another, or they may work together to influence outcomes.

Biological Factors: The genetic makeup of an individual may change the action of a drug in a number of ways as it moves through the body. Clinically, there may be an increase or decrease in the intensity and duration of the expected typical effect of the drug.

Environmental Factors: Diet, climate, smoking, alcohol, drugs, pollutants —may cause wide variations in drug response within an individual and even wider variations between groups of individuals.

Cultural Factors: Cultural or psycho-social factors, such as the attitudes and beliefs of an ethnic group, may affect the effectiveness of, or adherence to, a particular drug therapy.

Being Culturally Sensitive

Multicultural marketing isn’t just attaching a face to your campaign.

It has more to do with presenting information in a culturally relevant way and context. Isn’t all communication and marketing about better connecting with the audience?

So, what aspects of any ethnicity do marketers and advertisers need to understand to connect their brand messages well?

Here are a few important ones:  

1.       Language: It’s not just about translation from English. The message must be written for and from the perspective of the minority language audience. Health promotion communication should also take into account the visual and oral cultural cues, like pictures and music.

2.       Beliefs: Beliefs can be powerful forces that affect our health and capacity to heal. Whether personal or cultural, they influence us in one of two ways – they modify our behaviour or they stimulate physiological changes in our endocrine or immune systems. Many cultural beliefs have implications for healthcare, which may be direct or indirect.

As an example, many Asians believe that the number four is unlucky because when pronounced in Japanese or Chinese it sounds very similar to the word for “death”. Thus, items arranged in groups of four, such as pills or syringes, can symbolize bad luck for those people who believe in numerology.

3.       Behaviours: Culture has a bearing on the way a person acts in response to a particular situation. Buddhist teachings emphasize ‘’face’’ or dignity. An individual’s wrongdoing causes the immediate family to lose face. Such behaviours have a direct bearing on disease screening and diagnoses as patients may not admit or realize they have health problems, especially mental health problems, as this may bring shame upon their family.

4.       Communication style: Refers to ways of expressing oneself to others and can be very different for a Chinese-Canadian compared to an Indo-Canadian. Older Chinese patients tend to be polite and may smile and nod. Nodding does not necessarily indicate agreement or even understanding of medical facts. Understanding of verbal and non-verbal communication styles of these cultures is critically important during screening, diagnoses and outreach programs.

5.       Notions of modesty: Modesty is highly valued in South Asian culture. An example is an elderly woman who may be soft-spoken and not advocate for herself. Important decisions are made in this culture only after consulting with family members or close family friends. Involving the family and friends in intervention/prevention programs and long-term care for specific ailments like diabetes, cardiovascular disease and cancers can go a long way in increasing compliance, raising awareness and generating brand loyalty.

Despite the many differences among the cultures that make up our nation, we all have the same basic needs: to be able to convey the symptoms and concerns of an illness, to receive competent care, to be acknowledged and valued.

A few fundamentals

When conducting situation analysis and a SWOT analysis of your business plan, the following are important for success:

·         Explore implications of demographic changes (regional and national)

·         Segment patient population by ethnicity

·         Identify differences in disease incidence (determine if your product treats a condition in which a health disparity exists between the ethnic and general populations. For example, is mortality different among ethnic groups in your disease category?)

·         Examine the growth patterns of your customer base

·         Find out from physicians and managed care organizations what issues they encounter in an increasingly diverse population. Then identify challenges and opportunities your company can pursue

·         Find out what your competition is doing to serve the needs of the “emerging majority”

Rohit is a seasoned healthcare marketing and advertising professional with an entrepreneurial instinct and a degree in pharmacy. Rohit is currently employed with The Gibson Group, a healthcare communication agency in Canada.

Published in Health

by Kyle Duggan in Ottawa

As the world struggles against the rapid spread of the Zika virus, the Canadian government is opening its wallet to shell out nearly $5 million for research and international aid.

Health Minister Jane Philpott announced a funding package of $4.95 million before question period Wednesday afternoon, which she called a “significant and important international response” on Canada’s part.

The virus has been linked by health officials to causing microcephaly, a rare but serious birth defect that leads to unusually small heads and hindering newborn development.

