Chapter 37 Immigrant Canadians Flashcards
(91 cards)
1
Q
What % of the Canadian population is foreign born?
A
20.6%
2
Q
Canada was the first country to have ___________________
A
explicit federal legislation supporting multiculturalism
3
Q
What are four reason people migrate?
A
- enjoy the political and economic freedoms and social opportunities that host societies offer
- fulfill themselves
- maximize abilities
- improve living conditions for selves and family”
4
Q
Primary reason countries accept immigrants:
A
shortages in various labour sectors and skill levels
5
Q
Who has jurisdiction for policies, programs, and requirements concerning immigration in Canada?
A
Federal, provincial and territorial governments
6
Q
What are the two main categories of migrants? What are the 3 subcategories that fall under each?
A
Permanent resident - economic immigrants - family class immigrants - refugees Temporary resident - temporary foreign workers - foreign students - humanitarian population
7
Q
What are Undocumented Migrants? Examples?
A
people who are not authorized to be in Canada
- family members who come as visitors and stay beyond 6 months
- refugee claims denied
- temporary workers or students who remain after visa expired
- people who have entered country illegally
8
Q
A “newcomer” is:
A
a permanent residents who have been in Canada 5 years or less
9
Q
Permanent Resident
A
has all the rights guaranteed under the Canadian Charter of Rights and Freedoms except right to vote
-economic immigrants, family class immigrants, and refugees
10
Q
Temporary Resident
A
lawfully in Canada with valid documentation on a temporary basis, or individuals seek asylum and remain in the country pending outcome of claim
- temporary foreign workers
- foreign students
- humanitarian population
11
Q
Economic Immigrants
A
Permanent Resident
- selected for skills and ability to contribute to economy
- includes skilled workers, business immigrants, provincial or territorial nominees, and the Canadian experience class
- includes principle applicant and accompanying spouse and/or dependents
12
Q
Family Class Immigrant
A
Permanent Resident
- sponsored by a Canadian citizen or permanent resident living in Canada who is 18+; includes spouses, partners, parents, grandparents, and certain other relatives but EXCLUDES fiancés
13
Q
Refugees
A
Permanent Resident
- government-assisted refugees, privately sponsored refugees and refugee dependents
- need protection and fear return to home country;
- while waiting for claim to be accepted or denied, considered temporary residents
14
Q
Temporary Foreign Workers
A
Temp Res
- in Canada principally to work
- are classified based on skill level and skill type
15
Q
Foreign Students
A
Temp Res
- in Canada principally to study
16
Q
Humanitarian Population
A
Temp Res
- refugee claimants who request refugee protection upon or after arrival in Canada; a refugee claimant whose claim is accepted may make and application for permanent residents; - includes other foreign nationals allowed to remain in Canada on humanitarian or compassionate grounds
17
Q
Canada’s immigration policy was discriminatory until changes were legislated by ____________ in ______
A
the Canadian Bill of Rights in 1960
18
Q
In 1962, federal policy changed to eliminate discrimination based on ____________________ and in 1967 a point system was introduced that took into account __________________
A
race, religion and national origin
age, education, language skill and economic characteristics
19
Q
Most immigrants to Canada now are _________ and __________
A
South Asian and Chinese
20
Q
_____ % of Canadian population identified as a visible minority
A
19.1
21
Q
Are recent immigrants younger or older than Canadian born population?
A
younger
22
Q
___ out of ____ immigrants settle in BC, Ontario, and Quebec. (Although there has been a decrease over the past 10 years in ______)
A
3/4
BC and Ontario
23
Q
How many temporary residents are there living in Canada?
A
close to 700,000
24
Q
The number of this category of migrant has increased the most
A
economic
25
Immigration levels are about _________ people per year
Government wants to maintain yearly admission of permanent residents between ___________ per year
250,000
240,000-250,000
26
Temporary migrants to address shortages in _____________
labour sectors
27
Temporary migrants are a labour source that is ____________ and for low-skilled,______
flexible--related to employer needs
inexpensive
28
Can temporary foreign workers apply to have spouses and dependents join them?
