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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
13
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
29
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
30
• 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
32
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
41
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
43
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
44
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