“This will fund large international projects that will address the spread of the Zika virus,” she said.

According to the minister’s office, $3 million will go toward in research, through Canada Institutes of Health Research, and the International Research Development Centre. Specifically it goes into researching the link between Zika, microcephaly and Guillain-Barré syndrome, along with developing better ways of testing for the virus, studying how it gets transmitted, and finding better ways of preventing transmission from mosquitoes.

Public Health Agency of Canada will send $950,000 to the Pan American Health Organization for responding to countries hardest hit, and Global Affairs Canada will divvy up $1 million for humanitarian funding to a number of organizations, including the United Nations Children’s Fund, the World Health Organization, and the International Federation of Red Cross.

In the U.S., meanwhile, the White House and health officials have been urging Congress to grant $1.9 billion in new funding to deal with the health threat Zika poses internationally and domestically, and while waiting the administration has raided funding from an Ebola fund to make due.

In Canada, the Zika threat itself has been low because the country doesn’t have the Aedes type of mosquito that spreads the virus. According to Public Health Agency Canada’s last update from last week, Canada has 67 cases identified from travel and one from sexual transmission.

Zika has been around in Africa and Asia for decades, but in the past few years it was introduced into the Americas and has been spreading rapidly.


Republished in partnership with iPolitics.ca

 

Published in Health

by Rosanna Haroutounian in Quebec City

A trip to an organic dairy farm in Ontario was enough to inspire a former Wall Street banker to launch a global search for better ways to treat farm animals. 

“This was an organic farm, but the cows still weren’t treated well,” recalls author Sonia Faruqi. “They were indoors two-thirds of the year and outdoors only one-third of the year, and while they were indoors, they were chained to stalls, which is really unnatural for cows, who are grazing animals.” 

After volunteering for two weeks at the dairy farm, Faruqi visited other Ontario farms, but not without resistance from farmers, who she says are part of a tightly knit community. 

“Everyone they know is a farmer, so if you’re someone who comes from a city, or who’s brown, or even a woman in a very male-dominated industry, you're immediately very different,” explains Faruqi, who was born in Pakistan and raised in the United Arab Emirates. 

She worked at an investment bank on Wall Street in the United States before the 2008 economic crisis, after which she joined her family who had just immigrated to Canada. 

[quote align="center" color="#999999"]“Everyone they know is a farmer, so if you’re someone who comes from a city, or who’s brown, or even a woman in a very male-dominated industry, you're immediately very different.”[/quote]

Faruqi says she used her savings to visit and volunteer at farms in several countries, including the United States, Malaysia and Mexico. 

Her first book, Project Animal Farm: An Accidental Journey into the Secret World of Farming and the Truth About Our Food, documents her experiences abroad and what can be done to create a farming system that is better for farmers, animals and consumers. 

A world view on farming 

While Faruqi says she witnessed many examples of animals being mistreated, such as chickens being kept in overcrowded cages and pigs covered in their own feces, she also visited farms where animals were well treated and healthy. 

In Belize, Faruqi stayed on a farm with female Mennonite missionaries, who she says have a holistic view of the land and do not refer to raising livestock as agriculture or business, but as “animal husbandry.” 

She says the women named their cows and allowed them to graze in fields with ponds and other animals. 

“It was interesting for me to see that kind of affection for the animals and the land.”  

Faruqi also compared the farming practices between Indonesia, Malaysia and Singapore to explore how industrialization affects the treatment of animals. 

[quote align="center" color="#999999"]“It’s all changed to an extremely industrialized, very low-cost system.”[/quote]

She explains that in Malaysia, which has recently experienced rapid economic growth, the popularity of fast food chains like KFC and McDonald’s has led to an increase in factory-farm practices, including artificial insemination, antibiotic use and corn-based diets. 

“It’s all changed to an extremely industrialized, very low-cost system,” she explains. “Local farms, breeds, and knowledge that people have of animals and of the land – all of it is eradicated.” 

By contrast, in Indonesia, which is less industrialized, Faruqi witnessed hens walking freely in villages that only visited their owners’ homes in the mornings for breakfast. 

