Minorities In Canada Research Articles

Cross-Disciplinary Rapid Scoping Review of Structural Racial and Caste Discrimination Associated with Population Health Disparities in the 21st Century

A cross-disciplinary rapid scoping review was carried out, generally following the PRISMA-SCR protocol to examine historical racial and caste-based discrimination as structural determinants of health disparities in the 21st century. We selected 48 peer-reviewed full-text articles available from the University of Memphis Libraries database search, focusing on three selected case-study countries: the United States (US), Canada, and Nepal. The authors read each article, extracted highlights, and tabulated the thematic contents on structural health disparities attributed to racism or casteism. The results link historical racism/casteism to health disparities occurring in Black and African American, Native American, and other ethnic groups in the US; in Indigenous peoples and other visible minorities in Canada; and in the Dalits of Nepal, a population racialized by caste, grounded on at least four foundational theories explaining structural determinants of health disparities. The evidence from the literature indicates that genetic variations and biological differences (e.g., disease prevalence) occur within and between races/castes for various reasons (e.g., random gene mutations, geographic isolation, and endogamy). However, historical races/castes as socio-cultural constructs have no inherently exclusive basis of biological differences. Disregarding genetic discrimination based on pseudo-scientific theories, genetic testing is a valuable scientific means to achieve the better health of the populations. Epigenetic changes (e.g., weathering—the early aging of racialized women) due to the DNA methylation of genes among racialized populations are markers of intergenerational trauma due to racial/caste discrimination. Likewise, chronic stresses resulting from intergenerational racial/caste discrimination cause an “allostatic load”, characterized by an imbalance of neuronal and hormonal dysfunction, leading to occurrences of chronic diseases (e.g., hypertension, diabetes, and mental health) at disproportionate rates among racialized populations. Major areas identified for reparative policy changes and interventions for eliminating the health impacts of racism/casteism include areas of issues on health disparity research, organizational structures, programs and processes, racial justice in population health, cultural trauma, equitable healthcare system, and genetic discrimination.

Unveiling voices and narratives: exploring the perspectives on multiculturalism and bilingualism of recent adult Chinese immigrants in Canada

ABSTRACT Multiculturalism, a federal policy that emphasises cultural, social, and political rights for ethnic minorities in Canada, is a crucial aspect of immigrant life. Concurrently with the implementation of multiculturalism by the federal government, Canada adopted bilingualism as its official language policy. Although the primary motivation for this policy was to protect the French language and culture, it holds significant relevance for immigrants, especially those residing in Francophone-dominant areas such as Quebec. Despite the importance of these policies to immigrant life, few studies have explored immigrants’ perspectives on both federal policies. Addressing this gap, the present study examines the lived experiences of six adult Chinese immigrants who arrived in Canada and obtained permanent residency or Canadian citizenship after 2010. Through narrative inquiry, this research shares participants’ stories to explore how recent adult Chinese immigrants understand Canadian multiculturalism and bilingualism. Taking a critical stance on multiculturalism and bilingualism, this study examines, discusses and interprets the lived experiences of its participants with the goal to confront issues of inequality, privilege, and power dynamics. The findings reveal that Chinese immigrants’ understanding of multiculturalism and bilingualism is shaped by their personal experiences with both policies. Participants leverage their experiential knowledge of multiculturalism and bilingualism to navigate their new lives in Canada. Although participants voice some concerns about these policies, they also presented nuanced perspectives and opinions on both federal policies. These perspectives not only enrich the literature on Canadian multiculturalism and bilingualism, but also highlight Chinese immigrants’ desire for integration in Canada.

Self-Perceived Reasons for Suicide Attempts in Sexual and Gender Minorities in Canada

