Adolescent Medicine Rounds                                          Hospital for Sick Children                            ...
Overview: Immigrant YouthChildren and youth make up a significant portion of immigrants into Canada
Status of Immigrant Youth:                    Where are they settling?• 17% refugees, 32% independent category, and 40% fa...
About St. James Town Initiative   SJT Initiative is a 5 year CBPR Initiative of WI   Research Question:        What implic...
Strategies & Activities                         Multi-pronged Approach                         COMMUNITY ENGAGEMENTPartici...
14,666 Residents              64,636 People / km2     (Unofficial Estimate: 25,000)                  64% Immigrants       ...
Production of Health Immigrant Youth have AddedBurden of Migration Experience                                             ...
Migration Experiences• Complex, dynamic and context bound process that take place  over time• Psychosocial integration:  •...
What factors influence adolescent health               and wellbeing?Risks factors include, but are not limited to:• Pover...
Research Example                Voices of Multicultural Youth:              Impact of urban neighbourhood on              ...
Photovoice participants – SJT youth residents                                                11
Photovoice to understand youth perception on    neighbourhood and health & wellbeing?Photovoice asks you to take photograp...
PHYSICAL ENVIRONMENT                                                  Parks and Green Space                               ...
PHYSICAL ENVIRONMENT                                                                      Recreational Facilities© Wellesl...
PHYSICAL ENVIRONMENT                                                                              Recreational Facilities ...
PHYSICAL ENVIRONMENT                                                                         Plants and Gardens© Wellesley...
PHYSICAL ENVIRONMENT                                                                        Plants and Gardens© Wellesley ...
PHYSICAL ENVIRONMENTOvercrowding... In a neighbourhood such as St. JamesTown where most people live in high risebuildings ...
SOCIAL ENVIRONMENT                                                                     Safety, Crime, Drugs, Fear© Wellesl...
VIOLENCE AND CRIME“It is a problem that after 12 a.m. going out alone is kind of suicide to residence. I     have been in ...
SOCIAL ATTRIBUTES                                                                                 Places of Worship© Welle...
SOCIAL ATTRIBUTES                                                                         SchoolThis is good for our healt...
RESIDENT BEHAVIOUR                                                                                                © Welles...
ECONOMIC ENVIRONMENT© Wellesley Institute                    Money also leads to better access to health most people livin...
Neighbourhood Quality & Depression                                    (preliminary findings from SJT survey, 2011)        ...
Broad Determinants of Health       a CBPR project on Neighbourhood & Health and WellbeingResults from Concept Mapping Proj...
Importance of Neighbourhood Factors on                  Health and Well-BeingResults from Concept Mapping Project         ...
Training Workshop 1© Wellesley Institute                        September 23, 2011 |                                      ...
Important Stakeholders: Training Workshop 2© Wellesley Institute                        September 23, 2011 |              ...
Community Forum & Expo: August 17, 2010                                     © The Wellesley Institute                     ...
What are the Issues?Immigrant youth tend to:• Live in low-income households and low-cost neighbourhoods which often  have ...
Addressing the issue1. Address health inequities: Are services “missing” for young   people who, due to low socio-economic...
AcknowledgementEstelle Sun: Project Coordinator, Wellesley InstituteSami, Sarah & Dina: Youth Interns , summer 2009-2010Al...
Following - UpThese speaking notes, and reports are available on our  website at www.sjtinitiative.comMy email: nasim@well...
ST. JAMES TOWN INITIATIVE                                         www.sjtinitiative.comTHANK YOU                          ...
Upcoming SlideShare
Loading in …5
×

Social Determinants of Health for Immigrant Youth: Experiences from St. James Town Initiative

1,763 views

Published on

This presentation offers critical insight on immigrant youth and the living conditions, settlement, and acculturation issues that play a role in determining their health and well-being. Drawing largely from the Wellesley Institute's Youth Photovoice research findings, this presentation provides background knowledge on the social determinants of health and a glimpse into the lives of immigrant youth. The presentation was part of SickKids’ Adolescent Medicine Rounds, and was attended by physicians, residents, fellows, medical students, nurses, social workers, psychologists and therapists working in the adolescent health field.

