Edited by: Temi Toba-Oluboka
In Ottawa, 44% of the city’s current population consists of immigrants and children of immigrants who were all once newcomers [1]. In Toronto, in 2016, 51.2% of the population was born outside of Canada, and are thus first generation status or non-permanent residents [2]. With an aim to welcome over 400,000 new immigrants for the next three years (2021-2023), newcomers health and access to healthcare resources should be a priority within healthcare systems and policy makers who have to the power to promote change for this community[2].
Unknowingly to many, newcomers health has been shown to decline once entering Canada. Despite being known for “universal healthcare”, navigating the healthcare system in Canada can pose challenges to those already in this system let alone families coming from countries with different languages, cultures, access to healthcare and healthcare systems [3]. For many newcomers, financial concerns, housing, education and acclimatization are a priority and rightfully so. Additional reasons why newcomers may lose their health advantage may be due to changes in diet and exercise which are key factors to health. Here at Enayble Health, our goal is to identify the link between SES and access to physical activity resources within Canada [3] and we believe identifying this relationship within newcomer communities is needed.
One common condition that continues to be on the rise globally is obesity. Obesity is linked to common chronic conditions such as diabetes, heart disease, hypertension, asthma and some cancers. Obesity which has a genetic underpinning is also greatly influenced by nutrition and physical activity [4]. In the study, “Is migration to Canada associated with unhealthy weight gain? Overweight and obesity among Canada’s immigrants”, they describe a “healthy immigrant effect”. They suggest that on arrival, obesity rates are lower compared to native born Canadians but increases with years lived in Canada [4]. An additional study titled, “Ethnic differences in prediabetes incidence among immigrants to Canada: a population-based cohort study” followed a cohort for 8 years to identify the development of prediabetes [5]. Prediabetes refers to blood sugar levels that are higher than normal, but not yet high enough to be diagnosed as type 2 diabetes. 1,772,180 adults from age 20 – 85 yr old with normoglycemia (normal blood sugar) were followed in their cohort. Prediabetes incidence rates were found to be 40% higher among immigrants compared to long-term Canadian residents after adjusting for age, sex, and area income. Over the entire follow-up period, the adjusted cumulative incidence of prediabetes was 21.2% among immigrants and 16.0% among long-term Canadian residents. Over a 12-year follow-up period, the highest incidence of prediabetes was seen amongst South Asian, Sub-Saharan African and Caribbean, and Southeast Asian descent.
Diabetes Canada recognizes pre diabetes as a condition that should be followed in order to prevent Type 2 Diabetes [6]. Exercising regularly (for 150 minuets a week), following a healthy diet and weight loss are factors that can reduce the risk of prediabetes developing into Type 2 Diabetes. They also recognize the importance of utilizing resources in diabetes education, exercise specialists, dieticians and weight loss programs. However, the specific needs and priorities of newcomers are often times not geared towards these programs. Implementation of lifestyle interventions in primary care has also been shown to be poor and better coordination between healthcare, policy makers and advocates are needed to reduce this burden [7].
At Enayble Health, we want to help reduce these burdens and through our recent workshop partnering with the Syrian Canadian Foundation (SCF) and Rising Youth, we were able to describe the general importance of physical activity and the physical activity guidelines that exist. While our participant registration consisted of 25% newcomers and 62% of registrants identified as BIPOC, we were unable to accommodate all registrants due to capacity and funding limitations. However, the need and excitement of the newcomer and BIPOC community exists and individuals do want to become more physically active. Through workshops such as these, newcomers can find resources that fit their budget, lifestyle, culture and family needs. Additional solutions include providing this information through Immigration Canada with the resources already provided when discussing how to access healthcare resources. Sports For Life Canada [8], an organization that looks to improve on sports inclusion for newcomers has identified potential solutions to these issues as well. This includes:
“Making subsidy information accessible by sharing it with all families when they register their kids. This minimizes the stigma of having to ask for help.”
“Connect families with organizations that provide equipment, especially for activities requiring size specific equipment that needs to be replaced as the child grows.”
“Many municipalities have subsidy programs that allow residents in financial need to access recreational programs. Ensure effective distribution of this information through the Internet and community publications to reduce financial limitations.”
We know that being physically active in the long term can help reduce the risk, incidence and severity of common conditions Canadians face such as diabetes and obesity. By identifying gaps within systems that currently exist and posing potential solutions, we believe we can help newcomers and healthcare professionals reduce the burden of navigating recreational activities that can improve one’s health. While there is limited research on the percentage of newcomers that are physically active, with the knowledge that newcomer health declines once coming to Canada, there is a window of opportunity for healthcare providers and policy makers to provide culturally safe and adaptable forms of physical activity to newcomers to ensure that they can maintain their health and are surrounded by positive communities that inspire one to live a healthy lifestyle.
Summary:
Newcomers health has been shown to decline once entering Canada. One study describes the “healthy immigrant effect”. They suggest that on arrival, obesity rates are lower compared to native born Canadians but increases with years lived in Canada [9].
For many newcomers, financial concerns, housing, education and acclimatization are a priority and rightfully so. Additional reasons why newcomers may lose their health advantage may be due to changes in diet and exercise which are key factors to health.
One study showed that Prediabetes incidence rates were found to be 40% higher among immigrants compared to long-term Canadian residents after adjusting for age, sex, and area income. The highest incidence of prediabetes was seen amongst South Asian, Sub-Saharan African and Caribbean, and Southeast Asian descent.
References
https://www.ottawapublichealth.ca/en/public-health-services/immigrant-a-diverse-populations.aspx
Setia, M. S., Quesnel-Vallee, A., Abrahamowicz, M., Tousignant, P., & Lynch, J. (2011). Access to health-care in Canadian immigrants: a longitudinal study of the National Population Health Survey. Health & social care in the community, 19(1), 70–79. https://doi.org/10.1111/j.1365-2524.2010.00950.
Is migration to Canada associated with unhealthy weight gain? Overweight and obesity among Canada's immigrants
Fazli, G.S., Moineddin, R., Bierman, A.S. et al. Ethnic differences in prediabetes incidence among immigrants to Canada: a population-based cohort study. BMC Med 17, 100 (2019). https://doi.org/10.1186/s12916-019-1337-2
Dunbar JA, Hernan AL, Janus ED on behalf of the Melbourne Diabetes Prevention Study (MDPS) research group, et al. Challenges of diabetes prevention in the real world: results and lessons from the Melbourne Diabetes Prevention Study. BMJ Open Diabetes Res Care. 2015;3:e000131.
Is migration to Canada associated with unhealthy weight gain? Overweight and obesity among Canada's immigrants