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Reflecting on information gathered Print E-mail

Conducting a socio-ecological assessment was part of the program planning stage for this intervention program. Once the information was gathered, it became necessary to reflect on and integrate those findings. For the healthy women program, the process looked like this:

Ontario Public Health PractionersReflecting on information gathered

To help you as you brainstorm, we’re including this account of part of the information-gathering and reflection process of a community-based team working on the issue of immigrant women being at higher risk for breast and cervical cancer than Canadian-born women. They began by asking:

What do we know about the determinants of health and this issue?

The local health unit had little information available on the demographics of the Latin American community, or its participation in programs. Members of the health unit’s multicultural team told anecdotes about barriers to services for immigrant groups in general.

The working group did a literature review to determine characteristics of the broader Latin-American immigrant population, such as income, education level, family composition, language, knowledge and use of services by the women. Data specific to Ottawa’s Latin American community were collected as well.

The working group found considerable evidence on the economic and social inequality of ethno-racial and ethno-linguistic minority groups in Canada, although little was specific to the Latin American or Hispanic populations. They did find information on the size of the Hispanic population compared to other linguistic minority groups. Language data were available at a regional and local level and showed Spanish speakers face inequalities in income, education and health service access within their community and compared to other immigrants.

Statistics on cause of death by ethnicity or mother tongue were not available and data on health status were available only from U.S. and some Latin American countries. There was no high-quality, consistently collected data about ethno-cultural participation in screening programs in Canada.

The working group did find a well-documented multi-year screening initiative in the U.S. involving cancer centres, community groups, and university researchers that targets Hispanic women to increase their cancer screening participation rates. Pathways include community organization, health education and social marketing. However, studies about Hispanic women in the U.S. may not be useful in Canada, because this country attracts different types of Hispanic immigrants and has a different health system.

All available data indicated that the Latin American community, especially women and older adults, are economically marginalized in Canada. Hispanic women in Canada are similar to many other immigrant groups in some determinants of health: they are either extremely well educated, or have received only basic schooling and compared to Canadian-born women, they are more likely to live in poverty.

All newcomer groups tend to under-use health services. Several grey literature reports from community organizations said social isolation and fragmented access to health services is a problem for many Latin American newcomers. Small community groups had made some efforts over the previous ten years to improve immigrants’ ability to find care, but the efforts were fragmented. The working group found records of some community health-education efforts, but theoretical foundations for interventions and the pathways for acting on the determinants were not clear.

The group found the local community health centre and the Ontario Breast Screening Program (which were potential partners) collected data on mother tongues, ethnicity and birthplace inconsistently, so new forms were needed to collect baseline data (which was done over three months before intense outreach interventions began).

When the working group had identified gaps in the knowledge needed to do their work, they developed a detailed survey, conducted by trained lay health promoters to collect more information on demographics and health-service needs (Estable, Meyer & Torres, 2003).


Last Updated on Monday, 01 June 2009 08:01