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Access to health care among racialised immigrants to Canada in later life: a theoretical and empirical synthesis

Published online by Cambridge University Press:  24 March 2021

Shen (Lamson) Lin Open the ORCID record for Shen (Lamson) Lin [Opens in a new window]
Shen (Lamson) Lin*
Affiliation:
Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada Institute for Life Course and Aging, University of Toronto, Toronto, Canada
*
Corresponding author. Email: [email protected]
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Abstract

Evidence that immigrants tend to be underserved by the health-care system in the hosting country is well documented. While the impacts of im/migration on health-care utilisation patterns have been addressed to some extent in the existing literature, the conventional approach tends to homogenise the experience of racialised and White immigrants, and the intersecting power axes of racialisation, immigration and old age have been largely overlooked. This paper aims to consolidate three macro theories of health/behaviours, including Bronfenbrenner's ecological theory, the World Health Organization's paradigm of social determinants of health and Andersen's Behavioral Model of Health Service Use, to develop and validate an integrated multilevel framework of health-care access tailored for racialised older immigrants. Guided by this framework, a narrative review of 35 Canadian studies was conducted. Findings reveal that racial minority immigrants’ vulnerability in accessing health services are intrinsically linked to a complex interplay between racial-nativity status with numerous markers of power differences. These multilevel parameters range from socio-economic challenges, cross-cultural differences, labour and capital adequacy in the health sector, organisational accessibility and sensitivity, inter-sectoral policies, to societal values and ideology as forms of oppression. This review suggests that, counteracting a prevailing discourse of personal and cultural barriers to care, the multilevel framework is useful to inform upstream structural solutions to address power imbalances and to empower racialised immigrants in later life.

Keywords

health-care equitysocial determinants of healthminority ageingimmigrationrace and ethnicity
Type
Review Article
Information
Ageing & Society , Volume 42 , Issue 8 , August 2022 , pp. 1735 - 1759
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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References

Abubakar, I, Aldridge, RW, Devakumar, D, Orcutt, M, Burns, R, Barreto, ML, Dhavan, P, Fouad, FM, Groce, N, Guo, Y and Hargreaves, S (2018) The UCL–Lancet Commission on Migration and Health: the health of a world on the move. The Lancet 392, 2606–2654.CrossRefGoogle ScholarPubMed
Acevedo-Garcia, D, Sanchez-Vaznaugh, EV, Viruell-Fuentes, EA and Almeida, J (2012) Integrating social epidemiology into immigrant health research: a cross-national framework. Social Science and Medicine 75, 2060–2068.CrossRefGoogle ScholarPubMed
Adler, NE and Stewart, J (2010) Health disparities across the lifespan: meaning, methods, and mechanisms. Annals of the New York Academy of Sciences 1186, 5–23.CrossRefGoogle ScholarPubMed
Ahmed, S, Shommu, NS, Rumana, N, Barron, GR, Wicklum, S and Turin, TC (2016) Barriers to access of primary healthcare by immigrant populations in Canada: a literature review. Journal of Immigrant and Minority Health 18, 1522–1540.CrossRefGoogle ScholarPubMed
Alley, DE, Putney, NM, Rice, M and Bengtson, VL (2010) The increasing use of theory in social gerontology: 1990–2004. Journals of Gerontology: Psychological Sciences and Social Sciences 65B, 583–590.CrossRefGoogle Scholar
Alwin, DF (2012) Integrating varieties of life course concepts. Journals of Gerontology: Psychological Sciences and Social Sciences 67B, 206–220.CrossRefGoogle Scholar
Andersen, RM (1968) Families’ Use of Health Services: A Behavioral Model of Predisposing, Enabling, and Need Components (PhD thesis). Purdue University, West Lafayette, IN.Google Scholar
Andersen, R (1995) Revisiting the behavioral model and access to medical care: does it matter? Journal of Health and Social Behavior 36, 1–10.CrossRefGoogle ScholarPubMed
