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Urban Aboriginal mobility in Canada: examining the association with health care utilization.

https://arctichealth.org/en/permalink/ahliterature119728
Source
Soc Sci Med. 2012 Dec;75(12):2420-4
Publication Type
Article
Date
Dec-2012
Author
Marcie Snyder
Kathi Wilson
Author Affiliation
Department of Geography, University of Toronto Mississauga, 3359 Mississauga Rd. N., Mississauga, Ontario, Canada. marcie.snyder@utoronto.ca
Source
Soc Sci Med. 2012 Dec;75(12):2420-4
Date
Dec-2012
Language
English
Publication Type
Article
Keywords
Confidence Intervals
Female
Health Care Surveys
Health Services - utilization
Human Migration
Humans
Male
Manitoba
Odds Ratio
Ontario
Population Groups
Urban Population
Abstract
In recent decades, Indigenous peoples across the globe have become increasingly urbanized. Growing urbanization has been associated with high rates of geographic mobility between rural areas and cities, as well as within cities. In Canada, over 54 percent of Aboriginal peoples are urban and change their place of residence at a higher rate than the non-Aboriginal population. High rates of mobility may affect the delivery and use of health services. The purpose of this paper is to examine the association between urban Aboriginal peoples' mobility and conventional (physician/nurse) as well as traditional (traditional healer) health service use in two distinct Canadian cities: Toronto and Winnipeg. Using data from Statistics Canada's 2006 Aboriginal Peoples Survey, this analysis demonstrates that mobility is a significant predisposing correlate of health service use and that the impact of mobility on health care use varies by urban setting. In Toronto, urban newcomers were more likely to use a physician or nurse compared to long-term residents. This was in direct contrast to the effect of residency on physician and nurse use in Winnipeg. In Toronto, urban newcomers were less likely to use a traditional healer than long-term residents, indicating that traditional healing may represent an unmet health care need. The results demonstrate that distinct urban settings differentially influence patterns of health service utilization for mobile Aboriginal peoples. This has important implications for how health services are planned and delivered to urban Aboriginal movers on a local, and potentially global, scale.
PubMed ID
23078674 View in PubMed
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A research review: exploring the health of Canada's Aboriginal youth.

https://arctichealth.org/en/permalink/ahliterature120746
Source
Int J Circumpolar Health. 2012;71
Publication Type
Article
Date
2012
Author
Ashley Ning
Kathi Wilson
Author Affiliation
Department of Geography & Collaborative Program in Aboriginal Health, University of Toronto Mississauga, Mississauga, Canada. ashley.ning@mail.utoronto.ca
Source
Int J Circumpolar Health. 2012;71
Date
2012
Language
English
Publication Type
Article
Keywords
Adolescent
Canada
Health Services Research
Health Status Indicators
Humans
Indians, North American
Inuits
Abstract
To compare the current state of health research on Aboriginal and non-Aboriginal youth in Canada.
A search of published academic literature on Canadian Aboriginal youth health, including a comprehensive review of both non-Aboriginal and Aboriginal youth research, was conducted using MEDLINE and summarized.
A MEDLINE search was conducted for articles published over a 10-year period (2000-2010). The search was limited to research articles pertaining to Canadian youth, using various synonyms for "Canada," "youth," and "Aboriginal." Each article was coded according to 4 broad categories: Aboriginal identity, geographic location, research topic (health determinants, health status, health care), and the 12 key determinants of health proposed by the Public Health Agency of Canada (PHAC).
Of the 117 articles reviewed, only 34 pertained to Aboriginal youth, while the remaining 83 pertained to non-Aboriginal youth. The results revealed major discrepancies within the current body of research with respect to the geographic representation of Aboriginal youth, with several provinces missing from the literature, including the northern territories. Furthermore, the current research is not reflective of the demographic composition of Aboriginal youth, with an under-representation of Métis and urban Aboriginal youth. Health status of Aboriginal youth has received the most attention, appearing in 79% of the studies reviewed compared with 57% of the non-Aboriginal studies. The number of studies that focus on health determinants and health care is comparable for both groups, with the former accounting for 62 and 64% and the latter comprising 26 and 19% of Aboriginal and non-Aboriginal studies, respectively. However, this review reveals several differences with respect to specific focus on health determinants between the two populations. In non-Aboriginal youth studies, all the 12 key determinants of health of PHAC are explored, whereas in Aboriginal youth studies the health profile remains incomplete and several key determinants and health indicators are neglected.
The current studies are not reflective of the demographic and geographic profiles of Aboriginal youth in Canada, and they have also failed to provide a comprehensive examination of their unique health needs and concerns compared with studies on non-Aboriginal youth.
Notes
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PubMed ID
22973569 View in PubMed
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"I spent nine years looking for a doctor": exploring access to health care among immigrants in Mississauga, Ontario, Canada.

