Meanings of Health, Illness and Help seeking Strategies among Punjabi speaking

Immigrants in Hamilton

Who we areWho we are

Research Team: Research Team: Partnership, interdisciplinaryPartnership, interdisciplinary

Community Advisory Group:Community Advisory Group: Community informants/leadersCommunity informants/leaders

Goals of this studyGoals of this study To collect preliminary data on To collect preliminary data on

community perceptionscommunity perceptions

To initiate community based To initiate community based action action through community engagementthrough community engagement

To provide culturally relevant access To provide culturally relevant access to services to decrease disparity, to services to decrease disparity, support health and strengthen support health and strengthen partnerships partnerships

Hamilton Metropolitan AreaHamilton Metropolitan Area

Population in 2006: 504,559

Area: 1,117.21 sq. km.

● 9th largest census metropolitan area in Canada

● Cities with highest proportion of recent immigrants (01-06)

Toronto (21%)

Montreal (26%)

Mississauga (22%)

● 3 % South Asians

(Mid-2006 census)

Visible Visible MinoritiesMinorities1 1 - - City of City of HamiltonHamilton22

19961996

# of % of # of % of

Persons Pop.Persons Pop.

20012001

# of % of# of % of

Persons Pop.Persons Pop.

20062006

# of % of# of % of

Persons Pop.Persons Pop. Change from Change from

1996-20061996-2006

Total population Total population by visible by visible minority groupsminority groups

462,555462,555 484,385484,385 497,395497,395 34,84034,840 7.5%7.5%

Total visible Total visible minority minority populationpopulation

41,44041,440 8.3%8.3% 52,70552,705 10.6%10.6% 67,84567,845 13.6%13.6% 26,40526,405 63.7%63.7%

ChineseChinese 5,8905,890 1.2%1.2% 7.4757.475 1.5%1.5% 9,3009,300 1.9%1.9% 3,4103,410 57.9%57.9%

South AsianSouth Asian33 8,4508,450 1.7%1.7% 11,00011,000 2.2%2.2% 14,76514,765 3.0%3.0% 6,3156,315 74.7%74.7%

BlackBlack 8,6558,655 1.7%1.7% 10.46010.460 2.1%2.1% 13,90013,900 2.8%2.8% 5,2455,245 60.6%60.6%

FilipinoFilipino 3,0703,070 0.6%0.6% 4,4154,415 0.9%0.9% 4,0454,045 0.8%0.8% 975975 31.8%31.8%

Latin AmericanLatin American 3,3603,360 0.7%0.7% 4,2504,250 0.9%0.9% 5,5855,585 1.1%1.1% 2,2252,225 66.2%66.2%

Southeast AsianSoutheast Asian44 4,2404,240 0.9%0.9% 4,4654,465 0.9%0.9% 6,0006,000 1.2%1.2% 1,7601,760 41.5%41.5%

ArabArab 3,9603,960 0.8%0.8% 3,7003,700 0.7%0.7% 5,3905,390 1.1%1.1% 1,4301,430 36.1%36.1%

West AsianWest Asian55 Not availableNot available 2,0652,065 0.4%0.4% 3,4503,450 0.7%0.7% ---- ----

KoreanKorean 900900 0.2%0.2% 1,4901,490 0.3%0.3% 1,5401,540 0.3%0.3% 640640 71.1%71.1%

JapaneseJapanese 1,0801,080 0.2%0.2% 755755 0.2%0.2% 980980 0.2%0.2% -100-100 -9.3%-9.3%

Visible minority, Visible minority, not included not included elsewhereelsewhere66

955955 0.2%0.2% 1,6601,660 0.3%0.3% 1,0451,045 0.2%0.2% 9090 9.4%9.4%

Multiple visible Multiple visible minorityminority

895895 0.2%0.2% 970970 0.2%0.2% 1,8401,840 0.4%0.4% 945945 105.6%105.6%

Not a visible Not a visible minorityminority

421,110421,110 84.7%84.7% 431,680431,680 86.8%86.8% 429,555429,555 86.4%86.4% 8,4458,445 2.0%2.0%

Qualitative approach drawing Qualitative approach drawing on participatory action research on participatory action research

Seven important considerations…Seven important considerations…

Gaining Access Gaining Access Encouraging participationEncouraging participation Maintaining Interest COSTMaintaining Interest COST Data Collection issuesData Collection issues Member Checking TIMEMember Checking TIME Report backReport back ActionAction

Occupation InformationOccupation InformationOccupational differences are important to note, as they Occupational differences are important to note, as they

were reported to add tension to the already difficult were reported to add tension to the already difficult resettlement process.resettlement process.

