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Article
Publication date: 23 September 2013

Josephine Pui-Hing Wong, Alan Tai-Wai Li, Maurice Kwong-Lai Poon and Kenneth Po-Lun Fung

Canadian HIV/AIDS researchers, service providers and policy-makers are faced with new challenges of providing effective and inclusive care that meets the needs of the…

Abstract

Purpose

Canadian HIV/AIDS researchers, service providers and policy-makers are faced with new challenges of providing effective and inclusive care that meets the needs of the changing populations infected with and affected by HIV. Since 2005 immigrants and refugees from ethno-racial minority communities have comprised close to 20 percent of all new HIV infections in Canada. Anecdotes shared by PLWHAs and service providers indicated that mental health challenges faced by newcomer PLWHAs was a priority concern for HIV prevention, treatment and care. This paper reports on the results of an exploratory study, which examined the complex factors that influence the mental health of immigrants and refugees living with HIV/AIDS (IR-PLWHAs).

Design/methodology/approach

This exploratory study is informed by a critical social science paradigm, which acknowledges that the everyday reality is shaped by interlocking systems of social processes and unequal power relations. The paper used a qualitative interpretative design and focus groups to explore the intersecting effects of living with HIV/AIDS, migration and settlement, and HIV stigma and discrimination on the mental health of IR-PLWHAs.

Findings

The paper found that in addition to social and economic marginalization, IR-PLWHAs experienced multiple stressors associated with their HIV status: neurocognitive and physical impairments, HIV stigma and discrimination, and fear of deportation. The paper also found that the experiences of stigma and discrimination among IR-PLWHAs were complex and contextual, closely linked to their social positions defined by the intersecting dimensions of race, class, gender, citizenship, sexualities, body norms, and HIV status. The paper concludes that effective HIV prevention, treatment and care, and mental health promotion in newcomer and ethno-racial minority communities must consider the bio-psycho-social connections of different stressors and the interlocking systems of oppression faced by IR-PLWHAs.

Research limitations/implications

This study was exploratory in nature with a small number of participants who were recruited through AIDS organizations in Toronto. Consequently, the recruitment strategy may reach only those who were connected to the AIDS organizations. The paper believes that IR-PLWHAs who were not connected to the AIDS organizations might experience even more social exclusion and marginalization. These factors may limit the transferability of this study.

Originality/value

This is the first study that explores the bio-psycho-social connections and intersecting determinants of mental health among immigrants and refugees living with HIV and AIDS in Canada. The results of this study contribute to cross-sector dialogue among practitioners and researchers in the HIV/AIDS, mental health, and immigration and settlement services sectors.

Details

International Journal of Migration, Health and Social Care, vol. 9 no. 3
Type: Research Article
ISSN: 1747-9894

Keywords

Article
Publication date: 9 September 2014

Sharon D. Koehn, Pavlina Jarvis, Sharanjit K. Sandhra, Satwinder K. Bains and Madeleine Addison

The purpose of this paper is to explore if and how community organizations providing services to late-in-life Punjabi immigrants in British Columbia, Canada, offer…

Abstract

Purpose

The purpose of this paper is to explore if and how community organizations providing services to late-in-life Punjabi immigrants in British Columbia, Canada, offer services with the potential to promote their mental health or well-being. The authors also wanted to know how Punjabi seniors perceived available services and if they supported their mental well-being.

Design/methodology/approach

To guide the research, the authors used the VicHealth Framework, which identifies three overarching social and economic determinants of mental health: social inclusion (SI), freedom from violence and discrimination, and access to economic resources and participation. This mixed methods study combines descriptive survey and qualitative focus group data with input from Punjabi seniors and community service providers.

Findings

All three mental health determinants were identified as important by service providers and seniors, with SI as the most important. Family dynamics (shaped by migration and sponsorship status) influence all three determinants and can promote or diminish mental well-being.