ABSTRACT The aim of this study was to examine the self-perceived reasons of suicide attempts among sexual and gender minorities (SGM). We surveyed SGM living in Canada (n = 2778) and respondents who had attempted suicide answered open-ended questions about their perceived reason(s) of their first/only attempt (FOA) and last attempt (LA) (for those who attempted multiple times). Responses were double-coded and categorized as discrete findings. A quarter (25%, n = 695) of the total sample reported a history of suicide attempt, of whom 72% reported multiple attempts. Respondents described a wide variety of reasons for their suicide attempts, with an important number of individuals reporting multiple reasons (corresponding to 47.5% of FOA and 43% of LA). Emotional issues (FOA:42.1%, LA:44.0%) were the most prevalent category of reasons for suicide attempts followed by experience of mental illness (FOA:30.1%, LA:36.1%). Other common reasons included violence (FOA:23.2%, LA:10.2%), interpersonal conflict (FOA:13.4%, LA:6.0%), stress related to life circumstances (FOA:9.5%, LA:16.7%), relationship issues (FOA:7.9%, LA:13.3%), and minority stress related to sexuality (FOA:11.1%, LA:6.2%) and gender identity (FOA:5.0%, LA:6.8%). SGM assessments of the reasons underlying their suicide attempts yielded a variety of factors, many of which were absent from the literature on SGM suicide but amenable to tailored interventions.

“Les Miserables” Children of Great Britain in Canada: Maria Rye’s Migration Programme

In this paper, the author explores Maria Susan Rye’s emigration society. She initiated the relocation of British children from workhouses and orphanages to Canada in 1869. Documentary and narrative sources have rarely been used to explore this “inconvenient” topic of British history. Few works by Western researchers of child migration appeared only at the end of the twentieth century. In the article, the author analyses controversial events in the history of Great Britain and Canada in the nineteenth century. The purpose of the work is to consider the reasons for resettlement, Rye’s migration plan, the attitude of the British public towards it, its practical implementation in the Dominion, and the living conditions of minors in Canada. The author notes that the pauperisation of the British population was a major factor in the juvenile emigration in the context of industrialisation and demographic growth of the cities. Rye’s plan was to take children from slums and place them in Canadian families. The author pays special attention to Andrew Doyle’s mission. He was commissioned by the British government to investigate the activities of Rye, her colleagues, and the living conditions of the migrants. The author demonstrates that Doyle exaggerated the abuse and lack of supervision of children in order to discredit Rye’s project and impose the workhouse system on Canada. She concludes that the informal control of migrants practised by Rye should have been supplemented by legislative protection of the rights and interests of British minors in Canada.

The Impact of Comorbidities among Ethnic Minorities on COVID-19 Severity and Mortality in Canada and the USA: A Scoping Review.

(1) Current literature on ethnic minorities, comorbidities, and COVID-19 tends to investigate these factors separately, leaving gaps in our understanding about their interactions. Our review seeks to identify a relationship between ethnicity, comorbidities, and severe COVID-19 outcomes (ICU admission and mortality). We hope to enhance our understanding of the various factors that exacerbate COVID-19 severity and mortality in ethnic minorities in Canada and the USA. (2) All articles were received from PubMed, Scopus, CINAHL, and Ovid EMBASE from November 2020 to June 2022. Included articles contain information regarding comorbidities among ethnic minorities in relation to COVID-19 severity and mortality. (3) A total of 59 articles were included that examined various ethnic groups, including Black/African American, Asian, Hispanic, White/Caucasian, and Indigenous people. We found that the most examined comorbidities were diabetes, hypertension, obesity, and chronic kidney disease. A total of 76.9% of the articles (40 out of 52) found a significant association between different races and COVID-19 mortality, whereas 21.2% of the articles (11 out of 52) did not. (4) COVID-19 ICU admissions and mortality affect various ethnic groups differently, with Black patients generally having the most adverse outcomes. These outcomes may also interact with sex and age, though more research is needed assessing these variables together with ethnicity.

Trends in lung cancer diagnosis and care among visible minorities and non-visible minorities in Canada.

Identifying factors that influence the diagnosis and treatment of lung cancer is an important public health initiative. Various sociodemographic factors, including race and ethnicity, may influence an individual's risk of developing lung cancer, as well as access to relevant diagnostic and therapeutic procedures. Data from the 2006 Canadian long-form census were cross-linked with the Canadian Cancer Registry and hospital data to determine rates of lung cancer diagnosis among visible minorities and non-visible minorities in Canada, and to assess for differences in rates of hospital-based procedures pertaining to a lung cancer diagnosis based on visible-minority status. Individuals were allocated into six visible-minority categories, and separate results were generated nationally and across seven regions. Multivariate logistic regression controlled for relevant confounders. Rates of lung cancer were significantly lower among visible minorities versus non-visible minorities (329 versus 1108 cases per 100 000). This result is consistent across all visible-minority subgroups. Among those with a diagnosis of lung cancer, procedure rates were higher for all visible minorities nationally (53.4% [95% CI 53.2-53.6]). Multivariable analysis demonstrated higher procedure rates in general for visible minorities with a lung cancer diagnosis compared to non-visible minorities (OR 1.158 95% CI 1.053-1.273). In Canada, visible minorities experience lower rates of lung cancer diagnosis than non-visible minorities. Among those with a lung cancer diagnosis, we did not identify any negative disparities in rates of relevant diagnostic or therapeutic procedures, based on visible-minority status.