Andersen, R and Newman, JF (1973) Societal and individual determinants of medical care utilization in the United States. The Milbank Memorial Fund Quarterly: Health and Society 51, 95–124.CrossRefGoogle ScholarPubMed
Andersen, RM, Davidson, PL and Baumeister, SE (2014) Improving access to care in America: individual and contextual indicators. In Andersen, RM, Rice, TH and Kominsky, GF (eds), Changing the US Health Care System: Key Issues in Health Services Policy and Management. San Francisco, CA: John Wiley and Sons, pp. 3–31.Google Scholar
Antonipillai, V, Baumann, A, Hunter, A, Wahoush, O and O'Shea, T (2018) Health inequity and ‘restoring fairness’ through the Canadian refugee health policy reforms: a literature review. Journal of Immigrant and Minority Health 20, 203–213.CrossRefGoogle Scholar
Asanin, J and Wilson, K (2008) ‘I spent nine years looking for a doctor’: exploring access to health care among immigrants in Mississauga, Ontario, Canada. Social Science and Medicine 66, 1271–1283.CrossRefGoogle Scholar
Bailey, ZD and Moon, JR (2020) Racism and the political economy of COVID-19: will we continue to resurrect the past? Journal of Health Politics, Policy and Law 45, 937–950.CrossRefGoogle ScholarPubMed
Bakewell, F, Addleman, S, Dickinson, G and Thiruganasambandamoorthy, V (2018) Use of the emergency department by refugees under the Interim Federal Health Program: a health records review. PLOS ONE 13, e0197282.CrossRefGoogle ScholarPubMed
Bauer, GR, Mahendran, M, Braimoh, J, Alam, S and Churchill, S (2020) Identifying visible minorities or racialized persons on surveys: can we just ask? Canadian Journal of Public Health 111, 371–382.CrossRefGoogle ScholarPubMed
Baum, F and Fisher, M (2014) Why behavioural health promotion endures despite its failure to reduce health inequities. Sociology of Health and Illness 36, 213–225.CrossRefGoogle ScholarPubMed
Beard, JR, Officer, A, De Carvalho, IA, Sadana, R, Pot, AM, Michel, JP, Lloyd-Sherlock, P, Epping-Jordan, JE, Peeters, GG, Mahanani, WR and Thiyagarajan, JA (2016) The World report on ageing and health: a policy framework for healthy ageing. The Lancet 387, 2145–2154.CrossRefGoogle ScholarPubMed
Borde, E and Hernández, M (2019) Revisiting the social determinants of health agenda from the global South. Global Public Health 14, 847–862.CrossRefGoogle ScholarPubMed
Bragg, B and Wong, LL (2016) ‘Cancelled dreams’: family reunification and shifting Canadian immigration policy. Journal of Immigrant and Refugee Studies 14, 46–65.CrossRefGoogle Scholar
Bronfenbrenner, U (1977) Toward an experimental ecology of human development. American Psychologist 32, 513–531.CrossRefGoogle Scholar
Bronfenbrenner, U (1979) The Ecology of Human Development. Cambridge, MA: Harvard University Press, pp. 1–349.Google Scholar
Bronfenbrenner, U (1986) Ecology of the family as a context for human development: research perspectives. Developmental Psychology 22, 723.CrossRefGoogle Scholar
Bronfenbrenner, U (1994) Ecological models of human development. In Husen, T and Postlethwaite, TN (eds), The International Encyclopedia of Education, 2nd Edn. New York, NY: Elsevier Science, pp. 1643–1647.Google Scholar
Bronfenbrenner, U. (1999) Environments in developmental perspective: Theoretical and operational models. In Friedman, SL and Wachs, TD (eds). Measuring environment across the life span: Emerging methods and concepts. American Psychological Association, pp. 3–28.CrossRefGoogle Scholar
Bronfenbrenner, U and Morris, P (2006) The ecology of developmental processes. In Damon, W and Lerner, R (eds), Handbook of Child Psychology, 6th Edn. New York, NY: John Wiley, pp. 793–829.Google Scholar
Brown, TH (2018) Racial stratification, immigration, and health inequality: a life course-intersectional approach. Social Forces 96, 1507–1540.CrossRefGoogle Scholar
Browne, AJ, Varcoe, C, Smye, V, Reimer-Kirkham, S, Lynam, MJ and Wong, S (2009) Cultural safety and the challenges of translating critically oriented knowledge in practice. Nursing Philosophy 10, 167–179.CrossRefGoogle ScholarPubMed
