Abstract
OBJECTIVES: To identify low-income working families’ health challenges and understand their barriers and facilitators to navigating those challenges.
METHODS: We conducted a focused ethnographic study in a food bank in Montreal, Quebec. Using purposeful sampling, we recruited participants who had at least one employed family member and one live-in child. Sensitizing concepts included social determinants of health (SDH) and family strengths. Participant observation, focus groups and in-depth interviews constituted the primary means of data collection. Thematic and contextual analyses were conducted iteratively.
RESULTS: We recruited 25 participants, 22 clients (15 women and 7 men with up to 5 children per family) and 3 members of staff. All clients were immigrants, having been in Canada for a range of 2 months to 23 years, thus reflecting the ethnic demography of the site. Families described health as physical, mental and socio-cultural well-being. Challenges to well-being included insufficient finances, non-standard work, hurdles in professional equivalency, isolation, children’s acculturation, inadequate access to health care and the Canadian winter. Personal and structural barriers and facilitators to navigating challenges centred on parents’ sense of the challenges being finite, control over discrete dimensions of life and hope of children’s future success. Families who incorporated these perceptions into their narratives seemed to describe the challenges as navigable. Importantly, the SDH model did not anticipate the degree to which challenges would be defined by immigration factors.
CONCLUSION: In order to help low-income working immigrant families face diverse challenges to well-being, community workers and policy-makers must consider the specific challenges of immigration and the importance of individual families’ outlooks as they navigate them.
Keywords: Low income population, social determinants of health, family health, immigration, food insecurity, employment
Résumé
OBJECTIFS : Cerner les difficultés relatives à la santé des familles ayant un faible revenu de travail et comprendre les éléments qui entravent ou qui favorisent leur capacité de surmonter ces difficultés.
MÉTHODE : Nous avons mené une étude ethnographique ciblée dans une banque alimentaire de Montréal (Québec). Nous avons recruté par échantillonnage intentionnel des participants dont au moins un membre de la famille avait un revenu de travail et dont au moins un enfant vivait à la maison. Les concepts sensibilisants étaient les déterminants sociaux de la santé (DSS) et les forces familiales. Nos principales méthodes de collecte de données ont été l’observation des participants, les groupes de discussion et les entretiens en profondeur. Des analyses thématiques et contextuelles ont été menées de façon itérative.
RÉSULTATS : Nous avons recruté 25 participants, soit 22 clients (15 femmes et 7 hommes ayant jusqu’à 5 enfants par famille) et 3 membres du personnel. Tous les clients étaient immigrants et étaient au Canada depuis 2 mois à 23 ans, ce qui reflète la répartition ethnique du lieu. Les familles ont décrit la santé comme englobant le bien-être physique, mental et socioculturel. Les obstacles au bien-être étaient le manque d’argent, le travail non conventionnel, les exigences d’équivalences professionnelles, l’isolement, l’acculturation des enfants, l’accès inadéquat aux soins de santé et l’hiver canadien. Les éléments personnels et structurels entravant ou facilitant la capacité de surmonter les obstacles étaient centrés sur le sentiment parental de la finitude des difficultés, de contrôle sur différents aspects de la vie et d’espoir que leurs enfants réussissent un jour. Les familles qui intégraient ces perceptions dans leurs récits semblaient décrire les obstacles comme étant surmontables. Il est important de noter que le modèle des DSS n’avaient pas prévu la mesure dans laquelle les obstacles seraient définis par des facteurs d’immigration.
CONCLUSION : Afin d’aider les familles immigrantes ayant un faible revenu de travail à composer avec divers obstacles au bien-être, les travailleurs communautaires et les responsables des politiques doivent tenir compte des difficultés propres à l’immigration et de l’importance de la façon dont chaque famille perçoit ces difficultés pour les surmonter.
Mots Clés: population à faible revenu, déterminants sociaux de la santé, santé de la famille, immigration, insécurité alimentaire, emploi
Footnotes
Conflict of Interest: None to declare.
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