Research Library

Research on immigrant and refugee vaccination uptake in Canada shows that immunization decisions vary by vaccine type, location, age and migration status. Despite their diversity, these studies often treat immigrant and refugee populations as a single group relative to other Canadians. In this comparative study, we explored how previous risk communication and immunization experiences influence immunization decisions by immigrant and refugee women from three communities across Canada. Participants included women from the Punjabi immigrant community located in Surrey and Abbotsford, British Columbia (n = 36), the Nigerian immigrant community located in Winnipeg, Manitoba (n = 43), and the Congolese refugee community in Edmonton, Alberta (n = 18). Using focus groups, we sought to understand immunization experiences in Canada and before arrival, and what information sources influenced the immunization decision-making process by the women in the three communities. Given our participants’ different communication preferences and needs, we argue that a one-size-fits-all communication approach is inappropriate for immigrant and refugee populations. Research on immigrant and refugee vaccination uptake in Canada shows that immunization decisions vary by vaccine type, location, age and migration status. Despite their diversity, these studies often treat immigrant and refugee populations as a single group relative to other Canadians. In this comparative study, we explored how previous risk communication and immunization experiences influence immunization decisions by immigrant and refugee women from three communities across Canada. Participants included women from the Punjabi immigrant community located in Surrey and Abbotsford, British Columbia (n = 36), the Nigerian immigrant community located in Winnipeg, Manitoba (n = 43), and the Congolese refugee community in Edmonton, Alberta (n = 18). Using focus groups, we sought to understand immunization experiences in Canada and before arrival, and what information sources influenced the immunization decision-making process by the women in the three communities. Given our participants’ different communication preferences and needs, we argue that a one-size-fits-all communication approach is inappropriate for immigrant and refugee populations.
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Forced migration is one of the most pressing crises of our lifetime. Of the millions forced to migrate, many come to know the brutality of state-managed migration that habitually denies asylum seekers and places substantive restrictions on refugees who have been resettled. Sociologists of sport and leisure have examined the sporting experiences of refugees through an intersectional lens, foregrounding how displacement and resettlement are differently lived and negotiated across overlapping power structures and markers of gender, sexuality, ethnicity, religion, and legal status. Through a participatory and collective photovoice project, this article explores the experiences of an all-Afghan soccer team that played in a social, co-ed soccer league in the spring of 2022, just after they arrived in Edmonton, Alberta, Canada. In photovoice narratives and subsequent interviews, team members underlined many of the barriers they faced as they navigated the formal and informal rules and dominant norms of this seemingly inclusive sports landscape. In doing so, they revealed some of the limits of official discourses of Canadian multiculturism, which rarely accommodate more significant forms of difference, and which reproduce racial and ethnic hierarchies that powerfully discipline newcomers who are encouraged to embrace their precarious status as model minorities. Forced migration is one of the most pressing crises of our lifetime. Of the millions forced to migrate, many come to know the brutality of state-managed migration that habitually denies asylum seekers and places substantive restrictions on refugees who have been resettled. Sociologists of sport and leisure have examined the sporting experiences of refugees through an intersectional lens, foregrounding how displacement and resettlement are differently lived and negotiated across overlapping power structures and markers of gender, sexuality, ethnicity, religion, and legal status. Through a participatory and collective photovoice project, this article explores the experiences of an all-Afghan soccer team that played in a social, co-ed soccer league in the spring of 2022, just after they arrived in Edmonton, Alberta, Canada. In photovoice narratives and subsequent interviews, team members underlined many of the barriers they faced as they navigated the formal and informal rules and dominant norms of this seemingly inclusive sports landscape. In doing so, they revealed some of the limits of official discourses of Canadian multiculturism, which rarely accommodate more significant forms of difference, and which reproduce racial and ethnic hierarchies that powerfully discipline newcomers who are encouraged to embrace their precarious status as model minorities.
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The World Health Organization stresses the need for tailored COVID-19 models of vaccination to meet the needs of diverse populations and ultimately reach high rates of vaccination. However, little evidence exists on how COVID-19 models of vaccination operated in the novel context of the pandemic, how vulnerable populations, such as refugees, experience COVID-19 vaccination systems in high-income countries, and what lessons may be learned from vaccination efforts with vulnerable populations. To address this gap, this study explored COVID-19 vaccine delivery models available to newcomer refugees and immigrants, and refugee experiences across diferent COVID-19 vaccine delivery models in Calgary, Canada, and surrounding area in 2021 and 2022, to understand the barriers, strengths, and strategies of models to support access to COVID-19 vaccination for newcomer refugees and immigrants. Structured interviews with Government Assisted Refugees (n=39), and semistructured interviews with Privately Sponsored Refugees (n=6), private refugee sponsors (n=3), and stakeholders involved in vaccination systems (n=13) were conducted in 2022. Thematic analysis was conducted to draw out themes related to barriers, strengths, and strategies of vaccine delivery models and the intersections with patient experiences. Newcomer refugee and immigrant focused vaccination models and strategies were explored. They demonstrated how partnerships between organizations, multi-pronged approaches, and culturally responsive services were crucial to navigate ongoing and emergent factors, such as vaccine hesitancy, mandates, and other determinants of under-vaccination. Many vaccination models presented through interviews were not specific to refugees and included immigrants, temporary residents, ethnocultural community members, and other vulnerable populations in their design. Increasing COVID-19 vaccine uptake for newcomer refugees and immigrants, is complex and requires trust, ongoing information provision, and local partnerships to address ongoing and emerging factors. Three key policy implications were drawn. The World Health Organization stresses the need for tailored COVID-19 models of vaccination to meet the needs of diverse populations and ultimately reach high rates of vaccination. However, little evidence exists on how COVID-19 models of vaccination operated in the novel context of the pandemic, how vulnerable populations, such as refugees, experience COVID-19 vaccination systems in high-income countries, and what lessons may be learned from vaccination efforts with vulnerable populations. To address this gap, this study explored COVID-19 vaccine delivery models available to newcomer refugees and immigrants, and refugee experiences across diferent COVID-19 vaccine delivery models in Calgary, Canada, and surrounding area in 2021 and 2022, to understand the barriers, strengths, and strategies of models to support access to COVID-19 vaccination for newcomer refugees and immigrants. Structured interviews with Government Assisted Refugees (n=39), and semistructured interviews with Privately Sponsored Refugees (n=6), private refugee sponsors (n=3), and stakeholders involved in vaccination systems (n=13) were conducted in 2022. Thematic analysis was conducted to draw out themes related to barriers, strengths, and strategies of vaccine delivery models and the intersections with patient experiences. Newcomer refugee and immigrant focused vaccination models and strategies were explored. They demonstrated how partnerships between organizations, multi-pronged approaches, and culturally responsive services were crucial to navigate ongoing and emergent factors, such as vaccine hesitancy, mandates, and other determinants of under-vaccination. Many vaccination models presented through interviews were not specific to refugees and included immigrants, temporary residents, ethnocultural community members, and other vulnerable populations in their design. Increasing COVID-19 vaccine uptake for newcomer refugees and immigrants, is complex and requires trust, ongoing information provision, and local partnerships to address ongoing and emerging factors. Three key policy implications were drawn.
This publication has no Abstract to dispaly

