A struggle to find employment and a lack of understanding of the medical system are the main reasons for the “healthy immigrant effect,” a phenomenon of new immigrants’ health decline within their first five years of arriving to Canada, said Maya Roy, executive director of Newcomer Women’s Services, at the Immigrant and Racialized Women’s Health (IRWH) project conference on February 21 at Ryerson University’s Ted Rogers School of Management.
The event brought together researchers from Ryerson, York and the University of Toronto who, along with healthcare practitioners, community activists and policy makers, shared their ideas with the public on how to improve immigrant women’s health in Ontario.
“When immigrants arrive in Canada, [they] say…‘I’m in good health.’ Or their health state is seen as good. Over four or five years of being in Canada or even much later, that good health state kind of declines one or two points to modest health,” said Dr. Usha George, dean of Ryerson’s faculty of social work and one of the project members. “There is a lot of evidence indicating that minority populations have less access to health, more diseases and the severity of their diseases is also very high compared to the normal population.”
The cause, she explained, is “mainly lifestyle changes and a lack of understanding about the system itself and access to health care and even the quality of healthcare they receive.”
Declining immigrant health
Part of the problem, said Roy, is that government health promotional materials are geared towards middle-class Canadian-born women and do not take into consideration the social and economic landscape of most Canadian new immigrants.
Newcomers, who, according to the panel account for 12 per cent of Toronto’s population, have lower incomes, said Monica Campbell, director of Healthy Public Policy. They also have a higher unemployment rate and are paid less than native Canadians in similar jobs – with the gap being much worse in Toronto, Vancouver and Montreal, the top three immigrant destinations.
Immigrants who are concerned about finding suitable employment don’t have the time to join a sports team or exercise regularly, said Roy, who summarized new immigrants’ views on this matter with the slogan: “less jogging, more jobs.”
She said new immigrants need to be further included in social and political life. A lot of the time, immigrants’ professional qualifications from their native countries are not recognized in Canada, leading to underemployment.
Campbell said once they settle in Canada and their incomes improve, immigrants’ activity levels and overall health increase again.
Immigrants who are concerned about finding suitable employment don’t have the time to join a sports team or exercise regularly, said Roy, who summarized new immigrants’ views on this matter with the slogan: “less jogging, more jobs.”
Analyzing health disparity
The IRWH project was funded by the province of Ontario. Three years ago, a team comprised of professionals from all over Ontario set out to analyze and summarize academic literature to find out the causes behind health disparity among new immigrants in comparison to those born in Canada.
The conference included 12 speakers, three moderators and 175 attendees from across the province. Conferences like this one allow non-industry professionals to get access to academic research about important health matters.
“We believe that health literacy, that is knowing much more about health issues, will enable people to manage their health better,” said George.
Most of the speakers agreed that the three-month Ontario Health Insurance Plan (OHIP) wait for new immigrants should be eliminated. In Ontario, most arriving or former residents returning to the province have to wait three months before they can get their healthcare covered under OHIP (there are some exemptions).
A great number of immigrant women are of childbearing age, said Campbell, so a lot of them need antenatal care. This makes the three-month waiting period difficult.
Manavi Handa, assistant professor at the Midwifery Education Program at Ryerson, said non-status immigrants who do not get any health care coverage experience the greatest difficulties.
Difficulties accessing health services also increases the rates of mental health problems for both the mother and the offspring. “Post-partum and antenatal depression can cause long-term consequences for children,” she said.
Another problem, she mentioned, is that children of uninsured parents are not often taken to health care facilities when needed. This can happen because of parental fears and misunderstanding of the policy.
The highest dollar expenditure in Canadian health care is on post-natal care, said Handa, and increasing spending on pre-natal care is not only humane, but also financially beneficial for Ontario’s health care system. “Every one dollar spent on prenatal care saves two to three dollars to the health care system,” she said.
Campbell said the province also needs to deal with important issues such as racism and better healthcare for refugees. She said 67% of people in Toronto have experienced racial discrimination and this can cause depressive symptoms, which, along with work and life stress, can cause mental health complications for new immigrants.
67% of people in Toronto have experienced racial discrimination and this can cause depressive symptoms, which, along with work and life stress, can cause mental health complications for new immigrants.
Health discrepancies
Cultural differences can also have serious health implications. About 15 years ago, George conducted a study about mammograms for immigrant women. “We found that family doctors were reluctant to prescribe mammograms for immigrant women simply because they thought that they would not go anyway, so why prescribe it,” she said. “They make some assumptions around their health beliefs or their health practices and therefore [they] may not provide the kind of prescriptions that are required for preventive kind of healthcare.”
Dipti Purbhoo from Toronto central’s Community Care Access Centre (CCAC) talked about the challenges and needs of providing health care in Toronto, one of the most diverse cities in the world.
She explained it is important to focus on prevention of diseases like TB, since the incidence rate of this disease in Toronto is three times higher than the provincial average. HIV/AIDS rate in Toronto is 11.3 times higher than Ontario’s average.
Purbhoo also talked about the value of home-care workers and their need for higher wages, pensions and benefits. This mostly female workforce helps bathe seniors, clean homes and prepare meals for the city’s elderly for very little pay – $15.57/hour – with no benefits. They make less money than cleaners, so a lot of them have to take up cleaning jobs on the side to make ends meet.
Near the lunch break, Roy presented an emotional video about issues affecting elderly women in Canada. The video showed grandmothers from new immigrant communities talking about their desires.
A lot of their needs included access to cultural food, getting access to free transportation, feeling valued and respected by the youth and being independent.
Addressing the health needs of immigrant women is vital to ensuring a healthy province, and ultimately, a healthy country.
