Research Library

This article presents the issues and challenges facing older Chinese immigrants in accessing mainstream services in Edmonton, Alberta, in Western Canada. The awareness and access to mainstream services and information, perceptions of services, system improvements and use of social media are discussed. Barriers to services include: isolation, impacting physical and mental health; few multicultural services (barriers around translation and access to services); barriers around age and ability (accessibility); cost barriers. The article suggests several recommendations: culturally competent service provision by mainstream services (including removing cost barriers, improving translation and accessibility); more collaboration between ‘mainstream’ service providers and ethno-specific organizations; more consultation with Chinese community; greater accessibility to translation; increased funding for human resources and training. This article presents the issues and challenges facing older Chinese immigrants in accessing mainstream services in Edmonton, Alberta, in Western Canada. The awareness and access to mainstream services and information, perceptions of services, system improvements and use of social media are discussed. Barriers to services include: isolation, impacting physical and mental health; few multicultural services (barriers around translation and access to services); barriers around age and ability (accessibility); cost barriers. The article suggests several recommendations: culturally competent service provision by mainstream services (including removing cost barriers, improving translation and accessibility); more collaboration between ‘mainstream’ service providers and ethno-specific organizations; more consultation with Chinese community; greater accessibility to translation; increased funding for human resources and training.
This publication has no Abstract to dispaly