Refugee decisions to vaccinate for COVID-19 are a complex interplay of factors which include individual perceptions, access barriers, trust, and COVID-19 specific factors, which contribute to lower vaccine uptake. To address this, the WHO calls for localized solutions to increase COVID-19 vaccine uptake for refugees and evidence to inform future vaccination efforts. However, limited evidence engages directly with refugees about their experiences with COVID-19 vaccinations. To address this gap, researchers conducted qualitative interviews (N = 61) with refugees (n = 45), sponsors of refugees (n = 3), and key informants (n = 13) connected to local COVID-19 vaccination efforts for refugees in Calgary. Thematic analysis was conducted to synthesize themes related to vaccine perspectives, vaccination experiences, and patient intersections with policies and systems. Findings reveal that refugees benefit from ample services that are delivered at various stages, that are not solely related to vaccinations, and which create multiple positive touch points with health and immigration systems. This builds trust and vaccine confidence and promotes COVID-19 vaccine uptake. Despite multiple factors affecting vaccination decisions, a key reason for vaccination was timely and credible information delivered through trusted intermediaries and in an environment that addressed refugee needs and concerns. As refugees placed trust and relationships at the core of decision-making and vaccination, it is recommended that healthcare systems work through trust and relationships to reach refugees. This can be targeted through culturally responsive healthcare delivery that meets patients where they are, including barrier reduction measures such as translation and on-site vaccinations, and educational and outreach partnerships with private groups, community organizations and leaders. Refugee decisions to vaccinate for COVID-19 are a complex interplay of factors which include individual perceptions, access barriers, trust, and COVID-19 specific factors, which contribute to lower vaccine uptake. To address this, the WHO calls for localized solutions to increase COVID-19 vaccine uptake for refugees and evidence to inform future vaccination efforts. However, limited evidence engages directly with refugees about their experiences with COVID-19 vaccinations. To address this gap, researchers conducted qualitative interviews (N = 61) with refugees (n = 45), sponsors of refugees (n = 3), and key informants (n = 13) connected to local COVID-19 vaccination efforts for refugees in Calgary. Thematic analysis was conducted to synthesize themes related to vaccine perspectives, vaccination experiences, and patient intersections with policies and systems. Findings reveal that refugees benefit from ample services that are delivered at various stages, that are not solely related to vaccinations, and which create multiple positive touch points with health and immigration systems. This builds trust and vaccine confidence and promotes COVID-19 vaccine uptake. Despite multiple factors affecting vaccination decisions, a key reason for vaccination was timely and credible information delivered through trusted intermediaries and in an environment that addressed refugee needs and concerns. As refugees placed trust and relationships at the core of decision-making and vaccination, it is recommended that healthcare systems work through trust and relationships to reach refugees. This can be targeted through culturally responsive healthcare delivery that meets patients where they are, including barrier reduction measures such as translation and on-site vaccinations, and educational and outreach partnerships with private groups, community organizations and leaders.
This publication has no Abstract to dispaly