Development of residential schools for indigenous minorities in Canada – selected problems

The article deals with the issue of the relation between education and the processes of assimilation and discrimination of indigenous minorities (Indians and Inuit) in Canada. Particular emphasis was placed on reconstructing educational practices and the educational policy that is implemented toward indigenous minorities within Canadian school system (especially destruction of their ethnic identity in residential schools). An attempt was made at examining the relationship between schooling, religion, socialization, forced Christianization, language policy, and the development of aboriginal minorities in Canada.

Israel: a novel wedge issue in Canadian electoral politics

AbstractThis article investigates the relationship between partisan foreign policy positions on Israel and the voting behavior of religious minorities in Canada. It discusses Stephen Harper's strong pro-Israeli stance in foreign policy when the Conservatives were in power and focuses on two main explanations accounting for such politicization of Israel, namely moral obligations and political clientelism. These hypotheses are tested using the 1968–2015 Canadian Election Study (CES) surveys and the 2011–2015 Vox Pop Labs election data. The results suggest that the Israeli issue had an impact on the support for the Conservatives among voters from religious minorities. Considering the effect of this foreign policy positions, Jewish Canadians are shown to be more supportive of the Conservatives, while the opposite pattern is observed among Muslim Canadians. The implications of these findings are then discussed.

Representation of visible minorities in Canada's public service: Slow but significant progression

AbstractThis study examined the representation of visible minority (VM) employees in Canada's public service to clarify the extent to which Canada's Employment Equity Act (EEA) for diversity and equity management has influenced VM employment outcomes, with a focus on executive (leadership) and professional representation. Data from EEA annual reports (1997–2020) were analysed, and the results for VMs in the public service were juxtaposed with those for VMs in the broader labour market. VM employees' numerical representation under the EEA had increased and was slowly trending upwards in executive roles, exceeding their workforce availability in 2020. However, the representation of VMs in public service failed to match their actual proportion in the larger Canadian population. This group had a stronger representation in scientific and professional occupations, reflecting current immigration policies' support for skilled migration. The VM workforce in the broader labour market lacked equal representation, which indicates significant policy implications.

An Examination of The Impact of COVID-19 on the Mental Health and Substance Use of Social Minorities in Canada

COVID-19 outbreak in Canada has resulted the implementation of public health mitigation laws regarding self-isolation, country-wide lockdowns, and closure of public services to decrease the spread of COVID-19. The application of these public health policies facilitated unintended consequences and side effects that would eventually intensify the already existing mental health issues and substance abuse prevalent amongst these vulnerable populations. People who use drugs (PWUD), wellness service providers, households with young children, and LGBTQ2+ people have reported their concerns for either food security, financial obstacles including the lack of job guarantee, limited access to public resources, and the ongoing opioid crisis in Canada that collided with the pandemic. These concerns have contributed greatly to the positive feedback cycle between the increasing use of substance including alcohol, cannabis, and opioids, and deteriorating mental health issues such as anxiety, post-traumatic syndrome, and depression. This study aims to discuss and compile the responses of social minorities in Canada regarding the use of substances and mental health conditions.

Re-examining medical assistance in dying for mature minors in Canada: Reflections for health leaders.

In Canada, Medical Assistance in Dying (MAiD) is legal for many Canadians based on several criteria, though minors who are deemed sufficiently capable to make medical decisions (ie, mature minors) remain ineligible. In this article, we provide insight into recent philosophical and legal evidence related to MAiD for mature minors. We begin by providing an overview of literature pertaining to MAiD for mature minors in particular (including evidence from Belgium and the Netherlands), followed by a discussion on the lessons that can be learnt from Canada's MAiD implementation process (in general) and other forms of paediatric end-of-life care. As a whole, we aim to highlight some key takeaway messages for health leaders to consider as deliberations on MAiD for mature minors continue.