Castañeda, H, Holmes, SM, Madrigal, DS, Young, MED, Beyeler, N and Quesada, J (2015) Immigration as a social determinant of health. Annual Review of Public Health 36, 375–392.CrossRefGoogle ScholarPubMed
Chase, LE, Cleveland, J, Beatson, J and Rousseau, C (2017) The gap between entitlement and access to healthcare: an analysis of ‘candidacy’ in the help-seeking trajectories of asylum seekers in Montreal. Social Science and Medicine 182, 52–59.CrossRefGoogle ScholarPubMed
Cook, JE, Purdie-Vaughns, V, Meyer, IH and Busch, JT (2014) Intervening within and across levels: a multilevel approach to stigma and public health. Social Science and Medicine 103, 101–109.CrossRefGoogle ScholarPubMed
Culley, L (1996) A critique of multiculturalism in health care: the challenge for nurse education. Journal of Advanced Nursing 23, 564–570.CrossRefGoogle Scholar
Culley, L (2006) Transcending transculturalism? Race, ethnicity and health-care. Nursing Inquiry 13, 144–153.CrossRefGoogle ScholarPubMed
Curtis, J, Dong, W, Lightman, N and Parbst, M (2017) Race, language, or length of residency? Explaining unequal uptake of government pensions in Canada. Journal of Aging and Social Policy 29, 332–351.CrossRefGoogle ScholarPubMed
Danso, R (2007) Emancipating and empowering de-valued skilled immigrants: what hope does anti-oppressive social work practice offer? British Journal of Social Work 39, 539–555.CrossRefGoogle Scholar
Dastjerdi, M, Olson, K and Ogilvie, L (2012) A study of Iranian immigrants’ experiences of accessing Canadian health care services: a grounded theory. International Journal for Equity in Health 11, 1–15.CrossRefGoogle ScholarPubMed
Davison, KM, Lin, SL, Tong, H, Kobayashi, KM, Mora-Almanza, JG and Fuller-Thomson, E (2020) Nutritional factors, physical health and immigrant status are associated with anxiety disorders among middle-aged and older adults: findings from baseline data of the Canadian Longitudinal Study on Aging (CLSA). International Journal of Environmental Research and Public Health 17, 1493.CrossRefGoogle Scholar
De Maio, FG and Kemp, E (2010) The deterioration of health status among immigrants to Canada. Global Public Health 5, 462–478.CrossRefGoogle ScholarPubMed
Denise, S (2012) Oppression and im/migrant health in Canada. In McGibbon, EA (ed). Oppression: A Social Determinant of Health. Halifax, Canada: Fernwood Publishing, pp. 113–122.Google Scholar
Diderichsen, F, Evans, T and Whitehead, M (2001) The social basis of disparities in health. In Evans, T, Whitehead, M, Bhuiya, A, Diderichsen, F and Wirth, M (eds). Challenging Inequities in Health: From Ethics to Action. New York: Oxford University Press, pp. 12–23.CrossRefGoogle Scholar
Dixon-Woods, M, Cavers, D, Agarwal, S, Annandale, E, Arthur, A, Harvey, J, Hsu, R, Katbamna, S, Olsen, R, Smith, L and Riley, R (2006) Conducting a critical interpretive synthesis of the literature on access to healthcare by vulnerable groups. BMC Medical Research Methodology 6, 35.CrossRefGoogle ScholarPubMed
Donnelly, TT, McKellin, W, Hislop, G and Long, B (2009) Socioeconomic influences on Vietnamese-Canadian women's breast and cervical cancer prevention practices: a social determinant's perspective. Social Work in Public Health 24, 454–476.CrossRefGoogle ScholarPubMed
Durbin, A, Lin, E, Taylor, L and Callaghan, RC (2011) First-generation immigrants and hospital admission rates for psychosis and affective disorders: an ecological study in Ontario. Canadian Journal of Psychiatry 56, 418–426.CrossRefGoogle ScholarPubMed
Durbin, A, Lin, E, Moineddin, R, Steele, LS and Glazier, RH (2014) Use of mental health care for nonpsychotic conditions by immigrants in different admission classes and by refugees in Ontario, Canada. Open Medicine 8, 1–11.Google ScholarPubMed
Durbin, A, Moineddin, R, Lin, E, Steele, LS and Glazier, RH (2015) Examining the relationship between neighbourhood deprivation and mental health service use of immigrants in Ontario, Canada: a cross-sectional study. BMJ Open 5.CrossRefGoogle ScholarPubMed
Edge, S and Newbold, B (2013) Discrimination and the health of immigrants and refugees: exploring Canada's evidence base and directions for future research in newcomer receiving countries. Journal of Immigrant and Minority Health 15, 141–148.CrossRefGoogle ScholarPubMed