Research limitations/implications

The pilot study is limited in sample size and scope and further inquiry with different groups of immigrant older adults is warranted.

Practical implications

Service providers assert that more outreach and sustainable funding are needed to reach the majority of potential beneficiaries unable to participate in community programmes. Information on mental well-being of seniors should be targeted at both seniors and their families.

Originality/value

The VicHealth Framework provided a unique lens through which to explore the contributions of community organizations to mental health promotion for immigrant older adults.

Details

Ethnicity and Inequalities in Health and Social Care, vol. 7 no. 3
Type: Research Article
ISSN: 1757-0980

Keywords

Article
Publication date: 17 November 2011

Kenneth W. Lee

This paper aims to compare the health status of Roma in Europe and Aborigines in Australia, examining access to health care (both primary and long‐term), administrative…

Abstract

Purpose

This paper aims to compare the health status of Roma in Europe and Aborigines in Australia, examining access to health care (both primary and long‐term), administrative and communication problems, environmental risks associated with location of residences, women's health, substance abuse and mental health.

Design/methodology/approach

The paper discusses issues generated by cultural practices by both health care providers and the target groups.

Findings

Both Roma and Australian Aborigines have significantly poorer health status than the majority of the societies they are embedded in, and are clearly amongst the most disadvantaged members of their respective societies. Nevertheless, affirmative action programs for Aboriginal people over the last 40 years have produced some significant changes, with Aboriginal doctors and nurses, and culturally appropriate service provision being found in many areas.

Originality/value

Although there are considerable similarities between the health status and situation of Romanies and Australian Aborigines, clearly, there are also substantive differences. The paper suggests possible culturally appropriate service provision for Roma, based on Australian Aboriginal experiences and models.

Details

Ethnicity and Inequalities in Health and Social Care, vol. 4 no. 4
Type: Research Article
ISSN: 1757-0980

Keywords

Article
Publication date: 11 December 2017

Lynn Tang and David Pilgrim

The purpose of this paper is to provide qualitative evidence from the experience of Chinese service users in the UK to expand the literature on the use of

Abstract

Purpose

The purpose of this paper is to provide qualitative evidence from the experience of Chinese service users in the UK to expand the literature on the use of intersectionality analysis in research on the mental health of ethnic minority groups.

Design/methodology/approach

Repeated in-depth life-history interviews were carried out with 22 participants. Interviews were analysed using the constant comparative method.

Findings

Four areas of life are identified for their possible negative impact on mental health for this minority group: labour market and work conditions, marriage and family, education, and ageing. The findings illustrate how these intersecting variables may shape the social conditions this ethnic minority group face. For this ethnic minority group in the UK, inequalities can intersect at national as well as transnational level.

Originality/value

This paper highlights how power relations and structural inequalities including class, gender, age and ethnicity could be drawn upon to understand the interplay of determinants of mental health for ethnic minority groups. As the multi-factorial social forces are closely related to the emergence of poor mental health, it is suggested that interventions to reduce mental health problems in ethnic minority communities should be multi-level and not limited to individualised service responses.

Details

Mental Health Review Journal, vol. 22 no. 4
Type: Research Article
ISSN: 1361-9322

Keywords

Article
Publication date: 14 December 2015

Mushira Mohsin Khan and Karen Kobayashi

The purpose of this paper is to identify the salient barriers in the uptake and effective utilization of health promotion interventions among ethnocultural minority older…

Abstract

Purpose

The purpose of this paper is to identify the salient barriers in the uptake and effective utilization of health promotion interventions among ethnocultural minority older adults (EMOA).

Design/methodology/approach

The paper opted for a literature review of 25 sources (peer-reviewed articles as well as documents from the grey literature). The search was primarily conducted in a database developed during a scoping review on the health and health care access and utilization of EMOA. Emphasis was placed on older ethnocultural minorities in Canada; however examples from the UK (which has a comparable health care system) and the USA and Australia (which have large, ethnically diverse populations) were also selected. The Candidacy framework was used as an analytical lens in the review.