Many socioecological and structural factors affect women’s diets, physical activity, and her access and receptivity to perinatal care. We sought to explore women’s and providers’ perceptions and experiences of health in the pre- and post-natal period while facing difficult life circumstances, and accessing a community-based program partially funded by Canada Prenatal Nutrition Program (CPNP) in Alberta, Canada. Women perceived eating healthy foods, taking prenatal vitamins, and being physically active as key health behaviours during pregnancy and postpartum. However, they were commonly coping with many difficult life circumstances, and faced health barriers for themselves and their babies. These barriers included pregnancy or birth complications, family and spousal issues, financial difficulties, and living rurally. On the other hand, women and providers identified many aspects of the community-based program that addressed the burden of adversities as enablers to better health during pregnancy and postpartum. Community-based programs have an important role in alleviating some of the burden of coping with difficult life circumstances for women. With such potential, community-based programs need to be well supported through policies. Policies supporting these programs, and ensuring adequate funding, can enable more equitable services to rural women and truly promote maternal health during pregnancy and postpartum. Many socioecological and structural factors affect women’s diets, physical activity, and her access and receptivity to perinatal care. We sought to explore women’s and providers’ perceptions and experiences of health in the pre- and post-natal period while facing difficult life circumstances, and accessing a community-based program partially funded by Canada Prenatal Nutrition Program (CPNP) in Alberta, Canada. Women perceived eating healthy foods, taking prenatal vitamins, and being physically active as key health behaviours during pregnancy and postpartum. However, they were commonly coping with many difficult life circumstances, and faced health barriers for themselves and their babies. These barriers included pregnancy or birth complications, family and spousal issues, financial difficulties, and living rurally. On the other hand, women and providers identified many aspects of the community-based program that addressed the burden of adversities as enablers to better health during pregnancy and postpartum. Community-based programs have an important role in alleviating some of the burden of coping with difficult life circumstances for women. With such potential, community-based programs need to be well supported through policies. Policies supporting these programs, and ensuring adequate funding, can enable more equitable services to rural women and truly promote maternal health during pregnancy and postpartum.
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Female refugees can be a vulnerable population, often having suffered through traumatic events that pose risks to their health, especially during pregnancy. Pregnancy can be an entry point into the health care system, providing health care professionals the opportunity to gain women’s trust, connect refugees with resources, and optimize the health of mother and child. Policies surrounding the provision and funding of health care services to refugees can impact access to and quality of care. The aim of our study was to understand the experiences of health care professionals caring for pregnant refugee women in Calgary, AB. Health care providers described several barriers when caring for pregnant refugees, including language barriers, difficulty navigating the health care system, and cultural barriers such as managing traditional gender dynamics, only wanting a female provider and differences in medical practices. Providers managed these barriers through using a team-based approach to care, coordinating the patient’s care with other services, and addressing both the medical and social needs of the patient. The federal funding cuts added additional challenges, as many refugees were left without adequate health coverage and the system was complicated to understand. Health care providers developed creative strategies to maximize coverage for their patients including paying out of pocket or relying on donations to care for uninsured refugees. Finally, the recent Syrian refugee influx has increased the demand on service providers and further strained already limited resources. Female refugees can be a vulnerable population, often having suffered through traumatic events that pose risks to their health, especially during pregnancy. Pregnancy can be an entry point into the health care system, providing health care professionals the opportunity to gain women’s trust, connect refugees with resources, and optimize the health of mother and child. Policies surrounding the provision and funding of health care services to refugees can impact access to and quality of care. The aim of our study was to understand the experiences of health care professionals caring for pregnant refugee women in Calgary, AB. Health care providers described several barriers when caring for pregnant refugees, including language barriers, difficulty navigating the health care system, and cultural barriers such as managing traditional gender dynamics, only wanting a female provider and differences in medical practices. Providers managed these barriers through using a team-based approach to care, coordinating the patient’s care with other services, and addressing both the medical and social needs of the patient. The federal funding cuts added additional challenges, as many refugees were left without adequate health coverage and the system was complicated to understand. Health care providers developed creative strategies to maximize coverage for their patients including paying out of pocket or relying on donations to care for uninsured refugees. Finally, the recent Syrian refugee influx has increased the demand on service providers and further strained already limited resources.
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We studied how the gender of a medical provider affects the experience of immigrant women with obstetrical care. We interviewed 38 immigrant women from one hospital in Edmonton, Alberta. These women came from varied educational and ethnic backgrounds (predominately North/East African, Middle Eastern, and South Asian), but most were Muslim and married. Their average age was 27 years old. All of the women stated that they preferred a female provider. They explained their preference because they placed a high value on modesty, often as part of the Muslim faith. At the same time, the women deemed provider competency and having safe childbirth more important. Many said that they would accept care from a male provider if necessary. A small minority of the women reported experiencing psychological stress as a consequence of having received care from a male provider. Overall, women who participated in our study stated that they accepted care from male providers. But for some of them this compromise came at a price, and a small minority of women perceived it as hurtful. With this in mind, we see a need to identify those women for whom gender of provider is important. It will help with providing them with optimal care. We studied how the gender of a medical provider affects the experience of immigrant women with obstetrical care. We interviewed 38 immigrant women from one hospital in Edmonton, Alberta. These women came from varied educational and ethnic backgrounds (predominately North/East African, Middle Eastern, and South Asian), but most were Muslim and married. Their average age was 27 years old. All of the women stated that they preferred a female provider. They explained their preference because they placed a high value on modesty, often as part of the Muslim faith. At the same time, the women deemed provider competency and having safe childbirth more important. Many said that they would accept care from a male provider if necessary. A small minority of the women reported experiencing psychological stress as a consequence of having received care from a male provider. Overall, women who participated in our study stated that they accepted care from male providers. But for some of them this compromise came at a price, and a small minority of women perceived it as hurtful. With this in mind, we see a need to identify those women for whom gender of provider is important. It will help with providing them with optimal care.
This publication has no Abstract to dispaly

This study explores how immigrant parents in Alberta-Edmonton’s Filipino community adhere to preventive dental attendance (PDA) for their preschool children. We also look at the psychosocial factors influencing parental adherence. Results: Upon arriving in Canada, most Filipino parents thought that PDA was not a priority. After migration, however, they embraced new knowledge about the importance of PDA for their children. Discussion: Filipino parents were open to the Western model of preventive oral healthcare, with the duration of their time in Canada playing a key role in promoting regular dental visits for their children. This study explores how immigrant parents in Alberta-Edmonton’s Filipino community adhere to preventive dental attendance (PDA) for their preschool children. We also look at the psychosocial factors influencing parental adherence. Results: Upon arriving in Canada, most Filipino parents thought that PDA was not a priority. After migration, however, they embraced new knowledge about the importance of PDA for their children. Discussion: Filipino parents were open to the Western model of preventive oral healthcare, with the duration of their time in Canada playing a key role in promoting regular dental visits for their children.
This publication has no Abstract to dispaly