High-skilled can but not low-skilled
29
International students can apply for postgrad work permits for up to _____________ after completing education
3 years
30
Key reason for international students is:
that they are a source of income for schools—pay higher tuition
31
What is Diversity?
broad/inclusive term
- encompasses attributes like gender, age, language, visible and invisible disabilities, national origin and group affiliations
- we are all diverse in many ways--some are constant (ethnicity) and some change (age)
32
Although incorrect, in Canada, diversity is often considered synonymous with _________
ethnicity
33
___________ is often used as a code word for race
ethnicity
34
What is ethnicity?
refers to groups who share common social and cultural identity based on heritage, language, and religion (just one example of diversity)
35
What is Race?
socially constructed based on differences of some biological characteristic—social in both origin and maintenance
36
What is the social process that constructs racial categories in ways that label behaviour as having racial origins?
Racialization
37
Why is Racialization done?
to maintain prevailing social order and associated with inequities of opportunity
38
What is Multiculturalism?
culture and ethnic diversity where preservation and sharing of that diversity is encouraged
39
In 1988, the _____________ became a law
Multiculturalism Act
40
1971, Canada was 1st in world to have:
a multiculturalism policy
41
Labels often serve as ________ explanations for ____________________________. These explanations do 3 things:
- dominant
- how or why members of a certain group behave and what they beleive
1. Maintain assumptions
2. Are used to justify or rationalize decision about the provision of HC services
3. Contribute to people's experience of health, social, and economic difficulties
42
Migration can be considered _____________
A determinant of health
43
What conditions exacerbate feelings of isolation and stress in new immigrants?
lack of social support and low-waged insecure employment
44
Congruence (common language, community with same background) between immigrant groups and new home _________________ while lower levels of congruence (differences in skin colour or language) _______________
- makes transition to settlement less challenging
| - increase social stress, anger, and depression
45
New situations can lead to resilience and strength or it can be a source of stress if the changes are perceived as ____________
a threat to values or roles
46
What helps promote positive migrant outcomes?
- Identification and reinforcement of pre-existing strengths and resiliencies
- Identification and alteration of barriers that are harmful
- Strong formal and informal networks of support
47
What is the Healthy Immigrant Effect?
_________ immigrants reported the highest levels of health, _____________ reported the lowest
new immigrants entering Canada rate their health status more highly than Canadian born
economic, refugees
48
How does the health status of newcomers change during the first few years following migration and after 10 years post migration?
- declines during first few years
| - same as Canadians after 10
49
Reasons for decline in health upon immigrating to Canada?
- Stresses arising from settlement and structural barriers like difficulty finding work, poor work conditions
- Limitations in proficiency in English/French linked to decline
- Problem gaining access to HC services frequent and discrimination also frequent
- Women greater declines; have additional care responsibilities
50
Interim Federal Health Program (IFHP)
refugees who have been granted permanent resident status have comprehensive health coverage through the Interim Federal Health Program (IFHP)
51
Significant Barriers to Accessing HC Services (4)
- Cost for interim primary health care and extended health care
- Geographical distances to providers/services (especially for those who rely on public transportation)
- Lack of physicians (particularly female)
- Language differences—misunderstood or does not understand instructions
52
Nurses must do the following:
- Recognize diverse values and understandings of health within social and economic contexts
- Nurses have explicit responsibility in identifying, planning and participating in actions to create a more socially just and healthy society—one way to do this is to ADVOCATE
- Advocacy for social justice is in the CAN Code of Ethics—address unfairness in accessibility and distribution of health-care resources and services
53
Nurses most often advocate ____________ but biggest changes can happen when action is taken ________
on one-on-one basis
at all levels
54
Define SDoH and identify the 3 levels. Which level has greatest influence on health?