“I noticed people walking their cows,” she adds. “It was interesting to see that bond that people have with animals.” 

She notes that at some of the farms she visited in Ontario, farmers didn’t visit their farms and relied on automated systems to update them on their animals. 

The many downsides to factory farming

Faruqi says that despite the downsides to factory farming, the government in Malaysia promotes fast food because it symbolizes industrialization and development. 

“The same way people wear jeans and listen to American music, they’re also eating American foods, which are hamburgers and fries and actually not good for you,” she says. 

“There’s tens of billions of farm animals in the world and most of them are being made to suffer to produce cheap food for people, who should not be eating that much meat, milk and eggs to begin with.” 

[quote align="center" color="#999999"]“When people move here, they really want to integrate to the extent that they leave their own food heritage.”[/quote]

Faruqi says consumers have the power to promote good farming habits by eating less animal products and demanding that the animal products they do eat be produced in healthier ways. 

“There’s a misconception that you have to be white and wealthy to even think about this, which is not true, because in the end, everyone’s health is important.” 

A disproportionate impact on immigrants   

She notes that while language or income barriers might prevent newcomers from making healthy choices, many of them come to Canada practising healthy eating habits that they don’t retain. 

“When people move here, they really want to integrate to the extent that they leave their own food heritage.” 

The vegetarian diet that is popular in India is an example that Western societies can learn to value, she says. 

She notes that immigrants can also be disproportionately affected on the production side, because factory farms employ many immigrants in slaughterhouses. 

“Part of the reason is that these are jobs non-immigrants don’t want, for clear reasons,” she says. “Workers have mental and physical health issues, which are not really treated.” 

Faruqi advocates for more government oversight of factory farms and regulations to protect animal rights, as well as the inclusion of more women in agriculture. 

She says that under current laws in Canada and the U.S., a pig has the same rights as a table, “which is really ridiculous when you think about it, because one is an animate being with instincts and interests and desires, at the very least, to not suffer.”


{module NCM Blurb}

Published in Health

by Carlos Tello in Vancouver 

A new food guide combines recipes from British Columbia’s immigrant communities with local seafood options to teach new Canadians how to incorporate B.C. fish into a healthy diet. 

“You have chefs from all over the world, and then you make them cook this local product,” says Siddharth Choudhary, the executive chef of Siddhartha’s Kitchen, a Vancouver restaurant that specializes in Indian food. “So people will be able to make dishes with ingredients they can find in any grocery store. It’s kind of a nice mix.” 

A recent survey commissioned by Vancouver settlement organization MOSAIC, the B.C. Salmon Farmers Association and local newspaper, The Province, found out that although immigrants tend to generally eat the suggested amount of meat, fish and alternatives by the Canada Food Guide, they are less aware of how to ensure ‘healthy-heart’ diets. 

This type of diet keeps cholesterol low, prevents heart disease and includes foods high in Omega-3 acids like salmon and other types of local B.C. fish. 

[quote align="center" color="#999999"][I]mmigrants often don’t know how to incorporate salmon into their diets.[/quote]

According to Jeremy Dunn, the executive director of the B.C. Salmon Farmers Association, this could be because immigrants often don’t know how to incorporate salmon into their diets. 

“One thing we hear a fair bit from people with respect to salmon, especially with respect to making it at home, is that either they don’t know how to cook it, or they don’t know more than one way to cook it,” he says. “And so it gets boring.” 

In order to address this, MOSAIC and the B.C. Salmon Farmers Association recruited chefs from different backgrounds in order to produce the Eating Resource Guide, titled A Mosaic of Flavours, comprised of six recipes by six different chefs. 

The guide showcases different ways to cook meals that utilize B.C.’s local fish and seafood. Of the six recipes presented in the guide, four have salmon as a main ingredient. 'Indian Baked Salmon' and 'Salmon Chinese Way' are two examples.

Guide a nod to B.C.’s multiculturalism 

“Apart from the nutrition factor, the guide gives you different types of recipes. It gives you a little bit of Korean, of continental, of Indian, and more,” says Choudhary. 