Esses, VM, Medianu, S and Lawson, AS (2013) Uncertainty, threat, and the role of the media in promoting the dehumanization of immigrants and refugees. Journal of Social Issues 69, 518–536.CrossRefGoogle Scholar
Ferdous, M, Goopy, S, Yang, H, Rumana, N, Abedin, T and Turin, TC (2020) Barriers to breast cancer screening among immigrant populations in Canada. Journal of Immigrant and Minority Health 22, 410–420.CrossRefGoogle ScholarPubMed
Ferrer, I (2015) Examining the disjunctures between policy and care in Canada's Parent and Grandparent Supervisa. International Journal of Migration, Health and Social Care 11, 253–267.CrossRefGoogle Scholar
Ferrer, I, Grenier, A, Brotman, S and Koehn, S (2017) Understanding the experiences of racialized older people through an intersectional life course perspective. Journal of Aging Studies 41, 10–17.CrossRefGoogle ScholarPubMed
Fisher, JD and Fisher, WA (2002) The information-motivation-behavioral skills model. In DiClemente, RJ, Crosby, RA and Kegler, MC (eds). Emerging Theories in Health Promotion Practice and Research: Strategies for Improving Public Health, vol. 15. New York, NY: John Wiley & Sons.Google Scholar
Fuller-Thomson, E, Noack, AM and George, U (2011) Health decline among recent immigrants to Canada: findings from a nationally-representative longitudinal survey. Canadian Journal of Public Health 102, 273–280.CrossRefGoogle ScholarPubMed
Fuller-Thomson, E, Saab, Z, Davison, KM, Lin, SL, Taler, V, Kobayashi, K and Tong, H (2020) Nutrition, immigration and health determinants are linked to verbal fluency among Anglophone adults in the Canadian Longitudinal Study on Aging (CLSA). Journal of Nutrition, Health and Aging 24, 672–680.CrossRefGoogle Scholar
Gagnon, AJ (2002) Responsiveness of the Canadian Health Care System Towards Newcomers, vol. 40. Ottawa, ON: Commission on the Future of Health Care in Canada.Google Scholar
Gee, EMT, Kobayashi, KM and Prus, SG (2004) Examining the healthy immigrant effect in mid-to-later life: findings from the Canadian Community Health Survey. Canadian Journal on Aging/La Revue canadienne du vieillissement 23, S55–S63.CrossRefGoogle ScholarPubMed
George, U, Chaze, F, Fuller-Thomson, E and Brennenstuhl, S (2012) Underemployment and life satisfaction: a study of internationally trained engineers in Canada. Journal of Immigrant and Refugee Studies 10, 407–425.CrossRefGoogle Scholar
Geronimus, AT, Hicken, M, Keene, D and Bound, J (2006) ‘Weathering’ and age patterns of allostatic load scores among blacks and whites in the United States. American Journal of Public Health 96, 826–833.CrossRefGoogle ScholarPubMed
Giddens, A (1979) Agency, structure. In Central Problems in Social Theory. London: Palgrave, pp. 49–95.CrossRefGoogle Scholar
Gkiouleka, A, Huijts, T, Beckfield, J and Bambra, C (2018) Understanding the micro and macro politics of health: inequalities, intersectionality and institutions – a research agenda. Social Science and Medicine 200, 92–98.CrossRefGoogle ScholarPubMed
Government of Canada (2014) Evaluation of the Family Reunification Program 2014. Available at https://www.canada.ca/en/immigration-refugees-citizenship/corporate/reports-statistics/evaluations/family-reunification-program.htm.Google Scholar
Greenhalgh, T, Thorne, S and Malterud, K (2018) Time to challenge the spurious hierarchy of systematic over narrative reviews? European Journal of Clinical Investigation 48, 1–6.CrossRefGoogle ScholarPubMed
Hagestad, GO and Dannefer, D (2001) Concepts and theories of aging: beyond microfication in social science approaches. In Binstock, RH and George, LK (eds), Handbook of Aging and the Social Sciences. San Diego, CA: Academic Press, pp. 3–21.Google Scholar
Hertzman, C and Boyce, T (2010) How experience gets under the skin to create gradients in developmental health. Annual Review of Public Health 31, 329–347.CrossRefGoogle ScholarPubMed
Hoe, A (2017) Working in ‘Bad Jobs’: Immigrants in the New Canadian Economy (PhD thesis). University of Toronto, Toronto.Google Scholar
Hulko, W, Brotman, S and Ferrer, I (2017) Counter-storytelling: anti-oppressive social work with older adults. In Baines, D (ed). Doing Anti-oppressive Practice: Social Justice Social Work, 3rd Edn. Halifax, Canada: Fernwood Publishing, pp. 193–211.Google Scholar