- Conditions in which people are born, grow, live, work, and age, including health system
1. Family and Biological Context
2. Structural Context
3. Socioeconomic and Political Context
* ****most influential
55
What SDoH fall under the Familial and Biological Context?
a. Genetics
b. Health practices and coping skills
c. Healthy child development
56
What SDoH fall under the Structural Context?
a. Income
b. Social status
c. Gender
d. Culture
57
What SDoH fall under the Socioeconomic and Political Context?
a. Employment and working conditions
b. Health services
c. Education and literacy
d. Physical environment
e. Social environment
f. Social support networks
58
Successful resettling into a new country involves 3 things:
1. Establishing economic and social ties that foster independence and self-sufficiency
2. Family and community networks
3. Developing language and cultural competencies—make social and employment participation possible
59
How many years does it take to achieve social and economic stability
_____ of refugee families live in poverty during first 10 years
approx. 7-10 years
1/3
60
What perpetuates unemployment/shitty employment?
Structural oppression in form of racism and social exclusion
61
5 Factors that undermine immigrant mental health
* Lack of family and social support
* Unemployment and low income
* Unwelcoming physical and social environments
* Underuse of mental health services
* High stress from bad work conditions
62
Has been suggested that higher rates of diabetes among certain groups relates to:
- Genetics
- Socioeconomic factors related to immigration like acculturation, stress, social isolation, poverty, and food insecurity
63
Middle East, South Asia, Latin America, Caribbean and sub-Saharan Africa are how many times more likely than those from Western Europe or US to develop diabetes?
2-3 times
64
What is the single most important factor in determining rates of screening for cervical cancer?
Acculturation
- aware of and adopt Canadian norms relevant to cervical health/engage in practice of cervical screenings
65
Nurse's Role in Ensuring new immigrants get cervical screenings/health care?
Educating about cervical cancer and appropriate measures for well-being
Identifying and modifying barriers to receiving care
- -Creating environments that attend to cultural discomfort with sharing private
- -Concerns about receiving care from males
66
When conducting assessment, always:
- Remain aware of the way in which assessments can act to reinforce stereotypes to marginalize
- Always remember that nurses have authority to describe and make decisions based on description—which means always located within a system of power
67
Strategies for Working With Interpreters
- Get patient’s consent
- Identify factors that may influence—difference in dialect, religion, age, etc.
- Family members should not
- Stress importance of repeating everything that is said
- Explain importance of confidentiality
- Talk to patient, not interpreter
- Speak in simple terms
- Short sentences, ask interpreter to relay info - If you think more is happening, ask interpreter to explain what’s being said
- Ask interpreter to explain any discussion between them and nurse to patient
- Write down key points, direction, times, etc for patient
- Ask patient to repeat in own words info given
- Interpreters are part of process/context—may have valuable insight
- After encounter, ask interpreter to share perceptions—especially difficulties
68
Reflection vs Reflexivity
reflection occurs "after the fact" but reflexivity occurs during the interaction and involves explicit attention to structures and systems as well as personal
69
Questions for Self-Reflexivity
- Reflections About My Personal Self
- Reflections About Myself as a Nursing Student
- Reflections About Context
70
Why is a patient's behaviour often labelled as "noncompliant"? What impact does this have?
When a patient’s behaviour is different from what we judge appropriate, often label them as “noncompliant”
- This harms relationship and reflects our values about who has the power to judge behaviour
- Demeans patient and ourselves
- Indicates we haven’t taken the time to explore the patient’s:
- Level of understanding
- Meaning they ascribe to the HC concern
- Factors such as lack of access to providers or services or costs the patient can’t afford
71
What is the first step in working toward responses that are inclusive and accepting of diversity and working for change on all levels?
self-reflexivity
72
What is self-reflexivity? What 3 things do we question?
The process of critically thinking through/examining your assumptions and then shifting nursing practice to one that is less harmful.
* Own understanding of reality and beliefs about who we are
* What it means to be a nurse
* Assumptions about individual patients, groups, communities
73
What is the problem with focusing on only individual encounters with patient identified as different due to migration?
obscures the broader SDoH and contexts of the patient and also conceals the social norms and practices that permit oppression
74
What is a healthy community?
•One that is continually creating and improving those physical and social environments and expanding community resources which enable people to mutually support each other in performing all the functions of life and developing to fullest potential
*It's a process, not a status. Not necessarily the highest health but striving to be healthier
75
What are four reasons for the increase in the number of international migrants?
