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Reduce Differences in Health Status Build Healthy Public Policy Strengthen Community and Personal Action
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Affirming Immigrant Women’s Health Practices in PEI Marian MacKinnon, Associate Professor, University of Prince Edward Island and President, InterCultural Health Assembly of PEI, and Laura Lee Howard, Past Executive Director, PEI Association for Newcomers to Canada, Maritime Centre of Excellence for Women’s Health
In Prince Edward Island, approximately 150 immigrants arrive annually. Today a total of 4,380 immigrants, about half of whom are women, live on the island. Immigrants to PEI face problems similar to those of other immigrants to Canada. However, the province’s physical isolation and economic challenges contribute to greater cultural isolation, and fewer cultural supports and services are available. Immigrant women have not been involved in studies about, and have not been recognized as resources for, their own health care.¹ The PEI Immigrant Women’s Health Project addressed this gap in current research and explored what health means to immigrant women. In interviews we asked 22 women from 15 countries what they did before they immigrated to maintain their health and whether they were able to continue these practices in their new home. We also asked them about their experiences using health services in PEI. Our study found that immigrant women have similar health needs and subscribe to similar health maintenance practices as those born in Canada,² but their resources are significantly less. The women expressed well-defined beliefs about health as a resource for daily living. They were very aware of the importance of practices such as eating well, getting adequate rest, and engaging in exercise, hobbies and other stress reduction activities. They shared beliefs that physical, mental and spiritual health are closely related, that health in one area affects health in other areas, and that their health affected their ability to take care of themselves and their families, to relate to other people in positive ways and to financially support themselves or go to school. However, the women said they did not have the time or resources to manifest their health maintenance beliefs or continue their health care practices. For example, their traditional foods were not available in PEI, nor were the herbs that they had learned to use as medicines for minor ailments in their home countries. Another critical factor identified by all of the women was the lack of social support (e.g., the ability to visit family, to have a good family environment and support from family, and the ability to visit friends). One woman said, "Family. Miss them a lot and when I think too much about them, I get depressed. [That] affects my health... I can live without my country but without my family is more difficult." A feeling of not being accepted in their communities was identified by many of the women as a related impediment to personal health care. Many of the women said that for psychological distress, depression or other emotional illness, they would talk to friends or family or distract themselves with work or other activities rather than, or before, going to a doctor. Without social connection and a feeling of belonging, these optionsfor self-care are greatly reduced. In fact, for this group of women, everything that offered the comfort of the familiar seemed unavailable to them. Loss of social support is believed to predispose the individual to feelings of vulnerability and to eventual illness. Some researchers have reported that social support is a major variable providing protection from mental and physical illness, especially during stressful life events such as chosen or forced immigration.³ The lack of support experienced by the immigrant women who participated in this study, therefore, is a critical finding. One remedy, among the many that are needed, would be to make food and nutrition classes available to immigrant women. This would serve the dual purpose of teaching them how to adapt their traditional cooking styles to the foods available in Canada and, at the same time, provide them with an opportunity to build a social network. A related intervention would be for Health Canada to develop an alternative Food Guide that would take into consideration the food and cooking preferences of other cultures. Language—the ability to express oneself in English—was another factor the women said profoundly affected their health and that of their families, creating unemployment, disadvantages in employment and obstacles in health care services. Although health care in PEI is "free," these women still face the complexities of learning how to access health care services and how to communicate and be understood. All of the women who were asked about language as a barrier said that professional health care interpreters were needed. Obtaining the kind of health care they value—holistic assessments and thorough examinations by a physician— was also perceived as an impediment. Despite strong beliefs about health and how to sustain it, immigrant women find it difficult to maintain their health practices in PEI. Their health needs are related to several determinants of health and, consequently, strategies for supporting their health care practices are needed in several areas. Specifically, higher levels of English language classes are critical to enable immigrant women to continue healthmaintenance practices and gain sufficient skills to compete in the job market. All of the women in this study felt that it was essential to have information about the Canadian health care system upon arrival, rather than three to four years later when they became Canadian citizens. Professional health care interpreters are also needed. Community outreach programs to facilitate the women’s participation in their communities and improve access to social and leisure activities are another common-sense strategy. Perhaps the first step toward affirming immigrant women’s health and achieving inclusive health policy is for politicians, health care providers and communities to begin to value these women. Putting policies and programs in place to support them in their efforts to build a new life would also be "cost effective" because, as they themselves report, when they are healthy they are better able to take care of their families and themselves. For a copy of the full report, "Affirming Immigrant Women’s
Health: Building Inclusive Health Policy," contact: NOTES |
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