South Asian Canadians Research Articles

Sociodemographic factors associated with vaccine hesitancy in the South Asian community in Canada.

South Asians represent the largest non-white ethnic group in Canada and were disproportionately impacted by the COVID-19 pandemic. We sought to determine the factors associated with vaccine hesitancy in South Asian Canadians. We conducted a cross-sectional analysis of vaccine hesitancy using data collected at the baseline assessment of a prospective cohort study, COVID CommUNITY South Asian. Participants (18 + years) were recruited from the Greater Toronto and Hamilton Area in Ontario (ON) and the Greater Vancouver Area in British Columbia (BC) between April and November 2021. Demographic characteristics and vaccine attitudes measured by the Vaccine Attitudes Examination (VAX) scale were collected. Each item is scored on a 6-point Likert scale, and higher scores reflect greater hesitancy. A multivariable linear mixed effects model was used to identify sociodemographic factors associated with vaccine hesitancy, adjusting for multiple covariates. A total of 1496 self-identified South Asians (52% female) were analyzed (mean age = 38.5years; standard deviation (SD): 15.3). The mean VAX score was 3.2, SD: 0.8 [range: 1.0‒6.0]. Factors associated with vaccine hesitancy included: time since immigration (p = 0.04), previous COVID-19 infection (p < 0.001), marital status (p < 0.001), living in a multigenerational household (p = 0.03), age (p = 0.02), education (p < 0.001), and employment status (p = 0.001). Among South Asians living in ON and BC, time since immigration, prior COVID-19 infection, marital status, living in a multigenerational household, age, education, and employment status were associated with vaccine hesitancy. This information can be used to address vaccine hesitancy in the South Asian population in future COVID-19 waves or pandemics.

Refugee Worldbuilding in Broken Times: (Re)Creating Self-Location in South(east) Asian Canadian Narratives

This paper is focused on interpreting the way in which twenty-first-century refugee writing in Canada is currently approached critically and theoretically. It proposes new reading strategies that contest the influence of nation-state powers over literary production deployed with an aesthetics of cosmopolitanism. In particular, this article takes up refugee writing by Kim Thúy and Sharon Bala, respectively, in order to show how its search for a “Good Life” leads to the transformation of the characters’ subjectivity. This transformation responds to an epistemological shift which confronts issues of Western complicity in foreign human rights abuses and poses questions about alternative epistemologies to Eurocentric notions of healing and trauma recovery in the aftermath of mass violence.

Navigating Living Kidney Donation and Transplantation Among South Asian Canadians: The ACTION Project

South Asian (SA) Canadians with kidney failure have a 50%-77% lower likelihood of kidney transplant and are less likely to identify potential living donors (LDs). This study aimed to identify health system-, patient-, and community-level barriers and facilitators for accessing LD kidney transplantation in the SA community to inform the development of health system- and community-level interventions to address barriers. Qualitative study. 20 SA recipients of an LD or deceased-donor kidney transplant, 10 SA LDs, and 41 general SA community members. In-depth multilingual interviews were conducted with recipients and LDs. Gender-, language-, and age-stratified focus groups were conducted with general SA community members. Summative content analysis was used to analyze the data. Hesitancy in approaching potential donors, fear about the health of potential LDs, information gaps, language barriers, and challenges evaluating out-of-country donors were highlighted as significant barriers by recipients, and financial concerns and information gaps were identified by donors. Cultural barriers in the SA community were highlighted by donors, recipients, and community members as critical factors when considering donation and transplant; women and elderly SA Canadians highlighted nuanced challenges. Participants reported generally a favorable perception of their health care teams, citing SA representation in the teams as important to providing culturally and linguistically sensitive care. Limited geographic, race, and cultural representation and reliance on virtual data collection. This study highlights several culturally relevant barriers to donation and transplant that are potentially modifiable through patient-, health system-, and community-focused engagement and education.

Singing from the same hymnbook: South Asian Canadian solidarity in the long sixties in British Columbia

ABSTRACT This essay breaks new ground in writing the history of the long sixties by bringing in a strand of the Third World diasporic activism shaped by transnational mobility. It alludes to the role of the Naxalite movement in politicizing the youth of the Panjab, many of whom moved to Canada in the late 1960s and 1970s encouraged by changes in Canada’s immigration policies. This new wave of immigrants was confronted with racism and labour exploitation upon arrival. In response, they quickly formed new Left-wing organizations to defend their rights. The literary association of progressive Panjabi writers in British Columbia and other places was one such institution. It directly involved itself in political and cultural activism, besides literary activities by crossing racial and communal boundaries to create intercommunity solidarities. These Panjabi writers were also chroniclers of the global consciousness of their times as well as the local histories of resistance by their diasporic community. Through text and performance, their intercommunity cultural solidarity activism organically connected them to an older North American radical tradition of the anarcho-syndicalist Wobblies. The archive of the literary production of progressive Panjabi writers has been used in the essay alongside the video interviews recorded by the author with members of Panjabi theatre groups, musicians of a former rock band, a visual artist and photographer, and the founder of a local folk music festival. It brings to the fore new voices, perspectives, and experiences that shaped the intercommunity cultural solidarity activism of the long sixties in British Columbia.