How many are there currently? How many are there projected to be by 2050?
* Increase in global population
* Changes in economic opportunities related to globalization
* High youth unemployment worldwide
* Displacement and forced migration
214 million, 450 million
76
There is a significant increase in migration in which 4 populations?
- female
- temporary workers
- undocumented workers
- refugees
77
How many internal migrants are there worldwide?
740 million -- seek work
78
Changes to the composition of the Canadian population reflect 3 things
* Shift in migration to Canada from non-European countries
* Sustained immigration levels
* Low birth rates among non-immigrant population
79
By 2031:
Foreign-born residents will increase to _____%
- ____ of them will be a visible minority
____% of Canadians could be a visible minority
_____ of Canadians mother tongue won't be English or French
____% of all visible minorities will be in Toronto, Vancouver, and Montreal
- 25-28% (1/4)
- 3/4
- 29-32%
- 3/10
- 71%
80
Internationally Educated Nurses
- Why do we need them?
- ___% of RNs in Canada are IENs
- ___ % of them are educated in the Philippines
- Which two provinces have the highest number of IENs and why?
- What is deskilling?
- due to shortage in workforce
- 8.6% of RNs
- 30% of them educated in Philippines
- Alberta/Saskatchewan- recruitment efforts
- may seek employment that doesn’t require nursing registration---Deskilling
81
The optimal well-being of all humans from the individual to the collective perspectives. Health is considered a fundamental right and should be equally accessible by all. Includes being aware of how migration influences health and health services in country of origin and where they migrate.
Global Health
82
From a global health perspective, health outcomes are affected by which 3 factors?
- availability of comprehensive acute care
- availability of health promotion care
- equity of access
83
What are the positives and negatives effects of technology on immigrants?
Positive: transnationalism (significant changes to the ways migration is experienced) people can stay connected to home and family
Negative: exposure depends on context, country of origin and socioeconomic status--not everyone will have the same knowledge or experience--important to assess each person for experience using tech to promote health
84
From a public health perspective, increase in global migration has increased the potential for what?
worldwide spread of communicable diseases
85
What was the past focus of nursing research? What is the current focus? What are 5 areas that we need to do more research in/lack information about?
Past: focus on infectious disease and conditions of being “at risk”
Current: focus on individual or group health behaviours or outcomes
What we need/lack of:
• Integrating the contextual layers including SDoH, barriers to health, discrimination
•Short- and long-term strengths, resiliencies and coping skills of migrants
•Gender and stages through lifespan
•Mental health—particularly youth and women/type of migration status and level of education
•About personal and collective resources used to adjust
86
Nurses need to be aware of how ______, _______, _____ and _______ decisions affect migrants and be prepared to do something about it.
structural, legislative, funding and policy
87
Change at systemic levels involves:
- addressing public and government accountability
- evaluation of quality and accessibility of services
- evaluation of measures in place to promote safe and inviting environments for full participation
88
All nurses need to understand SDoH and have skills to advance social justice and equity but these are usually only taught in community health classes. What are 3 suggestions to promote this in nursing education:
* Focus on concepts early and throughout program in all courses
* Use non-nurse preceptors who often have holistic and broad viewpoint
* Structured opportunities for students to integrate theory and practice
89
What are 3 things you must learn in order to provide comprehensive and meaningful care to patient?
* What is important to them
* What they understand about health
* The structures and system influencing their lives
90
Being responsive to diversity means:
* Recognizing variety and complexity of migration pathways
* Diversity of premigration and postmigration experiences
* Differing accessibility to health care once in Canada
* Identifying barriers within systems of care (not just focusing on individual)
* Working to change policies and institutions so there is increased awareness and flexibility to respond to various needs, beliefs, and life contexts
91
What are the four big concepts this chapter addresses that are important for nurses to consider?
- importance of questioning assumptions
- recognizing power relations inherent to the act of describing
- conducting holistic assessments with every patient
- responsibility to work for change