For the chef, the fact that the guide mixes local and international ingredients and spices showcases the multicultural nature of B.C., a province in which visible minorities represent just over 25 per cent of the population. 

[quote align="center" color="#999999"][T]he guide mixes local and international ingredients and spices ...[/quote]

Moreover, Choudhary says the guide also highlights the stories of the chefs who come from a variety of ethno-cultural backgrounds. 

“By reading the guide, you can learn about these chefs coming from different countries who are working very hard in order to be successful,” he says. “I think it sets an example.” 

For Choudhary, being fluent in English and spending almost a decade working in Europe and Asia didn’t relieve him from the struggles many immigrants face when they settle in a new country. 

Choudhary moved to Canada with his family seven years ago and a year after settling in Vancouver, he opened Siddhartha’s Kitchen. 

“When I first arrived, I was very confused about what to do and how to do it,” he shares. 

At the time, Choudhary wasn’t aware of the existence of immigrant settlement agencies. After learning about the services these organizations provide to newcomers, he became eager to help. 

[quote align="center" color="#999999"]“We want to create awareness amongst newcomers on the relationship between healthy eating and heart disease.”[/quote]

His opportunity arrived last month, when he learned that MOSAIC was looking for chefs to compile a healthy eating guide. 

“I thought it would be a great idea to come up with a new recipe,” Choudhary says. “I wanted to incorporate my skills, to [do] whatever I could to contribute with MOSAIC.” 

Healthy diet is not enough

The purpose of the guide is not only to provide newcomers with ideas on how to incorporate more seafood into their diets, but also to start a conversation about the benefits of eating healthy. 

“We want to create awareness amongst newcomers on the relationship between healthy eating and heart disease,” says Ninu Kang, MOSAIC’s director of communications and development. “Our focus with this guide is to have newcomers start to think about their diets, and to create awareness about the different healthy foods that are available.” 

The Heart and Stroke Foundation reports that 600,000 Canadians are living with heart failure. A 2015 study found that some aspects of Western culture, like fast food and cigarettes, can contribute to declining heart health among immigrants when they arrive in Canada. 

According to the same study, immigrants from South Asia had the highest rates of heart problems. 

Dr. Manjeet Mann, a cardiologist based in Victoria, B.C., says eating oily fishes like salmon at least once a week is a good start towards a healthier lifestyle, but he warns that it is not enough. He recommends also discussing food choices with a dietitian and doing moderate exercise daily. 

“A guide is only useful if it can be applied to your day-to-day practice, and I find that without dietitian consultation, it tends to be very generic,” he says.

{module NCM Blurb}

Published in Health
Thursday, 04 February 2016 14:54

'Onus on Parents to Immunize Kids'

by Belen Febres-Cordero in Vancouver

New approaches to immunization may help newcomers get the information they need to ensure their children’s records are up-to-date, though barriers still exist across the country.

In June 2015, Ottawa implemented the immunization strategy Every Child, Every Year. Marie-Claude Turcotte, manager of the vaccine-preventable disease program at Ottawa Public Health (OPH), explains that it is parents’ responsibility to provide updated immunization records to OPH. “We do not receive the information directly from the doctor’s office,” she says.  

Through this strategy, parents are informed if their children’s immunization records do not meet the requirement of the Immunization of School Pupils Act (ISPA). They have a month to send the updated information to OPH. If they do not want to immunize their children for religious or medical reasons, they can provide an exception. 

“We try to make this process as easy as possible. Parents can give us the information by phone, fax, online, mail or in person,” says Turcotte. They also provide information in different languages and they have translators available.  In addition, they offer immunization clinics for individuals who do not have a family physician, where health insurance is not required. 

If parents do not provide the update on time, the child can be suspended for up to 20 school days.  

[quote align="center" color="#999999"]Improved access to clean water and vaccinations are the main reasons why longevity has increased over the last century.[/quote]

According to data OPH provided by email, between December 2015 and January 2016, OPH has issued suspensions to approximately 3,100 students. As of January 21, parents and guardians of 99% of students who were suspended between the same period have updated their immunization records, and these students have returned to school.

“It is crucial to have the system up-to-date because if there is an outbreak of a disease, we can see which children could be at risk and we can intervene on time,” says Turcotte. 

