Health Challenges for the South Asian
Population in Ontario/Canada
OMHARN Multicultural Health Conference - March 17, 2012
Dr. Naila Butt – Executive Director
Doris Rajan- Researcher
Challenges – two areas...
1) How we understand the role and goals of
research in relationship to immigrant and
racialized people; and
2) Specific challenges older people from diverse
ethno-racial backgrounds experience – the South
Asian perspective.
The roles and goals of research
 The merits of applied/community based
 Recognize lived expertise – letting research
“subjects” lead
 The social determinants of health – how
broader socio-economic environment interplays
with health
 Careful not to pathologize illness etc.
Goals of research (continued)
 For service providers that means
 person-centred care
 population-specific systemic discrimination
 access barriers;
 For researchers that means a comprehensive
analysis that operates on many levels – individual,
community and macro levels
Research Challenges
 Research often doesn't recognize the differences
in immigration status, i.e. refugees vs.
 Two types of senior immigrants:
a) seniors who immigrated when young and
b) newcomer seniors
There are different sets of issues, e.g.
isolation, language barriers and stress trauma
Research Challenges – multiple
 Intersectionality of marginalized statuses, i.e. age,
sex, race, class, etc., - compounding effect
 Analysis needs to be cross the time spectrum
 Populations are diverse - e.g. South Asians are
studied as one group, even though they are very
diverse, i.e. Punjabi from Pakistan is different from a
Punjabi from India
 Can’t cluster!
A double whammy for ethnic seniors ...
 Immigrant seniors have greater health care
 Leading to greater difficulty in
accessing/using health care.
The support system struggles to keep up
with the demographic changes
Challenges –
Example, South Asian Seniors
 Lack of English/French language skills
 Dependency on family members for transportation;
 Reliance on family members as interpreters which is
often unreliable or inaccurate;
 Restricted mobility due to childcare responsibilities;
 Lack of access to the internet;
 Social determinants- income level, immigration
status, the migrant experience, gender roles,
number of years in Canada, unemployment,
changes in family dynamics.
South Asian Seniors Issues ...
 Older women - widowed, poor English skills, live in a
three generation household
 Social isolation - weather, lack of income, lack of
English, transportation etc..
 Loneliness, stress, emotional problems
 Changing role of women and elders;
 Family conflicts due to financial hardships , in-law
conflicts and intergenerational differences.
 Elder abuse - seniors caring for their grandchildren,
housework, and cooking. Conflict with daughter-inlaws.
Mental Health and lifestyle ...
 Depression, loneliness and isolation
 Increased work loads, multiple jobs, insomnia
 Unhealthy eating and life style practices.
 Introduction of unhealthy fast foods and an
overdependence on low cost foods.
 Traditional cooking is often high in
carbohydrates, oil, salt and sugar.
Chronic Disease- South Asians
• Rates of Illness
• higher prevalence rates of preventable chronic conditions and
poorer health outcomes compared to other groups.
• Diabetes: Diabetes prevalence rates 11-14% compared to 56% for non-racialized Ontarians
• Cardiovascular Disease: an three to five times increase in the
risk for myocardial infarction and cardiovascular death
• Hypertension: African-Canadians are 3.3 times and South
Asians are 2.7 times more likely than non-racialized people to
have hypertension
Tamil Refugees – coming out of war
Personal loss of loved ones
Torture at the hands of the oppressors
Constant threat of violence
Horror of air attacks
Stress of being displaced and the experience of
Poor conditions of living in camps
Loss of property and livelihood
Lack of access to information during the
conflict – what is true and what is not?
Post Traumatic Stress
Flashbacks or nightmares of the original trauma
Avoiding places that remind them of the event
Difficulty falling or staying asleep
Trouble concentrating
Blackouts or difficulty remembering things
Increased tendency and reaction to being startled
Excessive watchfulness to threat
Alcohol abuse
Challenges - Health Services
 Lack of a person-centred approach  not
objectifying clients’ experiences as immigrants
and/or from a certain community.
 Lack of cultural competency and anti-racist
training for health and social services providers;
 Lack of linguistically and culturally appropriate
services and resources.
Holistic definition of health..
 That recognizes the larger systemic barriers that
are having a negative effect on mental and
physical health of seniors;
 Consider the senior immigrant as a total person
with a specific history and social, economic,
physical, emotional and spiritual needs.
 Examine the specific social and cultural factors,
family and inter-personal relationships and living
arrangements and conditions.
 Recognize merits of applied/community based
 Acknowledge lived expertise, i.e. that those most
affected lead the way in defining the issue and
identifying solutions
 Understand how social determinants interplay with
health issues
 For researchers that means a comprehensive
analysis that operates on individual, community
and macro policy level
Solutions - multi-level community
capacity building approach ...
Influence change at three levels;
1. the individual and family level,
2. mobilizing, educating, and empowering the
community and community based supports,
3. broader level policy reforms.
Social Services Network
 Not-for-profit charitable organization
 UWYR research that York Region services were
not keeping pace with the changing
demographics and needs of the community
 Unique service delivery model whereby the
services are delivered directly to the community
at their places of worship or meeting place.
 Services are offered by community mobilizers in
Hindi, Gujarati, Punjabi, Tamil, Punjabi and
Seniors Programs
• South Asian Adult Day Program
▫ Partnership with Unionville Home Society
▫ For SA Seniors who are cognitively impaired and or frail.
• Mental Health Awareness and Support Drop-In Centers:
Provide culturally and linguistically sensitive awareness
and support programs on mental health
• Seniors Hub at Armadale Community Centre
Partnership with the Town of Markham Wellbeing
programs. Programs such as Yoga, Laughing Yoga, ChiGong, Mild Mobility Exercises, Bridge Club, Sewing Club
Seniors Programs
• Mobile Computer Lab
• Computer skills to seniors in ethnic languages enabling
seniors to communicate with other seniors even in their
home countries.
• Taking Care of Me! Toolkit and training
• CHATS in collaboration with SSN developed a tool kit for
Facilitating Health & Wellness Workshops for SA Seniors in
Tamil and Punjabi.
• workshops included learning about the Health Care System
and Community Supports and Recreation Programs,
Managing Physical Health –Diabetes & Falls Prevention and –
A Healthy South Asian Diet.
The “Impact of Family Violence a
South Asian Perspective”
 Five year project in partnership with Toronto, York,
Peel and Durham Regional Police, York Region CAS.
 Objectives –
identify barriers, challenges, gaps and opportunities
towards sustainable change and
increase awareness amongst community and sectors
to address issues of family violence within the South
Asian Community
Report published
Next Conference May 2nd and 3rd at Seneca College
What OMHARN needs to do?
 Convene more opportunities for collaboration between
traditional academic researchers with population specific
community-based researchers;
 Action orientated and focused research that translates
knowledge into tools and resources that can be mobilized
through community development strategies that reach
individuals and families directly.
 Inform policy and decision makers
 Participatory action research that results in a sense of
ownership by all stakeholders.

Health Challenges for the South Asian Population in Ontario