COVID-19 vaccine effectiveness among South Asians in Canada.

We evaluated the effectiveness of COVID-19 vaccines among South Asians living in Ontario, Canada compared to non-South Asians and compared the odds of symptomatic COVID-19 infection and related hospitalizations and deaths among non-vaccinated South Asians and non-South Asians. This was a test negative design study conducted in Ontario, Canada between December 14, 2020 and November 15, 2021. All eligible individuals >18 years with symptoms of COVID-19 were subdivided by ethnicity (South Asian vs other) and vaccination status (vaccinated versus not). The primary outcome was vaccine effectiveness as defined by COVID-19 infections, hospitalizations, and deaths, and secondary outcome was the odds of COVID-19 infections, hospitalizations, and death comparing non-vaccinated South Asians to non-vaccinated non-South Asians. 883,155 individuals were included. Among South Asians, two doses of COVID-19 vaccine prevented 93.8% (95% CI 93.2, 94.4) of COVID-19 infections and 97.5% (95% CI 95.2, 98.6) of hospitalizations and deaths. Among non-South Asians, vaccines prevented 86.6% (CI 86.3, 86.9) of COVID-19 infections and 93.1% (CI 92.2, 93.8) of hospitalizations and deaths. Non-vaccinated South Asians had higher odds of symptomatic SARS-CoV-2 infection compared to non-vaccinated non-South Asians (OR 2.35, 95% CI 2.3, 2.4), regardless of their immigration status. COVID-19 vaccines are effective in preventing infections, hospitalizations and deaths among South Asians living in Canada. The observation that non-vaccinated South Asians have higher odds of symptomatic COVID-19 infection warrants further investigation.

Review: South Asian Canadian Digital Archive

Review: South Asian Canadian Digital Archive

Primary Care Physicians' and Hospitalists' Experience with Advance Care Planning with South Asian Canadian Older Adults before and during COVID-19.

Few older adults discuss their end-of-life care wishes with their physician, and even fewer minorities do this. We explored physicians' experience with advance care planning (ACP) including the barriers/facilitating factors encountered when initiating/conducting ACP discussions with South Asians (SA), one of Canada's largest minorities. Eleven primary care physicians (PC) and 11 hospitalists with ≥ 15 per cent SA patients ≥ 55 years of age were interviewed: 10 in 2020, 12 in 2021. Thematic analysis of transcripts indicated that cultural and communication barriers, physician's specialization, SA older adults' lack of ACP awareness, and decision-making deference to family and physicians were barriers to ACP discussions. Although the COVID-19 pandemic impacted physicians' practices, contrary to our hypothesis most reported no change in frequency of ACP discussions. Although ACP discussions were viewed as best conducted by PC physicians, only 55 per cent had ACP training and only 64 per cent had used ACP tools. Training in ACP facilitation, concerning ACP tool usage, and training in patient-physician communication are recommended.

Exploring the influence of social and structural support on entrepreneurial intentions among South Asian Canadian immigrants

The focus of this paper is on the perspectives people hold towards starting their businesses. An investigation was conducted on recent immigrants to Canada, the majority of whom were from South Asian nations. Subsequently, the SmartPLS 3.2.8 analysis tool was used to examine the collected data. According to the findings of the analysis, the perception of having structural support is a poor predictor of entrepreneurial intentions. Conversely, individual characteristics, such as self-efficacy and self-control, are significant predictors of entrepreneurial intentions. The results call into question immigration policies and regulations that select immigrants based on their potential for financial success rather than the businesses they intend to start themselves. The research suggests that if immigrants with high self-efficacy were provided support from their immigrant communities, they could more easily launch new businesses. This information can serve as a guide for immigration policymakers.