National and provincial policies

Most Canadian provinces do not meet national immunization targets for key diseases. Different efforts aiming to achieve these targets have been implemented across the country, but the approaches vary from province to province. 

While in Ontario immunizations are usually given at doctors’ offices and data is not officially recorded until a child enters school, provinces like Alberta and Newfoundland and Labrador have a nurse-led model focusing on early interventions that start at birth, says Colin Busby, senior policy analyst at the C.D. Howe Institute.  

Sofía Vargas emigrated from Chile and had her baby in Vancouver. She notes that in British Columbia interventions also start promptly. “There is a preoccupation to motivate parents to immunize their children,” she says. “As soon as the baby is born, the doctor explains why you should do it.” 

[quote align="center" color="#999999"]“Immunizations are safe and effective ways to prevent diseases. There is no effective treatment for many of them once they are contracted, so prevention is our only strategy.”[/quote]

Busby clarifies that each province has its unique features, and a policy that works in one is not necessarily effective in another. However, he believes that compelling parents to make a vaccination decision is an initial step to be considered nationally.  

Challenges unique to newcomers

Improved access to clean water and vaccinations are the main reasons why longevity has increased over the last century, Busby explains. However, finding accurate and timely information about immunization can be difficult for newcomers. 

“In a study conducted among immigrant women in Edmonton, we found that the reason why their children are not being immunized is that mothers are not being told where, when or how to receive vaccinations,” says Stephanie Kowal, knowledge translation coordinator in the School of Public Health at the University of Alberta.  

Dr. Ubaka Ogbogu, assistant professor in University of Alberta’s faculties of law and pharmacy and pharmaceutical sciences, identifies language barriers and challenges accessing health care as other difficulties newcomers may face.

[quote align="center" color="#999999"]Parents can access information about immunization in Canada at national and provincial websites.[/quote]

Moreover, vaccines used in Canada are not always part of immunization programs globally, and immigrant families may have lived in circumstances where health care is limited or unreliable, explains Dr. Noni MacDonald, professor of pediatrics at Dalhousie University in Nova Scotia. 

She highlights the need for addressing this issue. “Immunizations are safe and effective ways to prevent diseases. There is no effective treatment for many of them once they are contracted, so prevention is our only strategy.”

Ways to get informed

Parents can access information about immunization in Canada at national and provincial websites. They can also download an app created by Immunize Canada

However, Kowal believes that comprehensive information, communication and delivery services tailored to immigrants’ needs are lacking. 

Although there are some resources provided in languages other than English and French, Dr. Ogbogu says that most of the information available is not translated. 

Another challenge is that most information is online, leaving families without internet access behind, explains Kowal. She suggests seeking information through local libraries or family doctors; not being afraid of asking questions; and looking for translation services, available at some clinics and hospitals at no cost.  

Vargas adds that there are provincial phone numbers people can call to ask for medical information. She encourages parents to look for resources and get involved. “Vaccines are a remarkable milestone in public health,” she says. “It is our duty as parents to be responsible in this scientific development that translates into the safety and health of our children.” 

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Published in Health

by Tazeen Inam in Mississauga, Ontario

According to the 2015 child poverty report for Toronto, newcomer children, children of colour and children with disabilities are among the largest groups living in poverty. Families that fall into more than one of these groups face even more grim circumstances.

Sean Meagher, Executive Director of Social Planning Toronto suggests that immigrants with non-European backgrounds taking care of children born with disabilities face financial crises often.

“English speaking [people], compared to the significant number of immigrants who are not from that background, are successful in getting jobs and we do have a racially segmented employment market [that] people with coloured skin face.”

Sacrificing to take care of family

Those taking care of someone with a disability often relinquish their own plans, as is the case of Ottawa resident Maryem Hashi (name changed for privacy).

Hashi has three younger siblings between the ages of 22 and 26 years old who all have disabilities. She gave up her university studies and a full-time job to fulfill her responsibilities at home.