Intervening/Mediating variablesIntervening/Mediating variables

Financial aspects: Income/PovertyFinancial aspects: Income/Poverty EducationEducation Employment/underemploymentEmployment/underemployment Gender Gender (only mentioned by females- (only mentioned by females-

patriarchic)patriarchic) Interfamilial relationships Interfamilial relationships (females)(females) View of health care system- focus on View of health care system- focus on

treatment and not preventiontreatment and not prevention

Help-seeking barriers….Help-seeking barriers….

Priorities for ActionPriorities for ActionMuslim Women 1. Access to Recreation Centers

2. More female doctors 3. Fear of children losing cultural values

Muslim Men 1. Jobs 2. Worry about loss of religion and culture in future

generations 3. Difficulty finding doctors ; Information in own

language

Sikh Women 1. Information centres 2. Language specific resources 3. Culturally appropriate facilities for seniors;

information re child care facilities

Sikh Men 1. One single spot to get all necessary information ; access to information

2. No Canadian experience issue 3. Transportation for seniors; OHIP card issue

Hinu Women 1. Social Network Resource Centre2. Knowing what resources exist 3. Establish a social network for those >10 years

Hindu Men 1. Culturally sensitive health care services 2. OHIP card issue 3. Financial security; what resources & services

exist; educational materials on health

From Idea to Action……….From Idea to Action……….

Women for Women of India Isolated SeniorsWomen for Women of India Isolated Seniors project:project: – New Horizons grant application in partnership with Catholic New Horizons grant application in partnership with Catholic

Family Services, DARTS, Ontario Early Years Centre, Family Services, DARTS, Ontario Early Years Centre, Recreation Services, and Equal Access for Multicultural Health Recreation Services, and Equal Access for Multicultural Health workgroup for a project to support isolated seniworkgroup for a project to support isolated seniorsors

Translation of How to Start a Walking GroupTranslation of How to Start a Walking Group booklet and Pedometer guide booklet and Pedometer guide – into Punjabi, Arabic, Hindi, Bangladeshi and Urdu. To be into Punjabi, Arabic, Hindi, Bangladeshi and Urdu. To be

posted on website www.doitwell.caposted on website www.doitwell.ca

FREE physical activity program for women with limited incomes CALL:905-546-3540

child minding bus tickets prizes health talks healthy snacks pedometer loans gently used running shoes

Women’s Health Educators Provide free education sessions on women’s health in Urdu, Hindi, Punjabi, Chinese, Arabic and Vietnamese

Assist in setting up appointments for screening

Accompany women to appointments for free language support if needed

Call 905 546 3540 for more information.

Join us at 5 Hamilton locations to…Take a break from your busy day

Lessons Learned….Lessons Learned…. Advisory committeeAdvisory committee was instrumental in guiding was instrumental in guiding the researchthe research

Member CheckingMember Checking is key is key– Participants prioritized ideas, increasing the likelihood of Participants prioritized ideas, increasing the likelihood of

action and were involved with development of actions.action and were involved with development of actions.

Cultural, hierarchy issuesCultural, hierarchy issues – Older males should contact members of patriarchic Older males should contact members of patriarchic

communities,woman and younger men may not have communities,woman and younger men may not have credibility. A persons name is an important marker for credibility. A persons name is an important marker for members of the community, as it defines person’s caste, members of the community, as it defines person’s caste, occupation and where you come from.occupation and where you come from.

Recruitment issuesRecruitment issues– there may be relationship issues of which investigators are there may be relationship issues of which investigators are

unaware (i.e. facilitators being related). Investigators also unaware (i.e. facilitators being related). Investigators also need to be aware of biases and personal issues between the need to be aware of biases and personal issues between the facilitators that may impede their ability to work together. facilitators that may impede their ability to work together.

Lessons learnedLessons learned Personal outreachPersonal outreach

– i.e. approaching people individually, posting information where i.e. approaching people individually, posting information where members of the target group go in the community and where they live. members of the target group go in the community and where they live. Investigators MUST approach faith leaders at the beginning of the Investigators MUST approach faith leaders at the beginning of the project. If they don’t buy into the project, they will not allow access to project. If they don’t buy into the project, they will not allow access to the people in their faith community.the people in their faith community.

Facilitator biases were an issueFacilitator biases were an issue– Tape recorders were turned off during discussion about sensitive Tape recorders were turned off during discussion about sensitive

issues such as abuse and racism. Due to their desire to get ongoing issues such as abuse and racism. Due to their desire to get ongoing employment, facilitators’ desire to please their employers may affect employment, facilitators’ desire to please their employers may affect their honest feedbacktheir honest feedback..

TranscriptionTranscription– Require trained translators to prevent paraphrasing of discussion; and Require trained translators to prevent paraphrasing of discussion; and

encouraging verbatim translation. During meetings the facilitators at encouraging verbatim translation. During meetings the facilitators at times may have added information or changed information as it was times may have added information or changed information as it was discussed.. discussed..

ACTION: crucial to accountability to the ACTION: crucial to accountability to the community!!!community!!!