Healthy Newcomers, Healthy Communities. Introduction In 2010, Newcomer Womens Services Toronto...

Healthy Newcomers, Healthy Communities

Introduction

• In 2010, Newcomer Women’s Services Toronto embarked in a project to engage newcomer women in making policy recommendations to support newcomers in raising heart-healthy families.

• We convened an advisory committee to inform the content of a leadership training weekend for newcomer mothers

• After the training, a group of women conducted their own research projects and then presented their recommendations to the advisory committee

Outline

• Background: Healthy Immigrant Effect• MOSAICS – Newcomer Parents Leadership

Training• Factors Affecting Newcomer Health (what we

heard at the training)• Research Methodology• Research Projects:

– Access to Community Centres– Newcomers and Mental Stress

• Recommendations

4

Background:The Healthy Immigrant Effect

• “[A] pattern whereby newcomers initially present positive health characteristics that deteriorate or worsen following immigration is known as the "healthy immigrant effect." (Gushulak, 2007).

• 9 out of 10 immigrants are healthier [than average Canadian population] upon arrival in Canada, as they have to undergo a medical examination as part of the eligibility criteria.

5

MOSAICS – Newcomer Parents’ Leadership Training

• 50 women, 30 children, 1 weekend

• Topics covered:– Newcomer health– Nutrition– Diabetes– Public policy– Civic engagement– Public speaking

MOSAICS – Newcomer Parents’ In Action

7

Factors Affecting Newcomer Health (according to leadership training participants)

• Settlement stress– Communication (language, accent)– Change in social status– Separation from family/homesickness– Education/Credentials not recognized

• Financial issues– Lack of employment– High cost of housing, transportation, food

8

• Employment– Credentials not recognized– Change in economic status– No Canadian experience– Lack of knowledge of Canadian labour laws

and worker rights– Lack of information about employment

programs– Structural unemployment

Factors Affecting Newcomer Health (according to leadership training participants)

9

• Diet and nutrition– Trouble finding Halal food (lack of

knowledge / no clear labeling)– Parents don’t have enough time to prepare

food– Expensive to buy healthy food for big families– Food banks don’t provide fresh food, some

foods are expired or inappropriate– Organic food is too expensive

Factors Affecting Newcomer Health (according to leadership training participants)

10

• Isolation– Language barriers (shy to speak)– Fear of discrimination (different treatment because of

accent)

• Lack of information on programs and services for newcomers

• Lack of exercise• Poor public transportation

– Not all TTC stations are accessible, especially to strollers

Factors Affecting Newcomer Health (according to leadership training participants)

11

Community-Based Research

• After the leadership training weekend, 8 participants conducted research on two major themes:– Access to Community Centres

• Survey was designed and administered to 78 newcomers

• Environmental scan of community centres was conducted

– Newcomers and Mental Stress• Survey was designed and administered to 22

newcomers

12

Access to Community Centresby

Jingbo Xu, Tenzin Fatema, Amal Al-Badri, Farhana Choudhury, Mumtaz Somani, Nurun Khanam

• Access to community centres was examined because these facilities have the potential to address the following challenges:– Isolation– Lack of information on programs and

services for newcomers– Lack of exercise

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Ag e

0

5

10

15

20

25

30

35

under 18 19-30 31-45 46-65 over 65

G ender

01020304050607080

male female

Access to Community CentresSurvey Respondents

T ime in C anada

0

5

10

15

20

25

30

les s than 2 years 2-5 years 5-10 years more than 10years

14

Access to Community CentresSurvey Respondents

15

C ountry of Orig in

C hina

P akis tan

Iraq

S ri L anka

India

Mauritius

Other

B anglades h

Access to Community CentresSurvey Respondents

16

C hang e in health s inc e arrival in C anada (res pondents of all ag es )

0

5

10

15

20

25

30

35

40

gotten wors e s tayed the s ame gotten better

Access to Community CentresSurvey Results

17

C hange in health s ince arrival in C anadaY outh (under 30)

0

1

2

3

4

5

6

7

8

9

10

gotten wors e s tayed the s ame gotten better

Access to Community CentresSurvey Results

18

C hang e in health s inc e arrival in C anadaAdults (ag es 31-65)

0

5

10

15

20

25

30

gotten wors e s tayed the s ame gotten better

Access to Community CentresSurvey Results

19

C hang e in health s inc e arrival in C anadaS eniors (over 65)