Who Gets to Be “Canadian”? How Race Has Operated in Keeping Canada White

“ Where are you from?” is often a question that is asked of some Canadians – typically, Canadians for whom skin colour, race, accent, language (other than English and French), name (last, first and nick-name), religion, place of residence, “appearance,” and the organizations or clubs to which they belong, play a role in why they are being asked the question in the first place. But why are “ assumed non-accented ‘non-visible’ Canadians not asked this question? And when individuals – based on identities by which they are read as “not from Canada” – answer the question with “Canadian,” why would they get a follow-up question: “Where are your parents from?”;and/ or “Where are you really from?” In taking up this question, I discuss the treatment, settlement and experiences of Black/African, Chinese, and South Asian Canadians in terms of how Canadian laws, policies, and practices have operated to keep them from entering the country, and in turn shaped their life conditions once here. With reference to how, building on colonialism, systemic racism structures the conditions racialized people encounter daily, I go on to discuss the ways in which the history of populating Canada accounts for racialized peoples' experiences with anti-Indigenous, anti-Black, and anti-Asian racisms in living on Turtle Island.

At the intersection of homophobia and racism: Sociocultural context and the sexual health of South Asian Canadian gay and bisexual men.

At the intersection of homophobia and racism: Sociocultural context and the sexual health of South Asian Canadian gay and bisexual men.

South Asian Canadian Digital Archive:: Fostering Knowledge Diversity and Equity Through Multilingual Knowledge Infrastructures

Knowledge and its production is informed by the availability of and access to existing knowledge infrastructures. Historically, both the production of knowledge and knowledge infrastructures have been dominated and dictated by western1 schools of thoughts that elided, erased, neglected, and negated the existence of multiple epistemologies. This paper explores ways to understand the depth and breadth of global colonial legacies and epistemic coloniality—and locate the pathways out in the archives. Using South Asian Canadian Digital Archive (https://sacda.ca) as a case study, the paper questions ways to rethink, redefine, and refine the methodologies of traditional archives to enable spaces for open and inclusive scholarship. It further frames SACDA (1897 to present) as an open tool for building multilingual knowledge infrastructures and to bring the larger community into the process of collective knowledge mobilization, creation, and dissemination.

“Think positive and don’t die alone” - Foreign-born, South Asian older adults’ perceptions on healthy aging

ABSTRACT South Asians are the largest and fastest-growing racialized group in Canada, yet there are limited data on various aspects of health and well-being within this population. This includes the South Asian older adults’ ethnoculturally informed perceptions of ageing. The study aimed to understand how social and cultural forces impact the meaning assigned to healthy ageing amongst older South Asians in Canada. We recruited with purposeful and snowball sampling strategies in Southern Ontario. We conducted in-depth focus group and individual interviews (n = 19) in five South Asian languages, employing a multilingual and cross-cultural qualitative approach. In our analysis, we identified three central themes: (a) taking care of body (b) taking care of mind and heart and (c) healthy ageing through the integration of mind and body. Our study demonstrates that older immigrants are a diverse and heterogeneous population and that their conception of healthy ageing is strongly influenced by their country of origin. This study also demonstrates how racialized foreign-born older adults might provide distinctive perspectives on the ageing process and on social theories of ageing due to their simultaneous immersion in and belonging to global majority and global minority cultures. This research also adds to the limited body of literature on the theories of ageing, despite migration trends, still has a white-centric lens.

Understanding the relationship between body image and menopause in South Asian Canadian women

Research regarding women’s body image experiences during menopause is limited; few studies reflect the experiences of South Asian Canadian women. This study qualitatively explored body image and menopause experiences in South Asian Canadian women. Nine first-generation South Asian immigrant Canadian women (aged 49–59 years), in perimenopause or postmenopause, took part in semi-structured interviews. Overall, two themes were constructed. The push and pull of South Asian and Western cultures focused on South Asian and Western cultural perspectives on upbringing, beauty standards, and menopause. Navigating through uncertainty towards acceptance addressed the intricacy of body image, menopause, and aging experiences and the struggle to accept change to their bodies. The results highlight the intersectionality of gender, race, ethnicity, culture, and menopause status in participants’ understanding, perceptions, and behaviours toward body image and menopause experiences. The findings demonstrate a need for critical examinations of social constructs (i.e., Western ideal, Western views of menopause) that nfluence participants’ experiences, and indicate a need for the development of culturally-appropriate and community-based interventions and resources. Given the underlying narrative of influence and conflict between Western and South Asian cultures, examining acculturation may uncover potential protective strategies for subsequent generations of South Asian women.

Culturally Adapted Cognitive Behaviour Therapy (CaCBT) to Improve Community Mental Health Services for Canadians of South Asian Origin: A Qualitative Study.

