Abstract
Background: Dramatic changes to health and social policy have taken place in Ontario over the last five years with few attempts to measure their impact on health outcomes. This study explored service providers’ opinions about the impact of four major policy changes on the health of recent immigrant and refugee communities in Toronto’s inner city.
Methods: Semi-structured key informant interviews.
Results: Reductions in funding for welfare, hospitals and community agencies were seen to have had major effects on the health of newcomers. Emergent themes included erosion of the social determinants of health, reduced access to health care, increased need for advocacy, deterioration in mental health, and an increase in wife abuse.
Conclusions: Several areas were identified where policy changes were perceived to have had a negative impact on the health of recent immigrants and refugees. This study provides insights for policy-makers, inner-city planners and researchers conducting population-based studies of immigrant health.
Résumé
Contexte: Il y a eu de profonds bouleversements des politiques sanitaires et sociales de l’Ontario au cours des cinq dernières années, mais on en a très peu mesuré les incidences sur la santé. Notre étude porte sur les opinions de prestateurs de services quant aux incidences de quatre grands changements d’orientation sur la santé des nouveaux immigrants et réfugiés des quartiers déshérités de Toronto.
Méthode: Entretiens semi-directifs avec des informateurs clés. Résultats: Selon nos informateurs, les compressions dans les budgets de l’aide sociale, des hôpitaux et des organismes communautaires ont eu des effets importants sur la santé des nouveaux arrivants: érosion des déterminants sociaux de la santé, restriction de l’accès aux soins, besoin accru de défense des intérêts, détérioration de la santé mentale et augmentation de la violence conjugale.
Résultats: Selon nos informateurs, les compressions dans les budgets de l’aide sociale, des hôpitaux et des organismes communautaires ont eu des effets importants sur la santé des nouveaux arrivants : érosion des déterminants sociaux de la santé, restriction de l’accès aux soins, besoin accru de défense des intérêts, détérioration de la santé mentale et augmentation de la violence conjugale.
Conclusions: Dans plusieurs domaines, les changements d’orientation auraient eu des effets nuisibles sur la santé des immigrants et des réfugiés nouvellement arrivés. Les résultats de l’étude peuvent éclairer les décideurs, les planificateurs des quartiers déshérités et les chercheurs qui mènent des études représentatives sur la santé des immigrants.
Footnotes
At the time of writing, Dr. Steele was supported by the Joint Centre of Excellence for Research on Immigration and Settlement (CERIS) in Toronto and by a Medical Research Council of Canada Training Fellowship. Ms. Clark holds a Ph.D. fellowship from NHRDP/CIHR.
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