0

1

2

3

4

5

6

7

8

9

gotten wors e s tayed the s ame gotten better

Access to Community CentresSurvey Results

B arriers to C ommunity C entre Us e(res pondents of all ag es )

0 5 10 15 20 25 30 35

the programs are too expens ive

lack of childcare

they don't offer programs I'm interested in

It's far from my house

the programs are not offered at convenient times

I tried to regis ter but there's no space

I don't know what they have there

transportation is too expens ive

lack of time

20

Access to Community CentresSurvey Results

21

B arriers to C ommunity C entre Us e(youth - under 30)

0 1 2 3 4 5 6 7 8 9 10

lack of childcare

they don't offer programs I'm interes ted in

the programs are too expens ive

I tried to reg is ter but there's no s pace

I don't know what they have there

the programs are not offered at convenient times

trans portation is too expens ive

It's far from my hous e

lack of time

Access to Community CentresSurvey Results

22

B arriers to C om m unity C entre Us e(adults ag es 31-65)

0 2 4 6 8 10 12 14 16 18 20

lack of childcare

I tried to reg is ter but there's no s pace

they don't offer programs I'm interes ted in

the programs are too expens ive

It's far from my hous e

the programs are not offered at convenient times

I don't know what they have there

trans portation is too expens ive

lack of time

Access to Community CentresSurvey Results

23

B arriers to c ommunity c entre us e (s eniors - over 65)

0 1 2 3 4 5 6 7

lack of childcare

they don't offer programs I'm interes ted in

the programs are not offered at convenient times

It's far from my hous e

I tried to reg is ter but there's no s pace

I don't know what they have there

the programs are too expens ive

lack of time

trans portation is too expens ive

Access to Commmunity CentresSurvey Results

P rog rams of Interes t (res pondents of all ag es )

0 5 10 15 20 25 30 35 40

s ewingdriving

cookingcomputer c las s

s wimming (women only)knitting

employment s kills trainingnewcomer s upport group

field tripss wimming (mixed)

yoga (women only)movies

martial artsyoga (mixed)

s ports (women only)s ports (mixed)

parentingdancing (mixed)

dancing (women only)drama 24

Access to Community CentresSurvey Results

25

P rog rams of interes t(youth - under 30)

0 2 4 6 8 10 12

s ewing

s wimming (women only)

s wimming (mixed)

computer c las s

yoga (mixed)

yoga (women only)

s ports (women only)

movies

dancing (women only)

employment s kills training

field trips

s ports (mixed)

drama

martial arts

knitting

parenting

newcomer s upport group

dancing (mixed)

Access to Community CentresSurvey Results

26

P rog rams of Interes t(adults 31-65)

0 5 10 15 20 25

drivingcookings ewing

employment s kills trainings wimming (women only)

knittings wimming (mixed)

moviesfield trips

martial artsnewcomer s upport group

yoga (women only)danc ing (mixed)

s ports (mixed)dancing (women only)

yoga (mixed)s ports (women only)

dramaparenting

Access to Community CentresSurvey Results

27

P rog rams of Interes t(s eniors , over 65)

0 1 2 3 4 5 6

dancing (mixed)yoga (mixed)

s ewingcooking

computer c las ss wimming (mixed)

s ports (mixed)knittingmovies

newcomer s upport groupfield trips

martial artss wimming (women only)

employment s kills trainingyoga (women only)

drivingdancing (women only)

s ports (women only)drama

parenting

Access to Community CentresSurvey Results

28

Do available program match newcomers’ interests?

Community Centre

Sewing Driving Cooking Computer Women’s only swimming

Fitness programs

Eastview Neighbourhood Community Centre

☺ ☺South Riverdale Community Health Centre ☺ ☺Flemingdon Health Centre ☺ ☺ ☺Oakridge Community Centre ☺

Access to Community CentresEnvironmental Scan

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Can community centres accommodate women’s only fitness programs?