South Asian (SA) Canadians are disproportionately affected by higher rates of mood and anxiety disorders. SA Canadians with depression report significant barriers to accessing mental health care and the highest proportion of unmet mental health needs. The Mental Health Commission of Canada (MHCC) advocates for culturally and linguistically relevant services for SA Canadians. Culturally adapted cognitive behavior therapy (CaCBT) has shown to be more effective than standard cognitive behavior therapy (CBT). Adapting CBT for the growing SA population in Canada will ensure equitable access to effective, culturally-appropriate mental health interventions. The study used a qualitative design to elicit stakeholder consultation via in-depth interviews. This study is reported using the criteria included in Consolidated Criteria for Reporting Qualitative Studies (COREQ). The analysis follows an ethnographic approach and was informed by the principles of emergent design. Five themes were identified from the analysis, (i) Awareness and preparation: factors that impact the individual's understanding of therapy and mental illness. (ii) Access and provision: SA Canadians' perception of barriers, facilitators, and access to treatment. (iii) Assessment and engagement: experiences of receiving helpful treatment. (iv) Adjustments to therapy: modifications and suggestions to standard CBT. (v) Ideology and ambiguity: racism, immigration, discrimination, and other socio-political factors. Mainstream mental health services need to be culturally appropriate to better serve SA Canadians experiencing depression and anxiety. Services must understand the family dynamics, cultural values and socio-political factors that impact SA Canadians to reduce attrition rates in therapy.

#3144 KIDNEY TRANSPLANT-RELATED KNOWLEDGE AMONG SOUTH ASIAN COMPARED TO WHITE CANADIAN PATIENTS

Abstract Background and Aims Kidney transplant (KT) is the best treatment for many patients with kidney failure. However, patients from racialized communities are less likely to receive KT. Gaps in transplant-related knowledge may be one of the potential reasons for the observed inequities in accessing KT. Here we compare patient characteristics and KT-related knowledge between South Asian (SA) versus white Canadians with kidney failure using the “Knowledge Assessment of Renal Transplantation” (KART) questionnaire. Method Secondary analysis of data from a cross-sectional convenience sample of white and SA adults with kidney failure. Sociodemographic data, self-reported information about racialized status and KART score were collected through electronic data capture. The association between racialized status and participant demographics were assessed using ANOVA, Kruskal–Wallis test or chi squared test, as appropriate. The independent association between racialized status and KART scores was assessed by multivariable adjusted linear or multinomial logistic regression, with adjustment for immigration status, age, marital status, education, gender, Ontario Marginalization Index material deprivation quintile, Charlson Comorbidity Index and ethnicity. Results Among 578 participants (mean [SD] age: 57 [14] years, 64% male), 43% were white and 16% were SA. 84% vs 27% of SA vs white participants were immigrants. The Charlson Comorbidity Index score was &amp;gt;=4 for of 31[40%] SA vs 105[51%] white participants (p&amp;lt;0.001). The median (interquartile range) KART score of white vs SA participants was 17[6] vs 14[7] (p&amp;lt;0.001). In a univariable linear regression model the KART score was significantly associated with SA status (B: -3.27 ([95% CI]: -4.76, -1.77, p&amp;lt;0.001). This association remained significant after adjustment for potential confounding (B: -3.36 ([95% CI]: -5.05, -1.67, p&amp;lt;0.001) (Table 1). 26% of SA vs. 41% of white participants scored in the highest tertile for KART score (p&amp;lt;0.001) (Fig. 1). The relative risk ratio to be in the lowest KART tertile was 3.09 [95% CI: 1.49, 6.43] for SA compared to white participants in our final, adjusted multinomial model. Conclusion SA participants with kidney failure are commonly immigrants who have poorer KT-related knowledge compared to white participants. Our findings indicate the need to develop culturally relevant KT related patient education for South Asian Canadian communities.

Cardiovascular disease in South Asian Canadians: using risk factors to target primary and secondary prevention

Cardiovascular disease incidence and risk profiles vary substantially across ethnicities within Canada, with South Asians carrying a disproportionately high burden of disease. South Asians exhibit high incidences of modifiable risk factors that predispose them to cardiovascular disease: dyslipidemia, hypertension, diabetes, and physical inactivity. As well as a genetic predisposition through elevated lipoprotein(a) levels. Dietary and physical activity prescriptions must consider South Asian culture and barriers they face. These include culturally tailored dietary guidelines and women-only fitness centres. Lipoprotein(a), an atherogenic molecule, is genetically determined and elevated in South Asians but may be modified with antisense oligonucleotide therapy. This therapy warrants consideration as part of the treatment algorithms for South Asians with elevated lipoprotein(a) levels. Introducing these practices into primary and secondary prevention guidelines may reduce the cardiovascular disease burden seen in South Asians.