Nasim Haque, MD, DrPH
Director of Community Health
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI

Published in: Health & Medicine
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
1,763
On SlideShare
0
From Embeds
0
Number of Embeds
213
Actions
Shares
0
Downloads
13
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide

Social Determinants of Health for Immigrant Youth: Experiences from St. James Town Initiative

  1. 1. Adolescent Medicine Rounds Hospital for Sick Children November 30, 2011 Social Determinants of Health for Immigrant Youth: Experiences from St. James Town Initiative Nasim Haque, MD, DrPH Director, Community Health Wellesley InstituteNovember-30-11 | 1www.wellesleyinstitute.com
  2. 2. Overview: Immigrant YouthChildren and youth make up a significant portion of immigrants into Canada
  3. 3. Status of Immigrant Youth: Where are they settling?• 17% refugees, 32% independent category, and 40% family-class immigrant• ~ 200,000 non-status in Canada of which 50% reside in Toronto & their age demographics are not known• Among all immigrant youth in Canada in 2006, over 2/3rd live in Toronto, Vancouver or MontrealSalehi, R. 2010. Intersection of Health, Immigration, and Youth: A Systematic Literature Review. J. Immigrant MinorityHealth 12:788-797.November 30, 2011 3www.wellesleyinstitute.com | www.sjtinitiative.com
  4. 4. About St. James Town Initiative SJT Initiative is a 5 year CBPR Initiative of WI Research Question: What implications do neighbourhoods have on the health & well-being of immigrants? Results: Inform policy & support social change at neighbourhood levelNovember 30, 2011 4www.wellesleyinstitute.com | www.sjtinitiative.com
  5. 5. Strategies & Activities Multi-pronged Approach COMMUNITY ENGAGEMENTParticipatory Skill enhancing Student Work with SJT Initiative Action opportunities internships multiple website Research stakeholders Community Action SJT Residents Action Group 1) Adult Photovoice 4) Youth Photovoice 2) Community Mapping 5) Focus groups/interviews (CAC) 3) Concept Mapping 6) Sample Survey (CIHR funded)
  6. 6. 14,666 Residents 64,636 People / km2 (Unofficial Estimate: 25,000) 64% Immigrants 11/6 18 Aging High-Rise Buildings 30/ 201
  7. 7. Production of Health Immigrant Youth have AddedBurden of Migration Experience The social & economic environment HEALTH Person’s The physical individual / environment biological characteristics & behaviours November 30, 2011 7 www.wellesleyinstitute.com | www.sjtinitiative.com
  8. 8. Migration Experiences• Complex, dynamic and context bound process that take place over time• Psychosocial integration: • Acculturation, assimilation, settlement, adaptation• Important to understand pre and post-migration experiences of youth to address their health issuesNovember 30, 2011 8www.wellesleyinstitute.com | www.sjtinitiative.com
  9. 9. What factors influence adolescent health and wellbeing?Risks factors include, but are not limited to:• Poverty, social exclusion, peer rejection, isolation, and lack of family support• Growing up in disadvantaged circumstances• The migration process in countries of destination & origin• Lack of positive social and community networks and environmentsNovember 30, 2011 | 9www.wellesleyinstitute.com/sjtinitiative.com
  10. 10. Research Example Voices of Multicultural Youth: Impact of urban neighbourhood on health and wellbeing (2010)November 30, 2011 |www.wellesleyinstitute.com/sjtinitiative.com 10
  11. 11. Photovoice participants – SJT youth residents 11
  12. 12. Photovoice to understand youth perception on neighbourhood and health & wellbeing?Photovoice asks you to take photographs © Wellesley Instituteof things that are important to you - and to tell the story of why these things are important. The visual images andaccompanying stories are the tools used to reach policy- and decision-makers. 12
  13. 13. PHYSICAL ENVIRONMENT Parks and Green Space © Wellesley Institute In a community school field, this picture shows a number of children playing soccer on a summer day. It reflects back to my life as it was a school I use to attend and school field I use to play on as well. These activities are strengths in our community as children are kept away from trouble. It should be part of any child’s childhood memory as they spend their summer days having fun, rather than getting into trouble. 11/30/2011 13© Wellesley Institute (SJT Youth, 2010)