https://arctichealth.org/en/permalink/ahliterature159346
Source
Soc Sci Med. 2008 Mar;66(6):1271-83
Publication Type
Article
Date
Mar-2008
Author
Jennifer Asanin
Kathi Wilson
Author Affiliation
Department of Geography, University of Toronto Mississauga, Canada. j.asanin@utoronto.ca
Source
Soc Sci Med. 2008 Mar;66(6):1271-83
Date
Mar-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Canada
Communication Barriers
Cultural Competency
Delivery of Health Care - methods
Emigrants and Immigrants
Female
Health Policy
Health Services Accessibility
Healthcare Disparities
Humans
Male
Middle Aged
National Health Programs
Ontario
Socioeconomic Factors
Universal Coverage
Urban health
Abstract
There is a growing body of research in Canada and from other countries acknowledging that immigrants face barriers in accessing health care services. As immigrants make up an increasing percentage of the population in many developed nations, a better understanding and eliminating these barriers is a major priority. This research contributes to current understandings of access among immigrant populations in Canada by exploring perceptions of access to care through focus groups with a diverse group of immigrants living in a Mississauga, Ontario neighbourhood. The results of eight focus groups reveal that immigrants face geographic, socio-cultural and economic barriers when attempting to access health care services in their community. This paper provides policy recommendations relevant to the federal, provincial and local levels for eliminating these barriers.
PubMed ID
18194831 View in PubMed
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The mental health of Indigenous peoples in Canada: A critical review of research.

https://arctichealth.org/en/permalink/ahliterature290741
Source
Soc Sci Med. 2017 03; 176:93-112
Publication Type
Journal Article
Review
Research Support, Non-U.S. Gov't
Date
03-2017
Author
Sarah E Nelson
Kathi Wilson
Author Affiliation
University of Toronto Mississauga, Department of Geography, 3359 Mississauga Road, Mississauga, ON L5L 1C6, Canada. Electronic address: sarah.nelson@mail.utoronto.ca.
Source
Soc Sci Med. 2017 03; 176:93-112
Date
03-2017
Language
English
Publication Type
Journal Article
Review
Research Support, Non-U.S. Gov't
Keywords
Canada - epidemiology - ethnology
Cost of Illness
Humans
Mental Disorders - epidemiology - ethnology - therapy
Mental Health - standards - trends
Population Groups - ethnology - psychology
Prevalence
Abstract
Many scholars assert that Indigenous peoples across the globe suffer a disproportionate burden of mental illness. Research indicates that colonialism and its associated processes are important determinants of Indigenous peoples' health internationally. In Canada, despite an abundance of health research documenting inequalities in morbidity and mortality rates for Indigenous peoples, relatively little research has focused on mental health. This paper provides a critical scoping review of the literature related to Indigenous mental health in Canada. We searched eleven databases and two Indigenous health-focused journals for research related to mental health, Indigenous peoples, and Canada, for the years 2006-2016. Over two hundred papers are included in the review and coded according to research theme, population group, and geography. Results demonstrate that the literature is overwhelmingly concerned with issues related to colonialism in mental health services and the prevalence and causes of mental illness among Indigenous peoples in Canada, but with several significant gaps. Mental health research related to Indigenous peoples in Canada overemphasizes suicide and problematic substance use; a more critical use of the concepts of colonialism and historical trauma is advised; and several population groups are underrepresented in research, including Métis peoples and urban or off-reserve Indigenous peoples. The findings are useful in an international context by providing a starting point for discussions, dialogue, and further study regarding mental health research for Indigenous peoples around the world.
PubMed ID
28135694 View in PubMed
Less detail