[quote align="center" color="#999999"][I]mmigrants with non-European backgrounds taking care of children born with disabilities face financial crises often.[/quote]

 

Hashi, who moved here from Pakistan, recalls her initial days in Canada, when her mother had to face the ordeal of raising her siblings, without much access to Internet. With difficulty in speaking and understanding English, she had to navigate things like funding, health care and programs that suit the needs of her children.  

“My siblings didn’t receive any government funds and didn’t go to any specially designed programs to cater to their needs as my parents were not aware that some services were available,” explains Hashi. 

Hashi’s siblings have delayed development, which usually starts showing up after a child is two to five years old. It is a “mild” condition that affects their ability to do things “independently.”

“They tend to forget things easily and [have an] inability to do things on a daily basis like managing money, packing a [backpack], remembering directions, etc. and the challenge is to keep them in conversation,” shares Hashi.

Today, Hashi is a program assistant and works part-time in occupational therapy, serving children with disabilities under the age of three to five years old.  

What happens after 21 years old?

For Hashi’s siblings, a crucial time came when they each turned 21, as that is the cut-off age for school programming for kids with a disability.

“Due to the lack of government funded after school programs, people with disability after 21 years of age usually stay at home as there is a long waiting [lists] to get into programs suitable to their needs,” says Hashi. 

[quote align="center" color="#999999"]"[P]eople with disability after 21 years of age usually stay at home as there is a long waiting [lists] to get into programs suitable to their needs.”[/quote]

 

She says that such programs are a support for caregivers too, and allow the young person not to lose what they have learned from school.

“My siblings [have been] home for a couple of years, and [are] alone with depression and low self esteem; it’s hard to deal with their ordeal,” she shares. “If we take programs privately, it starts at $90 a day, which is unaffordable with multiple siblings [with a] disability.”

Rabia Khedr, executive director of the Canadian Association of Muslims with Disabilities, runs a program in Mississauga, Ont., DEEN (Disability Empowerment Equality Network) support service, which is an extended-hour day program and works on the capacity building of individuals with disabilities who have aged out of school programs.

“It will be an 8 a.m. to 8 p.m. program,” explains Khedr, “and gives enough time range to caregivers – particularly those who are striving to earn.”

The school has a sliding scale fee structure and the rest is fundraised through charitable donations.

In the long run, Khedr is planning a residence service, especially for people with disabilities who do not have caregivers. She shares that in Ontario alone 12,000 people with intellectual disabilities are waiting for housing.

Khedr’s extension of the school in Ottawa, where Hashi will provide some of her services too, is at the initial stage and individuals with disabilities will get three hours of activities on Sunday only starting in the new year.

[quote align="center" color="#999999"]"[W]e want at least medication to be cost-free for all.”[/quote]

 

Making ends meet

Every year on Dec. 3 is the International Day of Persons with Disability. The theme in 2015: Inclusion matters, access and empowerment of people with all abilities.

According to the department of finance, in 2011 the Canadian federal government transferred almost $4 billion to low-income families and spent $19.9 billion on Employment Insurance benefits alone.

Still for some, medications, dental care and eye check-ups are not included. And in the cases of people with disabilities things like electronic gadgets, crutches, wheelchairs and scooters to assist in daily life are also not fully covered.

“They have to hire special vans to take these individuals from place to place. This all has a cost,” says Hashi. “And we want at least medication to be cost-free for all.”

Khedr says that people who don’t have the experience of poverty won’t understand how choices can become increasingly limited when a person is on welfare assistance.

She suggests, “The solution lies in a combination of a few hours of activity and government funds.”


Journalist Priya Ramanujam mentored the writer of this article through the NCM Mentorship Program.

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Published in Health

by Aziza Hirsi in Toronto 

In July 2015, three sisters – Ilhan, Hodan and Ayan Ibrahim – launched Qurtuba Publishing House, an Islamic publishing company based out of Ottawa. 

The company is committed to reclaiming the stories and perspectives of Muslims and engaging in the sharing of knowledge for both Muslims and non-Muslims. 

“[We want to] help shift the narrative by producing relevant content on issues Muslims are facing today in the contemporary context and [provide] practical solutions on how to overcome these problems,” says Ilhan, the CEO of Qurtuba Publishing House. 