What can be learned about the healthcare access of undocumented workers? How can health equity be advanced through sensitivity to the process of precaritization and the precarities informing their lives? Thailand and Spain are the only countries in the world that offer the same healthcare access to undocumented migrants as citizens. Most European countries only offer emergency services: France, the Netherlands, Portugal, Spain, and Switzerland allow undocumented migrants to access similar services to citizens if they meet conditions (proof of identity; length of residence in the country). European cities such as Ghent, Frankfurt, and Dusseldorf, offer barrier-free healthcare. Throughout the USA, Federally Qualified Health Centers support care to the uninsured regardless of immigration status. In Canada, Ontario and Quebec, provide a base level of healthcare access to undocumented migrants, and a small number of stand-alone community-based clinics offer additional care and specialized services. To promote healthcare for undocumented migrants in Alberta, barrier-free access to vaccination, COVID-19 treatment, and proof of vaccinations are essential, but an equity lens to healthcare service— informed by analytic understanding and robust approach to precaritization as a social determinant, is most needed. What can be learned about the healthcare access of undocumented workers? How can health equity be advanced through sensitivity to the process of precaritization and the precarities informing their lives? Thailand and Spain are the only countries in the world that offer the same healthcare access to undocumented migrants as citizens. Most European countries only offer emergency services: France, the Netherlands, Portugal, Spain, and Switzerland allow undocumented migrants to access similar services to citizens if they meet conditions (proof of identity; length of residence in the country). European cities such as Ghent, Frankfurt, and Dusseldorf, offer barrier-free healthcare. Throughout the USA, Federally Qualified Health Centers support care to the uninsured regardless of immigration status. In Canada, Ontario and Quebec, provide a base level of healthcare access to undocumented migrants, and a small number of stand-alone community-based clinics offer additional care and specialized services. To promote healthcare for undocumented migrants in Alberta, barrier-free access to vaccination, COVID-19 treatment, and proof of vaccinations are essential, but an equity lens to healthcare service— informed by analytic understanding and robust approach to precaritization as a social determinant, is most needed.
This publication has no Abstract to dispaly

Racialized, low-income, and migrant communities in East and Northeast Calgary were disproportionately impacted by COVID-19, yet faced vaccine access barriers. This article is a formative evaluation of a low-barrier, community-engaged vaccine outreach clinic in Calgary, Alberta, Canada, on June 5–6, 2021. Stakeholder respondents felt the clinic was effective (99.2%), efficient (96.9%), patient-centered (92.3%), and safe (90.8%), and that the outreach model was scalable 94.6% (123/130). Suggested improvements include increased time for clinic planning and promotion, more multilingual staff, and further efforts to reduce accessibility barriers, such as priority check-in for people with disabilities. These findings support the value of community-engaged outreach to improve vaccine equity among other marginalized newcomer communities. Racialized, low-income, and migrant communities in East and Northeast Calgary were disproportionately impacted by COVID-19, yet faced vaccine access barriers. This article is a formative evaluation of a low-barrier, community-engaged vaccine outreach clinic in Calgary, Alberta, Canada, on June 5–6, 2021. Stakeholder respondents felt the clinic was effective (99.2%), efficient (96.9%), patient-centered (92.3%), and safe (90.8%), and that the outreach model was scalable 94.6% (123/130). Suggested improvements include increased time for clinic planning and promotion, more multilingual staff, and further efforts to reduce accessibility barriers, such as priority check-in for people with disabilities. These findings support the value of community-engaged outreach to improve vaccine equity among other marginalized newcomer communities.
This publication has no Abstract to dispaly

This study explored refugee experiences with COVID-19 vaccination in Calgary and area in 2021-2022 by interviewing refugees, sponsors of refugees and COVID-19 vaccination system stakeholders This study explored refugee experiences with COVID-19 vaccination in Calgary and area in 2021-2022 by interviewing refugees, sponsors of refugees and COVID-19 vaccination system stakeholders
This publication has no Abstract to dispaly