'Education? It is irrelevant to my job now. It makes me very depressed ...': exploring the health impacts of under/unemployment among highly skilled recent immigrants in Canada.

https://arctichealth.org/en/permalink/ahliterature154560
Source
Ethn Health. 2009 Apr;14(2):185-204
Publication Type
Article
Date
Apr-2009
Author
Jennifer Asanin Dean
Kathi Wilson
Author Affiliation
McMaster University, Hamilton, Ontario, Canada. asaninjl@mcmaster.ca
Source
Ethn Health. 2009 Apr;14(2):185-204
Date
Apr-2009
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Canada
Cross-Sectional Studies
Cultural Diversity
Depressive Disorder - epidemiology - etiology
Education, Continuing - statistics & numerical data
Educational Status
Emigrants and Immigrants - education - statistics & numerical data
Female
Health status
Humans
Incidence
Male
Middle Aged
Needs Assessment
Questionnaires
Risk assessment
Sex Factors
Social Change
Social Class
Socioeconomic Factors
Stress, Psychological
Unemployment - statistics & numerical data
Abstract
Immigrants account for 20% of the population and 60% of total population growth in Canada (Statistics Canada 2001). The majority of immigrants are accepted for entry to Canada under the Skilled Worker Program in order to fill employment shortages in the labour market (CIC 2007). Recent research has revealed that an increasing number of immigrants who gain entry under this programme face significant barriers to employment. As a result, many remain unemployed or accept employment outside of and below their field of education and training. However, the impacts such employment circumstances have on the health of immigrants have not yet been examined. This paper presents the results of a collaborative research project that explores the health impacts of under/unemployment among skilled immigrants in Mississauga, Ontario, Canada. In-depth interviews are used to examine the experiences of employment and perceptions of subsequent health impacts among 22 recent immigrants. The participants most frequently identified mental health impacts due to a lack of income, loss of employment-related skills, loss of social status and family pressures. These health concerns are also extended to family members. In addition to mental health, physical health is perceived to be affected by employment circumstances through high levels of stress and strenuous working conditions. These findings shed light on the nature of the links between employment and health relationship as well as determinants of immigrant health. Additional research is required to examine the long-term effects of under/unemployment.
PubMed ID
18949654 View in PubMed
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Aboriginal urbanization and rights in Canada: examining implications for health.

https://arctichealth.org/en/permalink/ahliterature115712
Source
Soc Sci Med. 2013 Aug;91:219-28
Publication Type
Article
Date
Aug-2013
Author
Laura C Senese
Kathi Wilson
Author Affiliation
Department of Geography & Program in Planning, University of Toronto, 100 St. George Street, Room 5047, Toronto, Ontario M5S 3G3, Canada. laura.senese@utoronto.ca
Source
Soc Sci Med. 2013 Aug;91:219-28
Date
Aug-2013
Language
English
Publication Type
Article
Keywords
Adult
Attitude to Health - ethnology
Canada
Cultural Characteristics
Female
Health Status Disparities
Human Rights
Humans
Indians, North American - psychology - statistics & numerical data
Male
Middle Aged
Prejudice - ethnology
Qualitative Research
Urban Health - ethnology
Urbanization
Young Adult
Abstract
Urbanization among Indigenous peoples is growing globally. This has implications for the assertion of Indigenous rights in urban areas, as rights are largely tied to land bases that generally lie outside of urban areas. Through their impacts on the broader social determinants of health, the links between Indigenous rights and urbanization may be related to health. Focusing on a Canadian example, this study explores relationships between Indigenous rights and urbanization, and the ways in which they are implicated in the health of urban Indigenous peoples living in Toronto, Canada. In-depth interviews focused on conceptions of and access to Aboriginal rights in the city, and perceived links with health, were conduced with 36 Aboriginal people who had moved to Toronto from a rural/reserve area. Participants conceived of Aboriginal rights largely as the rights to specific services/benefits and to respect for Aboriginal cultures/identities. There was a widespread perception among participants that these rights are not respected in Canada, and that this is heightened when living in an urban area. Disrespect for Aboriginal rights was perceived to negatively impact health by way of social determinants of health (e.g., psychosocial health impacts of discrimination experienced in Toronto). The paper discusses the results in the context of policy implications and future areas of research.
PubMed ID
23474122 View in PubMed
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The mental health of Indigenous peoples in Canada: A critical review of research.