  14. 14. PHYSICAL ENVIRONMENT Recreational Facilities© Wellesley Institute As a child, one way I kept myself occupied with my time was through playing basketball. It not only kept me off the streets, but also wasted the majority of my time, keeping me active. If more community programs ran such activities, it would bring the community closer and keep children off the streets away from any type of violence. These activities are strengths in our community as children are kept away from trouble. (SJT Youth, 2010)
  15. 15. PHYSICAL ENVIRONMENT Recreational Facilities In a community where 73 percent of the population is immigrants, parents have to work to put food on the table and so the kids are home alone. They will eventually go out in the summer when it is extremely hot and if the swimming pool is packed, it is likely the child will leave and play somewhere in the street. When they are in the street, they are exposed to bits and pieces of bad things. Eventually they will get curious and see why they are so bad themselves and they become criminals, drug dealers or even drug addicts...... Also swimming is way to prevent child obesity (SJT Youth, 2010)© Wellesley Institute November 30, 2011 | 15 www.wellesleyinstitute.com/sjtinitiative.com
  16. 16. PHYSICAL ENVIRONMENT Plants and Gardens© Wellesley Institute This image gives the neighbourhood a vibrant, peaceful and beautiful effect. It also relates to our lives because it is said flowers can help ease tension and mellow the mind. A reason that these flowers are related to health apart from the calming aspect is that it also increases plant life, breeds new ecosystems, and reduces some of the harmful gasses in our atmosphere. 16 (SJT Youth, 2010)
  17. 17. PHYSICAL ENVIRONMENT Plants and Gardens© Wellesley Institute This flower may look like an ordinary flower, however it represents so much more. It is unfortunate that we don’t see many gardens around or plants being planted around the neighbourhood. This also relates to our health in a bad way because our neighbourhood is filled with only buildings making it look depressing to walk through. Flowers give humans a chance of breathing fresh air, thus, it’s useful for health. By seeing different flowers our mind get energized November 30, 2011 | 17 www.wellesleyinstitute.com/sjtinitiative.com (SJT Youth, 2010)
  18. 18. PHYSICAL ENVIRONMENTOvercrowding... In a neighbourhood such as St. JamesTown where most people live in high risebuildings and come from low incomefamilies it may not seem like the bestidea to build more buildings when wedon’t already have that much greenspace around. This issue relates to yourlives because we need more things thanbuildings around our community, such asmore parks, centres for youth butinstead we invest in building and morebuildings. (SJT Youth, 2010) © Wellesley Institute 18
  19. 19. SOCIAL ENVIRONMENT Safety, Crime, Drugs, Fear© Wellesley Institute The picture shows a memorial of a residence of St. James Town whose life was robbed off him last year due to gun violence. The person who murdered “Juice” is yet to be found. It just comes to show that more security is needed in the area. A lot of undercover police are the area dressing up as drug dealers or buyers but they are usually easily spotted and pin pointed. 19 11/30/2011 (SJT Youth, 2010)
  20. 20. VIOLENCE AND CRIME“It is a problem that after 12 a.m. going out alone is kind of suicide to residence. I have been in trouble many times that now I try not to go or if I want to go I go with my friends which is more safe for me.”“During night time this area is not really safe, because in a neighborhood where a lot of gang plays, bad crime and other bad things happened and a lot of young boys and girls are coming at night time to smoke and sometime when they got drank they start fighting with people and with themselves. In my opinion that area is not safe at the middle of the night and we need more security there.”November 30, 2011 | 20www.wellesleyinstitute.com/sjtinitiative.com
  21. 21. SOCIAL ATTRIBUTES Places of Worship© Wellesley Institute In a way this can relate to our health because there are many other things that have to do with health and not just physicalness but also emotionally. People pray and worship what they do to make themselves feel better and that has to do with our health. (SJT Youth, 2010) 11/30/2011 21
  22. 22. SOCIAL ATTRIBUTES SchoolThis is good for our health because children are getting an education they deserve and will getso the future could be better. This strength exists because of the strong community involvementwith he school. All the parents are all in the parent council meetings and voice their opinionswhich benefit the school. (SJT Youth, 2010) 22