Janz, NK and Becker, MH (1984) The health belief model: a decade later. Health Education Quarterly 11, 1–47.CrossRefGoogle ScholarPubMed
Jimenez, DE, Bartels, SJ, Cardenas, V and Alegría, M (2013) Stigmatizing attitudes toward mental illness among racial/ethnic older adults in primary care. International Journal of Geriatric Psychiatry 28, 1061–1068.CrossRefGoogle ScholarPubMed
Johnson, JL, Bottorff, JL, Browne, AJ, Grewal, S, Hilton, BA and Clarke, H (2004) Othering and being othered in the context of health care services. Health Communication 16, 255–271.CrossRefGoogle ScholarPubMed
Juárez, SP, Honkaniemi, H, Dunlavy, AC, Aldridge, RW, Barreto, ML, Katikireddi, SV and Rostila, M (2019) Effects of non-health-targeted policies on migrant health: a systematic review and meta-analysis. The Lancet Global Health 7, e420–e435.CrossRefGoogle ScholarPubMed
Kalich, A, Heinemann, L and Ghahari, S (2016) A scoping review of immigrant experience of health care access barriers in Canada. Journal of Immigrant and Minority Health 18, 697–709.CrossRefGoogle ScholarPubMed
Kirmayer, LJ (2012) Rethinking cultural competence. Transcultural Psychiatry 49, 149–164.CrossRefGoogle ScholarPubMed
Koehn, S (2009) Negotiating candidacy: ethnic minority seniors’ access to care. Ageing & Society 29, 585–608.CrossRefGoogle ScholarPubMed
Koehn, S, Neysmith, S, Kobayashi, K and Khamisa, H (2013) Revealing the shape of knowledge using an intersectionality lens: results of a scoping review on the health and health care of ethnocultural minority older adults. Ageing & Society 33, 437–464.CrossRefGoogle Scholar
Koehn, S, Habib, S and Bukhari, S (2016) S4AC case study: enhancing underserved seniors’ access to health promotion programs. Canadian Journal on Aging/La Revue canadienne du vieillissement 35, 89–102.CrossRefGoogle ScholarPubMed
Krieger, N (2000) Refiguring ‘race’: epidemiology, racialized biology, and biological expressions of race relations. International Journal of Health Services 30, 211–216.CrossRefGoogle ScholarPubMed
Krieger, N (2001) A glossary for social epidemiology. Journal of Epidemiology and Community Health 55, 693–700.CrossRefGoogle ScholarPubMed
Laberge, M and Leclerc, M (2019) Immigration factors and potentially avoidable hospitalizations in Canada. SSM – Population Health 7, 100336.CrossRefGoogle ScholarPubMed
Lai, DW and Chau, SB (2007) Predictors of health service barriers for older Chinese immigrants in Canada. Health and Social Work 32, 57–65.CrossRefGoogle ScholarPubMed
Laroche, M (2000) Health status and health services utilization of Canada's immigrant and non-immigrant populations. Canadian Public Policy/Analyse de politiques 26, 51–75.CrossRefGoogle ScholarPubMed
Lebrun, LA and Dubay, LC (2010) Access to primary and preventive care among foreign-born adults in Canada and the United States. Health Services Research 45, 1693–1719.CrossRefGoogle ScholarPubMed
Lee, E and Bhuyan, R (2013) Negotiating within whiteness in cross-cultural clinical encounters. Social Service Review 87, 98–130.CrossRefGoogle Scholar
Levesque, JF, Harris, MF and Russell, G (2013) Patient-centred access to health care: conceptualising access at the interface of health systems and populations. International Journal for Equity in Health 12, 18.CrossRefGoogle ScholarPubMed
Lin, SL (2020) Inequities in access: the impact of a segmented health insurance system on physician visits and hospital admissions among older adults in the 2014 China Family Panel Studies. International Journal of Health Services 50, 184–198.CrossRefGoogle ScholarPubMed
Lin, SL, Kobayashi, K, Tong, H, Davison, KM, Arora, SR and Fuller-Thomson, E (2020) Close relations matter: the association between depression and refugee status in the Canadian Longitudinal Study on Aging (CLSA). Journal of Immigrant and Minority Health 22, 946–956.CrossRefGoogle Scholar
Link, BG and Phelan, J (1995) Social conditions as fundamental causes of disease. Journal of Health and Social Behavior 35, 80–94.CrossRefGoogle Scholar
Malmusi, D, Borrell, C and Benach, J (2010) Migration-related health inequalities: showing the complex interactions between gender, social class and place of origin. Social Science and Medicine 71, 1610–1619.CrossRefGoogle ScholarPubMed