The Unspeakable Nature of Death & Dying During Childhood: A Silenced Phenomenon in Pediatric Care.

In pediatric settings, the concept of hope is frequently positioned as a fundamental aspect of care and at odds with the possibility and proximity of death. This arguably fosters silence about death and dying in childhood despite evidence indicating the benefits of open communication at the end of life. In this paper, we describe the unspeakable nature of death and dying in childhood, including its conceptual and clinical causes and dimensions, its persistence, and the associated challenges for children and youth facing critical illnesses, their families, and society. We explore how the tension between hope and death can be reframed and apply our analysis to the context of medical assistance in dying for mature minors in Canada. Considering the lack of related literature, this paper offers initial reflections to form a framework for the unspeakable nature of death and dying in childhood and to advance the crucial need for research.

Toward an inclusive digital health system for sexual and gender minorities in Canada.

Most digital health systems (DHS) are unable to capture gender, sex, and sexual orientation (GSSO) data beyond a single binary attribute with female and male options. This binary system discourages access to preventative screening and gender-affirming care for sexual and gender minority (SGM) people. We conducted this 1-year multi-method project and cocreated an action plan to modernize GSSO information practices in Canadian DHS. The proposed actions are to: (1) Envisage an equity- and SGM-oriented health system; (2) Engage communities and organizations to modernize GSSO information practices in DHS; (3) Establish an inclusive GSSO terminology; (4) Enable DHS to collect, use, exchange, and reuse standardized GSSO data; (5) Integrate GSSO data collection and use within organizations; (6) Educate staff to provide culturally competent care and inform patients on the need for GSSO data; and (7) Establish a central hub to coordinate efforts.

Proposal for the extension of rights to medical assistance in dying (MAiD) to mature minors in Canada.

Proposal for the extension of rights to medical assistance in dying (MAiD) to mature minors in Canada.

Social Exclusion Among Official Language Minority Older Adults: A Rapid Review of the Literature in Canada, Finland and Wales

It has been suggested that older adults from minority linguistic and ethnic communities face higher risks of being socially excluded. The aim of this review was, therefore, to explore and review social exclusion studies conducted among official language minority older adults in three countries, namely Canada, Finland and Wales. A rapid review approach was used to review scientific literature in line with six social exclusion domains. The literature searches were made in Finnish, Swedish, English, French and Welsh and were restricted to research published within the timeline of 2001 – September 2019 and yielded 42 articles. The included studies were categorized into three different domains: socioeconomic influences, social participation and societal conditions. Converging and diverging patterns of social exclusion in old age were identified between the linguistic minorities. Linguistic barriers regarding access to health care and receiving health information were common across the three linguistic contexts, whereas exclusion from social participation was noticed amongst the linguistic minorities in Canada and Wales. Some connections between belonging to a linguistic minority and being exposed to a lower socioeconomic status and higher poverty risk were made, however, these findings were not robust across all three countries. The findings indicated that experiences of exclusion could be considered fairly common among linguistic minority older adults. We conclude that the research evidence presented in the review sheds light on issues of social inequality in old age between linguistic majorities and minorities, thus identifying important aspects of social exclusion to guide future research as well as policy and practice.

Studying the social determinants of COVID-19 in a data vacuum.

Race‐based and other demographic information on COVID‐19 patients is not being collected consistently across provinces in Canada. Therefore, whether the burden of COVID‐19 is falling disproportionately on the shoulders of particular demographic groups is relatively unknown. In this article, we first provide an overview of the available geographic and demographic data related to COVID‐19. We then make creative use of these existing data to fill the vacuum and identify key demographic risk factors for COVID‐19 across Canada's health regions. Drawing on COVID‐19 counts and tabular census data, we examine the association between communities’ demographic composition and the number of COVID‐19 infections. COVID‐19 infections are higher in communities with larger shares of Black and low‐income residents. Our approach offers a way for researchers and policymakers to use existing data to identify communities nationwide that are vulnerable to the pandemic in the absence of more detailed demographic and more granular geographic data.