Findings

Findings indicate that health promotion needs to be understood as comprehensive care, involving not only the provision of health care services, but also knowledge dissemination and the facilitation of access to these services. Limited health literacy, low levels of self-efficacy and autonomy, and diverse life course experiences, particularly in the case of immigrant older adults, give rise to issues around the identification of need and system navigation. Cultural beliefs on health and illness, particularly around diet and exercise, and a lack of trust in formal systems of health care, are barriers to the uptake of interventions. Similarly, service permeability is low when cultural competency is lacking.

Practical implications

The recommendations include the need for collaborative engagement with stakeholders, including family, peers, community partners and health practitioners, and the development of concise, culturally, and linguistically appropriate tools of health promotion that are targeted toward the intersecting needs of individuals in this diverse population of older adults.

Originality/value

Given the increasingly diverse nature of the older adult population in Canada over the past four decades, this paper makes an important contribution toward understanding the social, cultural, structural, biographical, and geographical factors that may optimize the effective dissemination and uptake of health promotion interventions among EMOA.

Details

International Journal of Migration, Health and Social Care, vol. 11 no. 4
Type: Research Article
ISSN: 1747-9894

Keywords

Article
Publication date: 29 November 2013

Margaret Robinson and Lori E. Ross

The purpose of this paper is to outline the use of intersectionality theory in research with gender and sexual minorities – that is, with lesbian, gay, bisexual, trans…

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Abstract

Purpose

The purpose of this paper is to outline the use of intersectionality theory in research with gender and sexual minorities – that is, with lesbian, gay, bisexual, trans, and queer (LGBTQ) people, and lesser-studied groups such as two-spirited people.

Design/methodology/approach

First, the paper note the limited way that LGBTQ research has taken up issues of intersecting oppression. The paper outlines why theoretical and methodological attention to overlapping oppressions is important, and why theorists of intersectionality have identified the additive model as inadequate. The paper presents a sketch of current best practices for intersectional research, notes special issues for intersectional research arising within qualitative and quantitative paradigms, and finishes with an overview of how these issues are taken up in this special issue of Ethnicity and Inequalities in Health and Social Care.

Findings

Current best practices for intersectional research include. Bringing a critical political lens to data analyses; contextualizing findings in light of systemic oppressions; strategically using both additive and multivariate regression models; and bringing a conscious awareness of the limitations of current methods to our analyses.

Originality/value

This paper addresses the use of intersectionality theory in research with gender and sexual minorities, highlighting methodological issues associated with qualitative and quantitative paradigms in LGBTQ research.

Details

Ethnicity and Inequalities in Health and Social Care, vol. 6 no. 4
Type: Research Article
ISSN: 1757-0980

Keywords

Open Access
Article
Publication date: 23 July 2018

Nancy Clark

The purpose of this paper is to describe Karen refugee women’s experience of resettlement and the factors which structured community capacity to support their mental health

3147

Abstract

Purpose

The purpose of this paper is to describe Karen refugee women’s experience of resettlement and the factors which structured community capacity to support their mental health and well-being.

Design/methodology/approach

A postcolonial and feminist standpoint was used to bring Karen women’s voice to the knowledge production process. Data were collected through ethnographic field observation, in-depth semi-structured individual and focus group interviews with Karen women as well as healthcare and social service providers.

Findings

Three interrelated themes emerged from the data: Karen women’s construction of mental health as “stress and worry”; gender, language and health literacy intersected, shaping Karen women’s access to health care and social resources; flexible partnerships between settlement agencies, primary care and public health promoted community capacity but were challenged by neoliberalism.

Research limitations/implications

Karen women and families are a diverse group with a unique historical context. Not all the findings are applicable across refugee women.

Practical implications

This paper highlights the social determinants of mental health for Karen women and community responses for mitigating psychological distress during resettlement.