Marmot, M (2005) Social determinants of health inequalities. The Lancet 365, 1099–1104.CrossRefGoogle ScholarPubMed
Marmot, M (2017) Social justice, epidemiology and health inequalities. European Journal of Epidemiology 32, 537–546.CrossRefGoogle ScholarPubMed
Marmot, M, Friel, S, Bell, R, Houweling, TA, Taylor, S and Commission on Social Determinants of Health (2008) Closing the gap in a generation: health equity through action on the social determinants of health. The Lancet 372, 1661–1669.CrossRefGoogle Scholar
Martin, D, Miller, AP, Quesnel-Vallée, A, Caron, NR, Vissandjée, B and Marchildon, GP (2018) Canada's universal health-care system: achieving its potential. The Lancet 391, 1718–1735.CrossRefGoogle ScholarPubMed
McKeary, M and Newbold, B (2010) Barriers to care: the challenges for Canadian refugees and their health care providers. Journal of Refugee Studies 23, 523–545.CrossRefGoogle Scholar
Minkler, M (1996) Critical perspectives on ageing: new challenges for gerontology. Ageing & Society 16, 467–487.CrossRefGoogle Scholar
Newbold, K (2006) Chronic conditions and the healthy immigrant effect: evidence from Canadian immigrants. Journal of Ethnic and Migration Studies 32, 765–784.CrossRefGoogle Scholar
Ng, E, Sanmartin, C, Tu, J and Manuel, D (2014) Use of acute care hospital services by immigrant seniors in Ontario: a linkage study. Health Reports 25, 15–22.Google ScholarPubMed
Nutbeam, D (2000) Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promotion International 15, 259–267.CrossRefGoogle Scholar
O'Mahony, JM and Donnelly, TT (2010) A postcolonial feminist perspective inquiry into immigrant women's mental health care experiences. Issues in Mental Health Nursing 31, 440–449.CrossRefGoogle Scholar
Oxman-Martinez, J, Hanley, J, Lach, L, Khanlou, N, Weerasinghe, S and Agnew, V (2005) Intersection of Canadian policy parameters affecting women with precarious immigration status: a baseline for understanding barriers to health. Journal of Immigrant and Minority Health 7, 247–258.CrossRefGoogle ScholarPubMed
Perry, B and Scrivens, R (2016) Uneasy alliances: a look at the right-wing extremist movement in Canada. Studies in Conflict and Terrorism 39, 819–841.CrossRefGoogle Scholar
Phelan, JC and Link, BG (2005) Controlling disease and creating disparities: a fundamental cause perspective. Journals of Gerontology: Psychological Sciences and Social Sciences 60B, S27–S33.CrossRefGoogle Scholar
Phelan, JC and Link, BG (2015) Is racism a fundamental cause of inequalities in health? Annual Review of Sociology 41, 311–330.CrossRefGoogle Scholar
Phelan, JC, Link, BG and Tehranifar, P (2010) Social conditions as fundamental causes of health inequalities: theory, evidence, and policy implications. Journal of Health and Social Behavior 51, S28–S40.CrossRefGoogle ScholarPubMed
Phillips, KA, Morrison, KR, Andersen, R and Aday, LA (1998) Understanding the context of healthcare utilization: assessing environmental and provider-related variables in the behavioral model of utilization. Health Services Research 33, 571–596.Google ScholarPubMed
Picot, WG and Sweetman, A (2004) The Deteriorating Economic Welfare of Immigrants and Possible Causes. Statistics Canada, Business and Labour Market Analysis Division. Available at http://publications.gc.ca/Collection/Statcan/11F0019MIE/11F0019MIE2005262.pdf.Google Scholar
Pollock, G, Newbold, B, Lafrenière, G and Edge, S (2011) Perceptions of Discrimination in Health Services Experienced by Immigrant Minorities in Ontario. Canada: Welcoming Communities Initiative.Google Scholar
Potocky-Tripodi, M and Potocky, M (2002) Best Practices for Social Work with Refugees and Immigrants. New York, NY: Columbia University Press.Google Scholar
Preston, V, Weiser, N, King, K, Mandell, N, Kim, AH and Luxton, M (2014) Worked to death: diverse experiences of economic security among older immigrants. In Kilbride, DM (ed.), Immigrant Integration: Research Implications for Future Policy. Toronto: Canadian Scholars’ Press, pp. 67–81.Google Scholar