Perceived racial and cultural discrimination and sense of belonging in Canadian society.

Multiculturalism promises equality and tolerance, yet racialized minorities in Canada continue to report experiences of discrimination. As Canada becomes increasingly culturally and racially diverse, it is important to understand what this discrimination means for sense of belonging in Canada. Using ordinary logistic regressions, we examine the effects of ethnocultural and racial discrimination on sense of belonging. Relying on a theoretical framework of the Rejection/Identification and Rejection/Disidentification models, we test the impacts of discrimination on national sense of belonging and on in-group sense of belonging. We further examine the differential effects of discrimination on sense of belonging for white and non-white Canadians. We find that discrimination negatively impacts both national and in-group sense of belonging among both non-white and white Canadians, although the impact is stronger among racialized minorities. Thus, we argue that discrimination reduces sense of belonging in Canada generally, but is more damaging to those who already occupy a marginalized social position. These findings have implications for our understanding of multiculturalism in Canada.

Facilitators and Barriers to Healthy Midlife Transition among South Asian Immigrant Women in Canada: A Qualitative Exploration.

Background: South Asian immigrant women make up the largest visible minority in Canada, where visible minorities include persons, other than Aboriginal peoples, who are non-Caucasian in race or non-white in colour, and approximately half of these women are above the age of 35. Few studies have investigated the factors that impact the midlife transition for these women. This study aims to identify the facilitators and barriers experienced by South Asian immigrant women during the midlife transition. Methods: Two focus groups and ten one-on-one interviews about the midlife transition were held with South Asian first-generation immigrant women in the Greater Toronto Area, Ontario, Canada; discussions were analyzed thematically. Findings: Personal facilitators to the midlife transition included being employed and possessing adequate life skills. Personal barriers consisted of financial strain, overwhelming demands, and limited life skills. Familial facilitators were stable financial status and support. Familial barriers included limited understanding and support and high expectations. Community facilitators included a close social circle and adequate healthcare. Community barriers were limited social support and cultural expectations. Fair and respectful societies were a facilitator, whereas inadequate policy support and acculturative stress were societal barriers. An environmental barrier was the colder Canadian climate. Discussion: Employment and education programs for South Asian immigrant women need to be prioritized to help them integrate into society. Family-centred assessment and education can improve familial support. Communities need to foster peer support groups and culturally sensitive healthcare. Social and employment policies should accommodate the midlife transition. Conclusions: South Asian immigrant women experience unique facilitators and barriers to their midlife transition that should be considered by healthcare providers, policymakers and society to support them.

Immigration, education, sense of community and mental well-being: the case of visible minority immigrants in Canada

ABSTRACT Immigrants often cite improvements in quality of life as the motivation for immigration, yet it can lead to the loss of social networks, family and community ties. This article employed key informant interviews to explore visible minorities’ sense of community from the perspectives of immigrant resettlement service providers. Nine key informants were interviewed to document visible minority immigrants’ experiences in Canada, and how this affected their sense of community. Participants identified barriers to immigrants’ development of a new sense of community, including discrimination tied to improper placement within the Canadian educational system, unemployment/underemployment, poor housing conditions, language barriers, and lack of social support networks. Confronting these barriers will require creating a stronger sense of community by providing more and better support of immigrants, visible minorities and everyone across Canada. This would help eliminate discrimination against ethnic minorities and enhance a sense of community belonging amongst visible minorities in Canada.

It is time to mobilize suicide prevention for sexual and gender minorities in Canada

Suicide is a significant health issue among sexual and gender minority adults (SGMA); yet, there are no tailored suicide prevention programs for these marginalized populations in Canada. We hosted two world cafés with community leaders, health professionals, policymakers, and researchers to identify recommendations for mobilizing SGMA-focused suicide prevention programs. We identified five priorities: (1) make society safer for sexual and gender minorities; (2) decrease barriers to mental health services; (3) support community-driven and community-based interventions; (4) increase suicide knowledge and reduce stigma; (5) expand the knowledge base on SGMA suicide. In the absence of a national Canadian SGMA suicide prevention policy, these priorities provide a starting point in addressing SGMA suicide inequities by advancing SGMA-tailored interventions.