This study examines stakeholders’ perspectives on the health and well-being of temporary foreign workers (TFWs) and their families in Alberta, Canada. Stakeholders involved in providing services to TFWs perceived that the workers experience (1) barriers in accessing mental health services, (2) mental health challenges, (3) family health challenges, (4) occupational health challenges, and (5) income and social status as a social determinant of health. Immigration and class status intersect to influence the health of this vulnerable population in Canada. This study examines stakeholders’ perspectives on the health and well-being of temporary foreign workers (TFWs) and their families in Alberta, Canada. Stakeholders involved in providing services to TFWs perceived that the workers experience (1) barriers in accessing mental health services, (2) mental health challenges, (3) family health challenges, (4) occupational health challenges, and (5) income and social status as a social determinant of health. Immigration and class status intersect to influence the health of this vulnerable population in Canada.
This publication has no Abstract to dispaly

Over the past decade, scholars have begun to explore neglected aspects of immigrant family life such as gender relations, domestic violence, parenting, and relationships with service providers. Many of these studies, however, are based on women’s experiences. As an equally crucial starting point in building sustainable and resilient immigrant communities, our study focuses on the experiences of African immigrant men in a Canadian context. It reveals African immigrant men’s frustration with their search for a better life. Our thematic analysis of participants’ responses identified three main stressors among this group: challenges with economic integration, changing ideals about masculinities and gender relations across transnational spaces, and tensions in the parent-child relationship. These findings suggest that despite the vulnerabilities they face in Canada, African men could play a strategic role as critical agents of change in families’ transitions and integration. Overall, our study calls for the active engagement of both African immigrant men and women in developing policies and practices that impact their everyday lives. Over the past decade, scholars have begun to explore neglected aspects of immigrant family life such as gender relations, domestic violence, parenting, and relationships with service providers. Many of these studies, however, are based on women’s experiences. As an equally crucial starting point in building sustainable and resilient immigrant communities, our study focuses on the experiences of African immigrant men in a Canadian context. It reveals African immigrant men’s frustration with their search for a better life. Our thematic analysis of participants’ responses identified three main stressors among this group: challenges with economic integration, changing ideals about masculinities and gender relations across transnational spaces, and tensions in the parent-child relationship. These findings suggest that despite the vulnerabilities they face in Canada, African men could play a strategic role as critical agents of change in families’ transitions and integration. Overall, our study calls for the active engagement of both African immigrant men and women in developing policies and practices that impact their everyday lives.
This publication has no Abstract to dispaly

Uninsured maternity patients comprise a small but complex group of patients and include marginalized Canadians, undocumented immigrants, visitors, and non-Canadians seeking health care and/ or citizenship for their newborn. This study found a trend of uninsured deliveries in Calgary that is accounted for by non-Canadian patients. Midwives and physicians agree on provision of emergency care but not preventive care. Across medical specialties, fewer caregivers felt obliged to care for non-Canadian patients seeking citizenship for their newborn. Among physicians, 61% were aware of the Canadian Medical Protective Association’s guidelines on liability coverage for non-Canadian patients, and only 28% consistently protected themselves legally. There is large variation regarding whether physicians bill for services when the patient is uninsured. In Calgary, the study observed an increase in numbers of uninsured maternity patients. Differing ethical perspectives on the care of these patients may lead to conflict within health care teams because of differences on ethical perspectives of care among team members. Health care providers require education to understand the implications and challenges of obstetrical care of non-Canadians. Uninsured maternity patients comprise a small but complex group of patients and include marginalized Canadians, undocumented immigrants, visitors, and non-Canadians seeking health care and/ or citizenship for their newborn. This study found a trend of uninsured deliveries in Calgary that is accounted for by non-Canadian patients. Midwives and physicians agree on provision of emergency care but not preventive care. Across medical specialties, fewer caregivers felt obliged to care for non-Canadian patients seeking citizenship for their newborn. Among physicians, 61% were aware of the Canadian Medical Protective Association’s guidelines on liability coverage for non-Canadian patients, and only 28% consistently protected themselves legally. There is large variation regarding whether physicians bill for services when the patient is uninsured. In Calgary, the study observed an increase in numbers of uninsured maternity patients. Differing ethical perspectives on the care of these patients may lead to conflict within health care teams because of differences on ethical perspectives of care among team members. Health care providers require education to understand the implications and challenges of obstetrical care of non-Canadians.
This publication has no Abstract to dispaly