Social implications

Public health policy requires a contextualized understanding of refugee women’s mental health. Health promotion in resettlement must include culturally safe provision of health care to mitigate sources of psychological distress during resettlement.

Originality/value

This research brings a postcolonial and feminist analysis to community capacity as a public health strategy.

Details

International Journal of Human Rights in Healthcare, vol. 11 no. 4
Type: Research Article
ISSN: 2056-4902

Keywords

Book part
Publication date: 23 October 2003

Lynn Weber and Deborah Parra-Medina

Scholars and activists working both within and outside the massive health-related machinery of government and the private sector and within and outside communities of

Abstract

Scholars and activists working both within and outside the massive health-related machinery of government and the private sector and within and outside communities of color address the same fundamental questions: Why do health disparities exist? Why have they persisted over such a long time? What can be done to significantly reduce or eliminate them?

Details

Gender Perspectives on Health and Medicine
Type: Book
ISBN: 978-1-84950-239-9

Article
Publication date: 15 June 2021

Lilcelia A. Williams

Intersectionality theory is a social justice theory customarily employed to address inequities which arise in the academic or legal arenas as it relates to race and…

Abstract

Purpose

Intersectionality theory is a social justice theory customarily employed to address inequities which arise in the academic or legal arenas as it relates to race and gender. The application of intersectionality theory extends beyond the convergence of multiple social identities. It provides an invaluable framework to examine the convergence of social identities, the social determinants of health and a global pandemic in communities of historically marginalized and underrepresented persons. The purpose of this paper is to examine how the coronavirus pandemic has exacerbated the disparities experienced by African American and Latinx persons using the principles of intersectionality theory as the schema.

Design/methodology/approach

A literature review was performed on the scholarly articles examining the disproportionate incidence and mortality rates of African Americans and Latinx persons in America.

Findings

The current literature confirms that the disparities which existed prior to the onset of the coronavirus pandemic have been magnified by systemic oppression and racism of historically marginalized and underrepresented persons in America. The coronavirus pandemic has spotlighted the disparities in sustainable employment and access to health care for African American and Latinx persons.

Originality/value

Employing a social justice theoretical framework of intersectionality provides an opportunity to examine the lived experiences of African American and Latinx persons without race/ethnicity being the primary focal point. Future research will illustrate the urgent need for public health policy reform to eradicate the disparities experienced by African American and Latinx populations.

Details

Equality, Diversity and Inclusion: An International Journal, vol. 41 no. 1
Type: Research Article
ISSN: 2040-7149

Keywords

Book part
Publication date: 28 April 2022

Daryl Mahon and Ravind Jeawon

Organisations and systems of care working within both specific and non-specific trauma-informed approaches must adapt a multicultural lens, in design, delivery and

Abstract

Organisations and systems of care working within both specific and non-specific trauma-informed approaches must adapt a multicultural lens, in design, delivery and evaluation of services and interventions. Cultural and social factors can directly influence the exposure of individuals to traumatic events (Roberts, Austin, Corliss, Vandermorris, & Koenen, 2010). At the same time, social and cultural identities influence the development and experience of trauma and symptoms, including treatment outcomes (Marsella, 2010; Wilson, 2007). In this chapter, Ravind Jeawon and I provide some of the essential factors that trauma-responsive systems may wish to consider. The first part of this chapter deals with the idea of multicultural identities and practices and highlights some of the outcomes associated with accessing behavioural healthcare. The impact of intersectionality and microaggression on those from diverse backgrounds is also considered. Finally, a guiding framework is provided that examines what needs to be implemented across organisations in order to provide the system with a multicultural lens in which to view and deliver appropriate services. Crucially, multicultural responsiveness will not come from tick box training regimes, it is something that needs to be kept on the agenda and is a lifelong trajectory.

Details

Trauma-Responsive Organisations: The Trauma Ecology Model
Type: Book
ISBN: 978-1-80382-429-1

Keywords

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