Prus, SG, Tfaily, R and Lin, Z (2010) Comparing racial and immigrant health status and health care access in later life in Canada and the United States. Canadian Journal on Aging, 383–395.CrossRefGoogle ScholarPubMed
Ramraj, C, Shahidi, FV, Darity, W Jr, Kawachi, I, Zuberi, D and Siddiqi, A (2016) Equally inequitable? A cross-national comparative study of racial health inequalities in the United States and Canada. Social Science and Medicine 161, 19–26.CrossRefGoogle ScholarPubMed
Sakamoto, I (2007 a) A critical examination of immigrant acculturation: toward an anti-oppressive social work model with immigrant adults in a pluralistic society. British Journal of Social Work 37, 515–535.CrossRefGoogle Scholar
Sakamoto, I (2007 b) An anti-oppressive approach to cultural competence. Canadian Social Work Review/Revue canadienne de service social 24, 105–114.Google Scholar
Sakamoto, I and Pitner, RO (2005) Use of critical consciousness in anti-oppressive social work practice: disentangling power dynamics at personal and structural levels. British Journal of Social Work 35, 435–452.CrossRefGoogle Scholar
Sallis, JF, Owen, N and Fisher, E (2015) Ecological models of health behavior. Health Behavior: Theory, Research, and Practice 5, 43–64.Google Scholar
Sanmartin, C and Ross, N (2006) Experiencing difficulties accessing first-contact health services in Canada: Canadians without regular doctors and recent immigrants have difficulties accessing first-contact healthcare services. Healthcare Policy 1, 103–119.Google ScholarPubMed
Schiamberg, LB and Gans, D (1999) An ecological framework for contextual risk factors in elder abuse by adult children. Journal of Elder Abuse and Neglect 11, 79–103.CrossRefGoogle Scholar
Schoenberg, NE, Peters, JC and Drew, EM (2003) Unraveling the mysteries of timing: women's perceptions about time to treatment for cardiac symptoms. Social Science and Medicine 56, 271–284.CrossRefGoogle ScholarPubMed
Seaton, EK, Noah, A, Yoo, B and Vargas, E (2020) Health implications of Black Lives Matter among Black adults. Journal of Racial and Ethnic Health Disparities 7, 1241–1248.CrossRefGoogle ScholarPubMed
Seeman, T, Epel, E, Gruenewald, T, Karlamangla, A and McEwen, BS (2010) Socio-economic differentials in peripheral biology: cumulative allostatic load. Annals of the New York Academy of Sciences 1186, 223–239.CrossRefGoogle ScholarPubMed
Siddiqi, A, Kawachi, I, Keating, DP and Hertzman, C (2013) A comparative study of population health in the United States and Canada during the neoliberal era, 1980–2008. International Journal of Health Services 43, 193–216.CrossRefGoogle ScholarPubMed
Siddiqi, A, Wang, S, Quinn, K, Nguyen, QC and Christy, AD (2016) Racial disparities in access to care under conditions of universal coverage. American Journal of Preventive Medicine 50, 220–225.CrossRefGoogle ScholarPubMed
Siddiqi, A, Shahidi, FV, Ramraj, C and Williams, DR (2017) Associations between race, discrimination and risk for chronic disease in a population-based sample from Canada. Social Science and Medicine 194, 135–141.CrossRefGoogle Scholar
Solar, O and Irwin, A (2010) A conceptual framework for action on the social determinants of health. World Health Organization, Geneva, Social Determinants of Health Discussion Paper 2. Available at https://www.who.int/social_determinants/publications/9789241500852/en/.Google Scholar
Spitzer, DL (2004) In visible bodies: minority women, nurses, time, and the new economy of care. Medical Anthropology Quarterly 18, 490–508.CrossRefGoogle ScholarPubMed
Spitzer, D, Neufeld, A, Harrison, M, Hughes, K and Stewart, M (2003) Caregiving in transnational context: ‘My wings have been cut; where can I fly?’ Gender and Society 17, 267–286.CrossRefGoogle Scholar
Statistics Canada (2013) Immigration and Ethnocultural Diversity in Canada: National Household Survey, 2011 (Statistics Canada Catalogue No. 99-010-X2011001). Available at https://www12.statcan.gc.ca/nhs-enm/2011/as-sa/99-010-x/99-010-x2011001-eng.cfm.Google Scholar
Statistics Canada (2016) Difficulty Accessing Health Care Services in Canada. Available at http://www.statcan.gc.ca/pub/82-624-x/2016001/article/14683-eng.pdf.Google Scholar