Of Love and Agency: Models of Motherhood in South Asian Diasporic Literature and Poetry

In this essay, I will explore the literature and poetry of the South-Asian diaspora, arguing that an effective balance of tradition and agency for South Asian Canadian women is predicated on the existence of models of mothering that demonstrate choice for daughters, are communal, and create a mobilizable community for both mothers and their children. In a collection of poems by Rupi Kaur, mothering is explored in several forms, many of which succumb to damaging colonial tropes. Most promising of these models, however, are those that showcase a mother’s continued battle for potential freedom and the ways in which she demonstrates possibility for her daughter. This model is further constructed in Anita Badami’s work as mothers begin to socialize and organize in ways that propel those they mother as active agents and build communities. In the highest stage of this model, Farzana Doctor develops a model to engage in communal mothering more widely as it spurs a social movement and allows for the reclamation of individual agency. The women’s imperfect but rousing efforts to provide agency for their daughters as they navigate the challenges of being female members of the diaspora are central to each piece of literature and define the experiences of South Asian-Canadian mothers, daughters, and communities.

Perceptions of COVID-19 risk, vaccine access and confidence: a qualitative description of South Asians in Canada

ObjectivesIn the first full year of the COVID-19 pandemic (2020), South Asians living in the Greater Toronto and Hamilton Area (GTHA) and Greater Vancouver area (GVA) experienced specific barriers to...

‘Paki go home’: The story of racism in the Gerrard India Bazaar

For South Asian Canadians who migrated to Toronto in the 1970s, the only place for them to purchase and consume South Asian foodstuffs would have been in the area referred to as ‘Little India’, which later developed into what is referred to today as the Gerrard India Bazaar (GIB). Little India is located on Gerrard Street, encompassing the nine blocks from Greenwood Avenue to Coxwell Avenue. The very first South Asian entrepreneur in Gerrard Street was Gian Naaz, who rented the defunct Eastwood Theatre in 1972 and began showing films in Hindi and other South Asian languages. Naaz’s success inspired and attracted other South Asian entrepreneurs, some of whom opened restaurants and grocery stores. These early South Asian businesses on Gerrard Street combatted racism and racial stereotyping and the GIB was a microcosm of the violences South Asians experienced all across Toronto in the 1970s and 80s. As such, this paper tells the story of how South Asians, both them and their businesses, persevered and helped develop the GIB as an ethnic enclave because it allowed South Asians to affirm notions of home and belonging in Canada, all without ever having a distinct residential identity.

The Relationship Between Diet, Gut Microbiota, and Serum Metabolome of South Asian Infants at 1 Year

BackgroundDiet is known to affect the gut microbiota and the serum metabolome in adults, but this has not been fully explored in infants. Infancy is an important developmental period that may influence a person’s long-term health. Infant development can be affected by diet, which also interacts with the developing gut microbiota. ObjectivesThis study aimed to explore the associations between diet, the gut microbiota, and the serum metabolome of 1-y-old infants with the overarching goal of identifying serum biomarkers of diet and/or the gut microbiota. MethodsWe derived dietary patterns of 1-y-old infants (n = 182) participating in the Canadian South Asian Birth Cohort (START) study. We compared gut microbiota α-diversity and β-diversity and taxa relative abundance from 16S rRNA gene profiles with dietary patterns (PERMANOVA, Envfit) and investigated diet–serum metabolite associations using a multivariate analysis (partial least squares–discriminant analysis) and univariate analysis (t test). We explored the effect of nondietary factors on diet–serum metabolite relationships by incorporating diet, the gut microbiota, and maternal, perinatal, and infant characteristics in a multivariable forward stepwise regression. We replicated this analysis in White European infants, from the CHILD Cohort Study (n = 81). ResultsA dietary pattern characterized by formula consumption and negatively associated with breastfeeding most strongly predicted variation in the gut microbiota (R2 = 0.109) and serum metabolome (R2 = 0.547). Breastfed participants showed higher abundance of microbes from the genera Bifidobacterium (3.29 log2-fold) and Lactobacillus (7.93 log2-fold) and higher median concentrations of the metabolites S-methylcysteine (1.38 μM) and tryptophan betaine (0.43 μM) than nonbreastfed participants. Formula consuming infants showed higher median concentrations of branched-chain/aromatic amino acids (average 48.3 μM) than non–formula-consuming infants. ConclusionsFormula consumption and breastfeeding most strongly predicted the serum metabolites of 1-y-old infants, even when the gut microbiota, solid food consumption, and other covariates were considered.