https://arctichealth.org/en/permalink/ahliterature279694
Source
Soc Sci Med. 2017 Jan 18;176:93-112
Publication Type
Article
Date
Jan-18-2017
Author
Sarah E Nelson
Kathi Wilson
Source
Soc Sci Med. 2017 Jan 18;176:93-112
Date
Jan-18-2017
Language
English
Publication Type
Article
Abstract
Many scholars assert that Indigenous peoples across the globe suffer a disproportionate burden of mental illness. Research indicates that colonialism and its associated processes are important determinants of Indigenous peoples' health internationally. In Canada, despite an abundance of health research documenting inequalities in morbidity and mortality rates for Indigenous peoples, relatively little research has focused on mental health. This paper provides a critical scoping review of the literature related to Indigenous mental health in Canada. We searched eleven databases and two Indigenous health-focused journals for research related to mental health, Indigenous peoples, and Canada, for the years 2006-2016. Over two hundred papers are included in the review and coded according to research theme, population group, and geography. Results demonstrate that the literature is overwhelmingly concerned with issues related to colonialism in mental health services and the prevalence and causes of mental illness among Indigenous peoples in Canada, but with several significant gaps. Mental health research related to Indigenous peoples in Canada overemphasizes suicide and problematic substance use; a more critical use of the concepts of colonialism and historical trauma is advised; and several population groups are underrepresented in research, including Métis peoples and urban or off-reserve Indigenous peoples. The findings are useful in an international context by providing a starting point for discussions, dialogue, and further study regarding mental health research for Indigenous peoples around the world.
PubMed ID
28135694 View in PubMed
Less detail

"My health has improved because I always have everything I need here...": A qualitative exploration of health improvement and decline among immigrants.

https://arctichealth.org/en/permalink/ahliterature145322
Source
Soc Sci Med. 2010 Apr;70(8):1219-28
Publication Type
Article
Date
Apr-2010
Author
Jennifer Asanin Dean
Kathi Wilson
Author Affiliation
School of Geography and Earth Sciences, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada. asaninjl@mcmaster.ca
Source
Soc Sci Med. 2010 Apr;70(8):1219-28
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Acculturation
Adult
Attitude to Health
Canada
Emigrants and Immigrants - psychology - statistics & numerical data
Female
Health Services Accessibility
Health status
Humans
Interviews as Topic
Life Style
Male
Middle Aged
Qualitative Research
Young Adult
Abstract
Immigrants in Canada constitute approximately 20% of the total population and will continue to account for a significant portion of the country's population in the future. Accordingly, a growing body of research has focused on examining the disparity in health status between the increasing foreign-born and the Canadian-born populations. The healthy immigrant effect, in particular, acknowledges that immigrants have better health status than their Canadian-born counterparts upon arrival in the country. However, studies have shown that over time the health of immigrants declines to a level on par with the Canadian-born population. There is much speculation as to the reasons for this decline including acculturation (i.e., uptake of unhealthy lifestyles) and a lack of access to health care. Yet, there have been few studies to examine possible reasons for potential declines in health, especially from the perspective of immigrants themselves. This study is one of the first to qualitatively examine perceived changes in health status and reasons for health status change among immigrants. The paper presents the results of 23 in-depth interviews with adults with recent (less than 3 years of residency), mid-term (3-10 years), and long-term (more than 10 years) immigrants living in the Greater Toronto Area. The results reveal that the majority of the participants believed their health had remained stable or even improved over time due to improved living standards and lifestyle behaviours in Canada. Those who perceived their health to have worsened over time attributed the change to the stress associated with migration, and the aging process rather than the adoption of an unhealthy lifestyle. Additionally, while the vast majority of participants reported improved access to resources upon migration, there were mixed reviews in terms of how beneficial these resources were or could be for health. The findings highlight the need for research to incorporate mental health into studies on changing immigrant health status and to focus on those factors contributing to high levels of stress among more recent immigrants.
PubMed ID
20167409 View in PubMed
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Accessibility and the Canadian health care system: squaring perceptions and realities.