  23. 23. RESIDENT BEHAVIOUR © Wellesley InstituteThis is related to our lives because every day we are witness to some type of harmfulcarcinogens produced by these cigarettes. Whether second hand, or first hand smoke, livingin St. James Town means a high chance of encountering cigarettes. Because of this morepeople are exposed to harmful chemicals. (SJT Youth, 2010)
  24. 24. ECONOMIC ENVIRONMENT© Wellesley Institute Money also leads to better access to health most people living in St. James Town do not have money to go to the doctor and most of them do not have money to pay their rent. The money earned by some people is not even enough to properly feed them. The big issues around in this area are about money including the cost of living income and employment. 11/30/2011 24 (SJT Youth, 2010)
  25. 25. Neighbourhood Quality & Depression (preliminary findings from SJT survey, 2011) Perceived Neighbourhood Problems Effects on Depression 4 3.5 3 2.5Odds Ratio Non-Immigrant 2 Chinese Filipino 1.5 Tamil 1 0.5 0 Not or A Few Problem Some Problems Severe Problems
  26. 26. Broad Determinants of Health a CBPR project on Neighbourhood & Health and WellbeingResults from Concept Mapping ProjectConceptMapping resultsshow thatresidents’ healthis affected by abroad range ofissues, most ofwhich areoutside of thehealth-caresystem 26
  27. 27. Importance of Neighbourhood Factors on Health and Well-BeingResults from Concept Mapping Project Importance Action Potential 4.12 3.51 Improvement for Health Society Residents rated Safety Improvement for Health the importance of Environment various Need Social & Protection Sense of Pride Environment neighbourhood factors that had Attractions Safety been identified as Education Green Space influencing their Green Space Lack of Maintenance &Improvement health and well- Sense of Pride Attractions being. Lack of Maintenance Need Social and Protection Society Education 3.08 3.56 r = .12 * Absolute values for ratings range from 1-5 November 30, 2011 | www.wellesleyinstitute.com/sjtinitiative.com
  28. 28. Training Workshop 1© Wellesley Institute September 23, 2011 | 28 www.wellesleyinstitute.com/sjtinitiative.com
  29. 29. Important Stakeholders: Training Workshop 2© Wellesley Institute September 23, 2011 | 29 www.wellesleyinstitute.com/sjtinitiative.com
  30. 30. Community Forum & Expo: August 17, 2010 © The Wellesley Institute www.wellesleyinstitute.com | www.sjtinitiative.com 30© Wellesley Institute
  31. 31. What are the Issues?Immigrant youth tend to:• Live in low-income households and low-cost neighbourhoods which often have higher poverty and crime rates and offer poor living conditions• Lack social support – a contributing factor to the higher rates of depression and social exclusion• Language barriers – remaining silent, appearing withdrawn, moody, and fearful• Internalize a new set of cultural norms, and a new value system more quickly than their parents – confrontation with parents• More likely to have less parental support to avoid risk behaviour and may be more susceptible to peer pressures to engage in risk behaviour 31
  32. 32. Addressing the issue1. Address health inequities: Are services “missing” for young people who, due to low socio-economic status, gender, migrant status, or family structure are at increased risk ? What mechanisms can help reach disadvantaged young people?2. Involve immigrant youth: Are immigrant youth adequately involved in the design of service delivery? What can be done to further involve them?3. Engage in inter-sectoral action: Given the importance of the school setting for most adolescents, what is the role of the health system in this regard?November 30, 2011 | 32www.wellesleyinstitute.com/sjtinitiative.com
  33. 33. AcknowledgementEstelle Sun: Project Coordinator, Wellesley InstituteSami, Sarah & Dina: Youth Interns , summer 2009-2010Ali Moallim : Community Leader, SJTSean McIntyre: Constituency Assistant to Area CouncillorSt. James Town Youth project participants November 16, 2011 33 www.wellesleyinstitute.com | www.sjtinitiative.com
  34. 34. Following - UpThese speaking notes, and reports are available on our website at www.sjtinitiative.comMy email: nasim@wellesleyinstitute.com 34
  35. 35. ST. JAMES TOWN INITIATIVE www.sjtinitiative.comTHANK YOU © The Wellesley Institute11/30/2011 35 www.wellesleyinstitute.com | www.sjtinitiative.com

×