In Canada, tuberculosis disproportionately affects people who were born abroad. The national tuberculosis medical surveillance programme aims to prevent these cases. These people are referred (referrals) for further in-country surveillance after migration if they have a history of active tuberculosis or have features of old, healed tuberculosis on chest radiograph. Others who are not referred (non-referrals) do not undergo surveillance. In this study we looked at the risk of transmitting TB that comes from referrals and non-referrals. We also compared the transmission rates between the two groups. To make this comparison, we looked at information that Alberta Tuberculosis Registry had about foreign-born migrants (aged 15-64 years). We looked at information about people who came to Alberta between Jan 1, 2002, and Dec 31, 2013. We were interested in cases that had culture-positive pulmonary tuberculosis. We found that the incidence of culture-positive pulmonary disease was nine times higher in referrals than all non-referrals and five times higher in referrals than non-referrals from high-risk countries. Despite a much higher incidence of pulmonary tuberculosis in referrals than non-referrals, referrals were 80% less likely to transmit tuberculosis. But we suggest that instead of focusing only on referrals, Canada could consider screening and treatment of latent tuberculosis in all migrants from high-risk countries. In Canada, tuberculosis disproportionately affects people who were born abroad. The national tuberculosis medical surveillance programme aims to prevent these cases. These people are referred (referrals) for further in-country surveillance after migration if they have a history of active tuberculosis or have features of old, healed tuberculosis on chest radiograph. Others who are not referred (non-referrals) do not undergo surveillance. In this study we looked at the risk of transmitting TB that comes from referrals and non-referrals. We also compared the transmission rates between the two groups. To make this comparison, we looked at information that Alberta Tuberculosis Registry had about foreign-born migrants (aged 15-64 years). We looked at information about people who came to Alberta between Jan 1, 2002, and Dec 31, 2013. We were interested in cases that had culture-positive pulmonary tuberculosis. We found that the incidence of culture-positive pulmonary disease was nine times higher in referrals than all non-referrals and five times higher in referrals than non-referrals from high-risk countries. Despite a much higher incidence of pulmonary tuberculosis in referrals than non-referrals, referrals were 80% less likely to transmit tuberculosis. But we suggest that instead of focusing only on referrals, Canada could consider screening and treatment of latent tuberculosis in all migrants from high-risk countries.
This publication has no Abstract to dispaly

Children of newcomers to Canada are at a moderate to high risk for developing early childhood caries (ECC). The purpose of this study was to investigate the oral health of preschool children of refugee and immigrant families in Winnipeg. We recruited 211 children. Overall, 45.5% of the children had ECC and 31.8% had severe ECC (S-ECC). Infant dental enucleation was observed in 6 children. Things that we associate with severity of oral health conditions were increasing age, the presence of debris on teeth, parents believing their child has dental problems and the presence of enamel hypoplasia. Overall, ECC is prevalent in children of newcomer families in Manitoba. These data will inform advocacy efforts to improve access to dental care and tailor early childhood oral health promotion and ECC prevention activities for refugees and recent immigrants. Children of newcomers to Canada are at a moderate to high risk for developing early childhood caries (ECC). The purpose of this study was to investigate the oral health of preschool children of refugee and immigrant families in Winnipeg. We recruited 211 children. Overall, 45.5% of the children had ECC and 31.8% had severe ECC (S-ECC). Infant dental enucleation was observed in 6 children. Things that we associate with severity of oral health conditions were increasing age, the presence of debris on teeth, parents believing their child has dental problems and the presence of enamel hypoplasia. Overall, ECC is prevalent in children of newcomer families in Manitoba. These data will inform advocacy efforts to improve access to dental care and tailor early childhood oral health promotion and ECC prevention activities for refugees and recent immigrants.
This publication has no Abstract to dispaly