Community Centre Response

Oakridge “Why not?” – willing to look into it, if given support

4040 Lawrence Storefront “We’ll think about it”

Flemingdon Neighbourhood Services

“This is a request that should be sent to the Manager of the department”

Eastview “No one has requested that before”

Access to Community CentresEnvironmental Scan

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• Provide more opportunities for newcomers to socialize and overcome isolation– More volunteer opportunities– Driving, sewing, cooking classes

• More support for families with young children

• Increase the recreational services and programs in underserved areas

Access to Community CentresRecommendations

Newcomers and Mental StressBy

Hafsa Imam and Nurun Khanam

• The factors influencing the mental stress of newcomers were examined because mental stress is a key determinant of health and may be a contributor to the healthy immigrant effect

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Newcomers and Mental StressSurvey Respondents

Age

0

5

10

15

20

25

under 18 19-30 31-45 46-65 over 65

Gender

0

2

4

6

8

10

12

male female

33

Time in Canada

0

1

2

3

4

5

6

7

8

less than 2 years 2-5 years 5-10 years more than 10years

Newcomers and Mental StressSurvey Respondents

34

Country of origin

Bangladesh

India

Pakistan

Phillipines

Newcomers and Mental StressSurvey Respondents

35

Level of Education

0

2

4

6

8

10

12

14

some post-secondary

university graduate post-graduate(Masters or PhD)

Newcomers and Mental StressSurvey Respondents

36

Newcomers and Mental StressSurvey Respondents

Previous Occupations in Home Country

Accountant (1) Businessman (1)

Engineer (4) Lawyer (1)

NGO worker (2) Nutritionist (2)

Scientist (1) Statistician (1)

Police officer (1) Teacher (1)

Not applicable (7)

Current Occupations in Canada

Retail (7)– Tim Horton’s– Walmart– McDonalds– Shoppers Drug Mart– Home Depot

Hospitality (2)– Hotel management– Restaurant chef

Security guard (2)

Cleaner (1)

Taxi Driver (4) “Survival job” (1)

Not applicable (5)

37

Change in health since arrival in Canada

0

2

4

6

8

10

12

14

gotten worse stayed the same gotten better

Newcomers and Mental StressSurvey Results

38

How much do the following factors affect your level of stress?

0 5 10 15 20

Finding a job in my field

Finding affordable housing

3 month delay for health card

Working in a survival job

Language barrier

Social isolation

Lack of opportunities to exercise

Finding healthy food

Children adjusting to Canada

Finding familiar foods

not at all

a little

moderately

a lot

Newcomers and Mental StressSurvey Results

Sources of Settlement Information

0 5 10 15 20

friends

internet

settlement worker

family

library

place of worship

child's school

community centre39

Newcomers and Mental StressSurvey Results

40

• Bridging programs for newcomers in their fields of expertise

• Housing support/subsidy for first two years after arrival in Canada

• Eliminate the 3 month delay for obtaining health insurance (OHIP cards)

• Cost free and quick accreditation

Newcomers and Mental StressRecommendations

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The Big Picture as we see it

• The data points to the need for a shift away from the current ‘health promotion lifestyle framework’ (which privileges middle-class Canadian-born) to a more structural analysis of settlement & health

i.e. ‘Less jogging, more jobs’

‘Portion size vs. Portion availability’

42

The Big Picture ….

A structural analysis integrates an understanding of the racialization of poverty and the social of determinants of health grounded in the reality of settlement and migration stress facing newcomer families

Racism + Poverty = Poor Newcomer Health

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Possible Policy Options (within existing resources)

• Schedule ‘women-only’ swimming for mothers and their children after school

• Schedule joint or dual programming: scheduling mothers and children’s classes to address timing and TTC costs

• Train outreach workers to reach people at newcomer gathering places

• Create ‘knowledge portals’; conduct ‘search engine optimization’ so newcomers can Google ‘women and swimming class’; ‘family recreation programs’ and access services

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Acknowledgements

• Research Team: Mumtaz Somani, Amal Al-Badri, Sadia Sultana, Farhana Chowdhury, Jingbo Xu, Tenzin Fatema, Nurun Khanam, Hafsa Imam, & Sawitri Mardyani

• Khaleda Yasmin, Diabetes Education Community Network of East Toronto

• Cindy Tsai, Women’s Health in Women’s Hands

• Peter Dorfman, Toronto Public Health – City of Toronto

• Kristen Worley, Parks, Forestry & Recreation – City of Toronto

• Lisa Quirke, PhD Candidate, University of Toronto

• Canadian Diabetes Association

This project has been made possible through funding from the Heart & Stroke Foundation of Ontario