Administrative data was used to study COVID-19 vaccine coverage in immigrants and refugees compared to the Canadian-born population. Broadly, immigrants and refugees (78.2%) had comparable vaccine coverage to Canadian-born individuals (76%). However, initiatives to improve vaccine coverage is needed for older immigrants, immigrants in rural areas, and immigrants from certain ethnicities. Administrative data was used to study COVID-19 vaccine coverage in immigrants and refugees compared to the Canadian-born population. Broadly, immigrants and refugees (78.2%) had comparable vaccine coverage to Canadian-born individuals (76%). However, initiatives to improve vaccine coverage is needed for older immigrants, immigrants in rural areas, and immigrants from certain ethnicities.
This publication has no Abstract to dispaly

We investigated health risks associated with climate and air pollution hazards and community covariates to generate insights into the resilience of older adults and immigrants at the community level in a northern urban center in the Canadian prairies (i.e. Edmonton, AB). Communities with higher proportions of older adults were associated with increased cardiovascular, injury, mental, and respiratory health event rates. Notably, heat effects on injury rates impacted communities with higher percentages of older adults (Prevalence Rate Ratio (PRR) [95%CI] 1.110 [1.011, 1.219] at 25% ≥65 years). Ozone effects on cardiovascular event rates exhibited similar trends. Areas with higher percentages of immigrants generally had lower rates of health events. However, increasing diurnal temperature range became a risk factor for respiratory health rates where there were higher percentages of refugees (PRR 1.205 [1.004, 1.447] at 20%). Industrial emission effects on injury and respiratory health rates also amplified in areas with higher percentages of refugees (PRR 1.127 [1.058, 1.200]; 1.130 [1.050, 1.216] at 20%). Similar effects were observed for mental health event rates and total immigrants. Greater neighborhood material and social deprivation were significant risk factors for increased health event rates across outcomes. Future work should focus on disproportionately affected vulnerable populations to address community-level resilience. We investigated health risks associated with climate and air pollution hazards and community covariates to generate insights into the resilience of older adults and immigrants at the community level in a northern urban center in the Canadian prairies (i.e. Edmonton, AB). Communities with higher proportions of older adults were associated with increased cardiovascular, injury, mental, and respiratory health event rates. Notably, heat effects on injury rates impacted communities with higher percentages of older adults (Prevalence Rate Ratio (PRR) [95%CI] 1.110 [1.011, 1.219] at 25% ≥65 years). Ozone effects on cardiovascular event rates exhibited similar trends. Areas with higher percentages of immigrants generally had lower rates of health events. However, increasing diurnal temperature range became a risk factor for respiratory health rates where there were higher percentages of refugees (PRR 1.205 [1.004, 1.447] at 20%). Industrial emission effects on injury and respiratory health rates also amplified in areas with higher percentages of refugees (PRR 1.127 [1.058, 1.200]; 1.130 [1.050, 1.216] at 20%). Similar effects were observed for mental health event rates and total immigrants. Greater neighborhood material and social deprivation were significant risk factors for increased health event rates across outcomes. Future work should focus on disproportionately affected vulnerable populations to address community-level resilience.
This publication has no Abstract to dispaly

This community-based research study provides new data collected from 25 in-depth individual interviews with immigrant women HCAs who were working in LTC in Calgary, Alberta between January 1 and March 30, 2021. The data, analysed through the lens of intersectional exclusion, highlight how the pandemic has impacted the working lives of immigrant women employed in LTC facilities on a daily basis, as well as their suggestions for enhancing their safety and employment conditions. Two key themes emerged during the process of data analysis: (a) HCA experiences of economic exclusion and workplace precarity—many of which pre-dated the pandemic but have been exacerbated by current policies and practices that prioritize profits over quality of community care, and (b) experiences of broader social exclusion, many of which are tied to being considered “just HCAs” who are doing “immigrant’s work”, rather than including HCAs in broader conversations about how to reform and improve the LTC sector for future. Concluding thoughts discuss how to improve policy to support low wage workers within LTC in order to address intersectional inequalities and to better support front-line care workers during current and future health pandemic recovery efforts. This community-based research study provides new data collected from 25 in-depth individual interviews with immigrant women HCAs who were working in LTC in Calgary, Alberta between January 1 and March 30, 2021. The data, analysed through the lens of intersectional exclusion, highlight how the pandemic has impacted the working lives of immigrant women employed in LTC facilities on a daily basis, as well as their suggestions for enhancing their safety and employment conditions. Two key themes emerged during the process of data analysis: (a) HCA experiences of economic exclusion and workplace precarity—many of which pre-dated the pandemic but have been exacerbated by current policies and practices that prioritize profits over quality of community care, and (b) experiences of broader social exclusion, many of which are tied to being considered “just HCAs” who are doing “immigrant’s work”, rather than including HCAs in broader conversations about how to reform and improve the LTC sector for future. Concluding thoughts discuss how to improve policy to support low wage workers within LTC in order to address intersectional inequalities and to better support front-line care workers during current and future health pandemic recovery efforts.
This publication has no Abstract to dispaly