Double Burden of Rural Migration in Canada? Considering the Social Determinants of Health Related to Immigrant Settlement Outside the Cosmopolis.

Asiya Patel,Kathi Wilson,Effat Ghassemi,Jennifer Dean,Sara Edge

doi:10.3390/ijerph16050678

Abstract

There is a large and growing body of research acknowledging the existence of health disparities between foreign-born and native-born populations in many high immigrant-receiving countries. Significant attention has been paid to the role of physical and social environments in the changing health status of immigrants over time. However, very limited attention has been given to these issues within the context of rural geographies, despite global evidence that immigrants are increasingly settling outside of traditional gateway cities and into rural communities. This paper presents the results of a scoping review aimed at assessing the state of knowledge on the health impacts of immigrant migration into rural communities in Canada. Guided by Arksey and O’Malley’s scoping protocol, we conduct a review of academic literature in Canada related to rural migration. A total of 25 articles met inclusion criteria which included access to the social determinants of health. Findings identified a paucity of research directly connecting rural settlement to health but the literature did emphasize five distinct social determinants of health for rural residing immigrants: social inclusion, culturally-appropriate services, gender, employment, and housing. This paper concludes with an identification of research gaps and opportunities for future research into whether rural-residing immigrants face a double burden with respect to health inequity.

Highlights

There is a large and growing body of research acknowledging the existence of health disparities between foreign-born and native-born populations in many high immigrant receiving countries including Australia [1,2,3,4], the United Kingdom [2] and the United States [2,5]
While few (4/25) of the studies explicitly mentioned “social determinants of health”, our data extraction and analysis found five determinants were implicitly addressed in the literature; they are discussed in order of prominence here
Scholars have echoed a call for more inclusive and multi-disciplinary policy-making that reflects the needs of vulnerable populations, including immigrants [25,72,82,83]. This scoping review provided insight into the state of knowledge on the health impacts of the changing settlement patterns among Canada’s immigrant population. While this is an underexplored area of research with few studies directly linking rural settlement to health, our review found that there were five social determinants of health that shed light onto potential health implications for immigrants: social inclusion, culturally appropriate health and settlement services, gender, employment, and housing

Summary

Introduction

There is a large and growing body of research acknowledging the existence of health disparities between foreign-born and native-born populations in many high immigrant receiving countries including Australia [1,2,3,4], the United Kingdom [2] and the United States [2,5]. In Canada, for example, the initially-strong health status of immigrants declines with time spent in the country [6,7], with long-term immigrants reporting lower self-reported health [8,9], higher prevalence of chronic diseases [10] and poorer access to health care services [11,12,13] compared to the Canadian-born population. Health geographers and planners alike have focused on the role of local environments in determining population health broadly, and immigrant health in particular [14,15,16,17]. Public Health 2019, 16, 678; doi:10.3390/ijerph16050678 www.mdpi.com/journal/ijerph

Objectives

Methods

Results

Discussion

Conclusion