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HSCI 855 - Week 12: Immigrant Health Promotion - Coggle Diagram

- - - - Report
        
        a. Why shouldn't migrant groups be wary of using western health systems that don't appropriately address our needs anyways?
      - Seek help
      - Receive a proper diagnosis
    - - It doesn't sit right with me to discuss the epidemiological data without also having the conversation of the ongoing generational trauma from colonialism, imperialism, and the effects of capitalism even on food choice, what success looks like etc. among immigrant groups, and particularly among South Asian communities in these examples
        
        a. For me personally, I'm thinking about how the Partition of India only happened in 1947 yet this isn rarely in dialogue with the the health of Punjabi people in particular.
  - - - Allows us to understand the effect of intersectionality on the social determinants to produce conditions of “multiple jeopardy” thereby limiting the uptake of health promotion practices within specific groups
        
        a. COVID-19 recovery strategies need to adopt an intersectional lens taking into account race, migration and gender since ACB women and ACB immigrant women have been among the populations most impacted both personally and economically.
        
        i.There is an urgent need to incorporate variables capturing race, beyond “visible minority” status; gender, beyond looking at differences between women and men; and factors to help understand the complexities of migration trajectories (i.e., beyond the dichotomy of born in Canada versus not born in Canada categories) in Canadian datasets.
        
        ii. "Women, who are often unemployed or precariously employed in sectors affected by the pandemic, such as retail and service jobs, have experienced proportionately steeper job losses than men (Statistics Canada 2020). Women also comprise 70% of health and social service workers, which places them at greater risk of exposure to the virus."
        
        In Canada, more than 1/3 of people employed as nurse aides are immigrants, and women make up 86% percent of this population
        
        Face GBV due to financial instability, unstable social and protective networks, reinforcement of unequal power dynamics - affects access to necessary health and social supports
        
        a. Isolation increased risk of violence for many women, acting as a barrier to safety and support - immigrant women at increased risk during the covid-19 pandemic
        
        "According to Khanlou and Ssawe (2020), racialized women are experiencing a syndemic of gender-based violence and systemic racism in the context of COVID-19, placing their well- being at a disproportionate risk"
- - - - I think this framing puts the onus on the immigrants, when it should be on the systems/institutions
    - - How can this be turned around to be used as a strengths based approach? Doesn't this show aspects of resilience when there is mistrust of organized health care? Is this a bad thing?
    - - Again these people have moved and have less access to their cultural foods, often immigrants are working longer hours (legally/illegally) to make ends meet and may be more heavily relying on convenience foods, these simplifications do not contextualize their stories/struggles enough
    - - "While the increased availability of nutritional knowledge in the host country may result in a change in dietary habits based upon length of residence, the consumption of red meat, convenience foods, sugar-sweetened beverages, and desserts and candy may increase due to their easy access and low cost"
    - - Families partaking in care-taking takes a huge burden off of the healthcare system. If this was appropriately recognized through compensation, older adults may not feel bad to seek preventative services as their children now have the time/money to take care of them
  - - - Living in poverty increases economic barriers to health promotion practices
      - Immigrant women balancing stressors of competitive labour market with demands of care provision for their older relatives at home
  - - - Informal sources for health information - traditional and complementary medicine practitioners
    - - May compound issue related to linguistic capability - limited uptake of health promotion practice
  - - - Less likely to use cancer screening services - “Specifically, recently immigrated visible minority women are more likely to have never had a Pap test, partly due to the limited availability of culturally competent physicians” (Amankwah, Ngwakongnwi, & Quan, 2009)
  - - - There is a prevalent narrative in many south Asian cultures of the “mean/gossiping aunty” and the way these women are so easily caricaturized by people in their communities and often younger women in their communities is a form of internalized misogyny/racism, and yet whole brands have been built off of this narrative
        
        a. ex. Hatecopy, whose artwork I adore, but initially, at least, profited off of this narrative. Once you recognize it, you feel ashamed and sad for this first generation of women that immigrated over and have had so much taken away from them, only for the younger generation to reduce them into one generalization/identity/oversimplification
    - - Traditional patriarchal norms and dependence on men
      - Values and behaviours that preclude immigrant women from participating in health promotion programs and/or accessing important health care resources
        
        a. Need for culturally relevant health and social programs/interventions
  - - - Ex. Becoming less active is a normal part of aging - South Asian older adults
        
        a. Decline in health = warning sign to modify lifestyle
      - Ex. Widowed immigrant women ambivalence towards leisure activities
        
        a. Largely determined by culture and tradition-driven prescriptions, such as a stoic approach towards health and illness
        
        b. guided by strict gender-based normative ideals constructed during the earlier stages of their lives in their country of birth.
        
        c. The ability to make choices based upon internalized and culture-specific values, therefore, is an important determinant of access to, and uptake of, health promotion practices.
  - - - Language and cultural barriers that may make forging new connections more difficult in the host country
      - Immigration experience oftentimes separates people from lifelong networks of family and friends
- - - - Even the name of it - Saet means health in Punjabi :)
      - “Preliminary results from the trial indicate that attendance in the exercise program remained high throughout the 12-week period, visceral adipose tissue (VAT) was significantly reduced among women who adhered to the program, and several women reported an improvement in their sense of wellbeing”
      - Efficacy of cardiovascular exercise on reducing body fat distribution in post-menopausal South Asian women
      - Bhangra mixed with standard aerobic exercise
      - Importance...
        
        a. Offered in accessible/familiar place
        
        b. Culturally appropriate program
        
        i. Able to wear traditional clothing - find greater comfort in it
        
        c. Greater participation in program, low drop-outs
    - - “Funded by the Community Action Initiative, East Vancouver’s REACH Multicultural Family Centre partnered with immigrant-serving organizations, community centres, and community health and mental health agencies to promote the mental health and wellbeing of high-risk immigrant communities in Metro Vancouver”
      - Involved cross-cultural health promoters (CCHPs), also known as cross-cultural health brokers (CCHBs), trusted leaders of a cultural community, who not only served as language translators but also facilitated the effective transfer of information in culturally sensitive ways. In essence, these “brokers” acted as a bridge between the values and beliefs of “mainstream” Canadian culture and the traditions and values of the client’s culture.
      - The CCHP/Bs were either certified Canadian social work or counselling practitioners and/or they were foreign-trained health professionals. The program had two components: (1) social support groups; and (2) community capacity-building activities.
  - - - Family members, trained volunteers, and outreach workers could also be used to facilitate dialogue and community engagement in the production and delivery of health promotion resources and interventions
    - - Feelings may be magnified in immigrant population
- - - - 1.Invest in training to ensure they meet local practice standards
    - - Working in coalition with networks that include migrant resource centres, trade unions, advocacy, and human rights organisations, can facilitate outreach and mutual learning
      - Migrant resource centres have been established through the efforts of migrants, often employing local and transnational networks.They offer services and facilitate migrants’ access to healthcare—often regardless of documented status.
        
        a. Examples...
        
        i. Farmworker Health Network in the USA
        
        ii. Multicultural Coalition for Equity in Health in Canada
        
        iii. Mission for Migrant Workers in Hong Kong
        
        b. Operate with assistance from public and private partners
        
        c. These coalitions aim to reduce adverse social determinants of health and offer innovative sites for launching interventions at the workplace and in the community