Canadian federal policy provides a framework for the immigration and health experiences of immigrant women. The official immigration category under which a migrant is admitted determines to what degree her right to remain in the country (immigration status) is precarious. Women immigrants fall primarily into the more dependent categories and they experience barriers to access to health services arising from this precarious status. Federal immigration and health policies create direct barriers to health through regulation of immigrants' access to services as well as unintended secondary barriers. These direct and secondary policy barriers intersect with each other and with socio-cultural barriers arising from the migrant's socioeconomic and ethno-cultural background to undermine equitable access to health for immigrant women living in Canada.

Background Knowledge about the health impacts of the absence of health insurance for migrants with precarious status (MPS) in Canada is scarce. MPS refer to immigrants with authorized but temporary legal status (i.e. temporary foreign workers, visitors, international students) and/ or unauthorized status (out of legal status, i.e. undocumented). This is the first large empirical study that examines the social determinants of self-perceived health of MPS who are uninsured and residing in Montreal. Methods and findings Between June 2016 and September 2017, we performed a cross-sectional survey of uninsured migrants in Montreal, Quebec. Migrants without health insurance (18+) were sampled through venue-based recruitment, snowball strategy and media announcements. A questionnaire focusing on sociodemographic, socioeconomic and psychosocial characteristics, social determinants, health needs and access to health care, and health self-perception was administered to 806 individuals: 54.1% were recruited in urban spaces and 45.9% in a health clinic. 53.9% were categorized as having temporary legal status in Canada and 46% were without authorized status. Regions of birth were: Asia (5.2%), Caribbean (13.8%), Europe (7.3%), Latin America (35.8%), Middle East (21%), Sub-Saharan Africa (15.8%) and the United States (1.1%). The median age was 37 years (range:18-87). The proportion of respondents reporting negative (bad/fair) self-perception of health was 44.8%: 36.1% among migrants with authorized legal status and 54.4% among those with unauthorized status (statistically significant difference; p<0.001). Factors associated with negative self-perceived health were assessed using logistic regression. Those who were more likely to PLOS ONE |

In this article, we draw on a 2012 Montreal-based study that examined the embodied, every day practices of immigrant children and families in the context of urban greenspaces such as parks, fields, backyards, streetscapes, gardens, forests and rivers. Results suggest that activities in the natural environment serve as a protective factor in the health and well-being of this population, providing emotional and physical nourishment in the face of adversity. Using the Social Determinants of Health model adopted by the World Health Organization (WHO, 1998), we analyze how participants accessed urban nature to minimize the effects of inadequate housing, to strengthen social cohesion and reduce emotional stress. We conclude with a discussion supporting the inclusion of the natural environment in the Social Determinants of Health Model.

Contemporary discourses on ageing promote active participation as an ideal framework from which to encourage and support older people's health, independence and life satisfaction. But is such a vision of participation meaningful and/or accessible to all older adults? This paper explores how people ageing with disabilities understand the notion of social participation, juxtaposing their accounts with key trends found in ageing policy. Insights from individual interviews and a collective writing project conducted with older adults in Quebec who were living with lifelong disabilities (mobility, vision or hearing) reveal the tensions that exist between policy guidelines and participant narratives. Results highlight three crucial conditions with regard to the community participation of people ageing with disabilities: self-determination, creating an inclusive environment and identity integration. Together, these themes reveal that ageing policies on participation should be revisited in order to improve opportunities for meaningful involvement. Our discussion suggests the need to widen the definition of participation so that it can be used to validate a variety of life options, guarantee structural and cultural access to participative settings and offer social spaces capable of supporting evolving identities, lived experiences and the collective circumstances of ageing with disabilities.

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