Sex, gender, ethnicity, and access to health care services: Research and policy challenges for immigrant women in Canada

Abstract

This article explores the matching process at micro-, meso-, and macro-levels in health services in order to arrive at culturally competent and gender-sensitive health care. We provide a brief overview of sex, gend~ ethnicity, and health, specifically in terms of sex and ethnic matching at micro-, meso-, and macro-levels. Throughout the article we raise some controversial elements surrounding matching by providing a discussion of studies conducted in this field. In conclusion we examine the challenges to sex and ethnic matching in order to provide recommendations and alternative strategies toward the achievement of culturally competent and gender-sensitive health care. Cet article examine le processus de jumelage aux niveaux micro-, mdso-, et macro-dans les services de santd afin d'en arriver ?z des services de santd qui soient culturellement compdtents et adaptds aux diff&ences entre les hommes et Ies femmes. Nous donnons un bref apercu du sexe, de l'origine ethnique et de l'dtat de sant~ surtout en ce qui concerne le jumelage du point de vue du sexe et de l'ethnie aux niveaux micro-, mdso-et macro-. Tout au long de l' article, nous soulevons certains dl~rnents controversds qui entourent Ie jumelage en discutant d'dtudes mendes dans ce domaine. En conclusion, nous examinons les difficultds que repr~sente le jumelage du point de vue du sexe et de l'ethnie afin de formuler des recommandations et des strategies de rechange pour en arriver dL des services de santd culturellement compdtents et adapt~s aux diffdrences entre les hommes et les femmes.

Ethnicity and Postmigration Health Trajectory in New Immigrants to Canada

“…These findings are in line with the multiple jeopardy perspective. 49,50 Female immigrants were less likely to have employment opportunities and more likely to experience occupational downgrading than were their male counterparts. 51,52 We found considerable ethnic differences among female immigrants in employment status and salaries.…”

Intersection of Canadian Policy Parameters Affecting Women with Precarious Immigration Status: A Baseline for Understanding Barriers to Health

“…The social determinants of health outlined by the department (14) 8 are particularly relevant given our focus on access disparities related to precarious immigration status and the concurrent economic inequality, sexism and racism experienced by immigrant women. The existing literature on this underserved population suggests that women in most, if not all, of the precarious immigration categories, are disadvantaged in terms of these social determinants of health (17,20). Canadian federal agencies have documented the independent importance of gender, language, age, socio-cultural context and immigration policy on access to health and social services (21,17,22).…”

“…Immigrants also under-utilize preventive services and may be at risk for misdiagnosis and inappropriate treatment. In recognition of these barriers, the need to work towards culturally competent and gender-sensitive health care services has been argued by many researchers (28,20). Before reaching an understanding of such socio-cultural barriers however, it is essential to clarify the policy context that frames immigrant women's official eligibility for, and equitable access to public health services.…”

La pratique dans un contexte pluriethnique

“…21, n o 2 celle de leur milieu d'origine, est de taille (Battaglini et al, 2005 ;Vissandjée et al, 2001 ;Vissandjée et Dupéré, 2000). De surcroît, il semble que ces barrières d'accès s'inscrivent dans un contexte caractérisé par un manque de compréhension du rôle (de l'influence) des valeurs et des habitudes culturelles lors des échanges de services (Brotman, 2003).…”