Statistics Canada (2017) Age and Sex, and Type of Dwelling Data: Key Results from the 2016 Census (Statistics Canada Catalogue No. 11-001-X). Available at https://www150.statcan.gc.ca/n1/daily-quotidien/170503/dq170503a-eng.htm.Google Scholar
Statistics Canada (2018) The Canadian Immigrant Labour Market: Recent Trends from 2006 to 2017. Available at https://www150.statcan.gc.ca/n1/pub/71-606-x/71-606-x2018001-eng.htm.Google Scholar
Surood, S and Lai, DW (2010) Impact of culture on use of Western health services by older South Asian Canadians. Canadian Journal of Public Health 101, 176–180.CrossRefGoogle ScholarPubMed
Thomson, MS, Chaze, F, George, U and Guruge, S (2015) Improving immigrant populations’ access to mental health services in Canada: a review of barriers and recommendations. Journal of Immigrant and Minority Health 17, 1895–1905.CrossRefGoogle ScholarPubMed
Vang, ZM, Sigouin, J, Flenon, A and Gagnon, A (2017) Are immigrants healthier than native-born Canadians? A systematic review of the healthy immigrant effect in Canada. Ethnicity and Health 22, 209–241.CrossRefGoogle ScholarPubMed
Veenstra, G (2009) Racialized identity and health in Canada: results from a nationally representative survey. Social Science and Medicine 69, 538–542.CrossRefGoogle ScholarPubMed
Viner, RM, Ozer, EM, Denny, S, Marmot, M, Resnick, M, Fatusi, A and Currie, C (2012) Adolescence and the social determinants of health. The Lancet 379, 1641–1652.CrossRefGoogle ScholarPubMed
Viruell-Fuentes, EA, Miranda, PY and Abdulrahim, S (2012) More than culture: structural racism, intersectionality theory, and immigrant health. Social Science and Medicine 75, 2099–2106.CrossRefGoogle ScholarPubMed
Vissandjée, B, Weinfeld, M, Dupéré, S and Abdool, S (2001) Sex, gender, ethnicity, and access to health care services: research and policy challenges for immigrant women in Canada. Journal of International Migration and Integration 2, 55–75.CrossRefGoogle Scholar
Wahl, HW and Oswald, F (2010) Environmental perspectives on ageing. In Dannefer, D and Phillipson, C (eds), The SAGE Handbook of Social Gerontology. London: Sage, pp. 111–124.CrossRefGoogle Scholar
Wang, L and Kwak, MJ (2015) Immigration, barriers to healthcare and transnational ties: a case study of South Korean immigrants in Toronto, Canada. Social Science and Medicine 133, 340–348.CrossRefGoogle ScholarPubMed
Wang, L, Rosenberg, M and Lo, L (2008) Ethnicity and utilization of family physicians: a case study of Mainland Chinese immigrants in Toronto, Canada. Social Science and Medicine 67, 1410–1422.CrossRefGoogle ScholarPubMed
Wang, L, Guruge, S and Montana, G (2019) Older immigrants’ access to primary health care in Canada: a scoping review. Canadian Journal on Aging/La Revue canadienne du vieillissement 38, 193–209.CrossRefGoogle ScholarPubMed
White, K, Williams, T and Greenberg, B (1961) The ecology of medical care. New England Journal of Medicine 265, 885–892.CrossRefGoogle ScholarPubMed
Woodgate, RL, Busolo, DS, Crockett, M, Dean, RA, Amaladas, MR and Plourde, PJ (2017) A qualitative study on African immigrant and refugee families’ experiences of accessing primary health care services in Manitoba, Canada: it's not easy! International Journal for Equity in Health 16, 5.CrossRefGoogle Scholar
Woods, MD, Kirk, MD, Agarwal, MS, Annandale, E, Arthur, T, Harvey, J, Hsu, R, Katbamna, S, Olsen, R, Smith, L and Riley, L (2005) Vulnerable Groups and Access to Health Care: A Critical Interpretive Review. National Coordinating Centre NHS Service Delivery Organ R & D (NCCSDO).Google Scholar
World Health Organization (1948) Preamble to the Constitution of the World Health Organization as Adopted by the International Health Conference, New York, 19–22 June, 1946; Signed on 22 July 1946 by the Representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and Entered into Force on 7 April 1948. Available at http://www.who.int/governance/eb/who_constitution_en.pdf.Google Scholar
World Health Organization (2014) Helsinki Statement on Health in All Policies: Framework for Country Action. Geneva: World Health Organization.Google Scholar
Wu, C, Wilkes, R, Qian, Y and Kennedy, EB (2020) Acute Discrimination and East Asian–White Mental Health Gap During COVID-19 in Canada. Available at https://ssrn.com/abstract=3626460.CrossRefGoogle Scholar