Health and wellness for Muslims 

One of the areas that Qurtuba is focusing on with its work is health and wellness in the Muslim community. 

Ayan, the managing editor and co-founder, is preparing to publish her book, The Health Conscious Muslim: One Muslim Woman’s Journey of Navigating the World of Health and Fitness, which draws on her experiences to become healthy and active. 

[quote align="center" color="#999999"]Especially for Muslim women ... we all think about it, [but a healthy lifestyle] is not accessible to us.[/quote]

“Coming from a Somali background, our cultural foods are very much based in high fats, high sodium, high sugar content fat,” says Ayan, who works as a nurse and draws on her medical experiences. “We have to eat it in moderation.” 

“Looking from a health standpoint, we are consuming a lot of unhealthy food in our cultural food,” she adds. “A lot of Somali people and Muslim people are feeling the consequences of that.”

“We have a high rate of diabetes, [the risk of having a] stroke is also prevalent in our community. And [there are many who] are overweight.” 

A major part of the problem with accessing such information is the lack of literature from minority voices. 

“Health isn’t at the forefront for Muslims,” Ayan explains. “I think, especially for Muslim women, we dream about it, we all think about it, [but a healthy lifestyle] is not accessible to us.” 

Many echo similar thoughts.

“I want to lead a healthy lifestyle,” says Iman Togone, a student at the University of Toronto. “But I don’t know where to begin. It’s very difficult to find healthy and affordable alternatives to junk or fatty food.” 

Togone also express concern about finding a way to balance her love for traditional Somali food with a healthy lifestyle.

“Having a book written by someone like me would help me overcome other barriers as well, such as finding a women’s gym to exercise or one that has women’s hours that are convenient.” 

Reenas Mohammed, a second year student at the University of Toronto, says it’s difficult to lead a healthy lifestyle when your family does not. 

“Being healthy is critical especially as you get older,” Mohammed says. “Being able to look to someone like me who is able to break down the steps to being healthy is a significant inspiration.” 

Non-western perspectives 

For the founders of Qurtuba Publishing, the lack of educational material on non-western perspectives is another area of concern. 

“We love to learn, however, the information we wanted wasn’t available,” Hodan, the company’s marketing manager, says. 

“I studied political science and international relations and – as much as I love western thought – … there was such a lack of content [on the…] Islamic perspective.” 

[quote align="center" color="#999999"]"[A]s much as I love western thought – … there was such a lack of content [on the…] Islamic perspective.[/quote]

“Why aren’t there more books catering to contemporary Muslim intellectual needs?” Hodan asks. “And why isn’t there a diversity of topics … that [address] the contemporary needs of Muslims?”  

These same questions and concerns may have spurred the establishment of Christian, Jewish, Hindu and Buddhist, as well as other religious and Islamic, publishing companies. In this regard, Qurtuba Publishing House is not necessarily unique, but where the company aims to go further is its commitment to share knowledge. 

“What makes us different from other publishing houses is that we provide practicality of those books,” Ilhan explains. 

“We are hoping to take our books that we are producing and actually create workshops to help people develop those tools and those skills to overcome those problems they may be facing in their families, in their personal lives, in their spirituality, [and] in their communities.” 

Qurtuba's vision was what first caught Mohammed's attention when she found out about the publishing house. 

“I was impressed with their commitment to helping Muslims grapple with modern day problems like debt, conflicts with parents and self development,” she says. 

[quote align="center" color="#999999"]“We didn’t start [this] company to make money.”[/quote]

Solving a social problem

Where many other publishing companies have been established solely for profit, Qurtuba was established out of a commitment to social justice.

“Being someone who comes from an immigrant community or marginalized or minority community, we just naturally have an affinity with that type of thinking,” Hodan explains.

“We didn’t start [this] company to make money,” she says. “We wanted to solve a social problem which was how do we help create more economic resilience in Muslim communities?”

“How do we start supporting a new narrative?” Hodan continues. “How do we contribute constructively to mainstream discussions [as well as] how Muslims think about themselves [and] how other people who are non-Muslims think about us?”

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Published in Arts & Culture
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