https://arctichealth.org/en/permalink/ahliterature182001
Source
Health Policy. 2004 Feb;67(2):137-48
Publication Type
Article
Date
Feb-2004
Author
Kathi Wilson
Mark W Rosenberg
Author Affiliation
Department of Geography, University of Toronto at Mississauga, Mississauga, Ont., Canada L5L 1C6. kwilson@eratos.erin.utoronto.ca
Source
Health Policy. 2004 Feb;67(2):137-48
Date
Feb-2004
Language
English
Publication Type
Article
Keywords
Adult
Aged
Attitude to Health
Canada
Family Characteristics
Female
Health Care Surveys
Health Policy
Health Services Accessibility - standards
Humans
Male
Middle Aged
National Health Programs - organization & administration - standards - utilization
Public Opinion
Socioeconomic Factors
Waiting Lists
Abstract
The 1984 Canada Health Act (CHA) is the major piece of Federal legislation that governs health care accessibility in the provinces and territories. According to the CHA, all provinces and territories in Canada must uphold five principles in order to receive federal funding for health care (universality, comprehensiveness, portability, public administration, and accessibility). In Canada, there are competing views among policy makers and consumers about how the CHA's principle of accessibility should be defined, interpreted and used in delivering health care. During the 1990s, the health care perceptions of Canadians and their health care behaviours were measured through both public opinion polls and Statistics Canada's National Population Health Survey (NPHS). The goal of this paper is to examine perceptions of accessibility in public opinion polls and actual accessibility as measured through the NPHS. Public opinion polls demonstrate that while Canadians want to preserve the principles of the CHA, a majority of Canadians are losing confidence in their health care system. In contrast, the results from the NPHS reveal that only 6% of Canadians aged 25 years and older have experienced accessibility problems. Among those who report access problems, the barriers to accessibility are linked to specific socio-economic, socio-demographic and health characteristics of individuals. We discuss these findings in the context of the current debates surrounding accessibility within the CHA and the Canadian health care system.
PubMed ID
14720632 View in PubMed
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"Unless you went in with your head under your arm": patient perceptions of emergency room visits.

https://arctichealth.org/en/permalink/ahliterature174331
Source
Soc Sci Med. 2005 Dec;61(11):2363-73
Publication Type
Article
Date
Dec-2005
Author
Katie Wellstood
Kathi Wilson
John Eyles
Author Affiliation
McMaster Institute of Environment and Health, McMaster University, 1280 Main Street West, Hamilton, Ont., Canada L8S 4K1.
Source
Soc Sci Med. 2005 Dec;61(11):2363-73
Date
Dec-2005
Language
English
Publication Type
Article
Keywords
Attitude to Health
Canada
Emergency Service, Hospital
Female
Humans
Inpatients - psychology
Male
Patient satisfaction
Professional-Patient Relations
Quality of Health Care
Waiting Lists
Abstract
There is increasing concern in Canada regarding growing pressures on emergency room care. Frequent media reports call attention to overcrowding, lengthy waiting times and the re-routing of ambulances due to the closure of emergency rooms during periods of overcrowding. Much of this information, however, is anecdotal. As such, little is known about patients' experiences in emergency rooms in Canada. The purpose of this study is to explore patients' perceptions of their most recent emergency room visit. Semi-structured, in-depth interviews were conducted with 41 men and women from two socially distinct neighbourhoods in Hamilton, Ontario, Canada. Much of the previous work on experiences in emergency room care is international in scope and uses quantitative methods to examine patient satisfaction with emergency care. This study considers patient experiences more broadly and looks beyond satisfaction to examine reasons for seeking emergency room care and the factors that shape experiences. The findings show that most patients describe their experiences in negative terms. The aspects of emergency room care that were most often linked with negative experiences were waiting times, patient perceptions of the quality of care received and staff-patient interactions. The findings are discussed in the context of recent health care reforms in Canada, which we argue have not addressed adequately the 'crisis' in emergency rooms.
PubMed ID
15953669 View in PubMed
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23 records – page 1 of 3.