Examining transnational health practices and healthcare access among older immigrants in Canada

Social Sciences and Humanities Research Council of Canada (SSHRC) Insight Grants

Principle Investigators: Dr. Lu Wang, Dr. Guruge Sepali and Dr. Janet Lum

Canada is undergoing two parallel and unprecedented transformations (immigration, aging), leading to a highly transnational and rapidly aging population. Immigrants today are transnational migrants who maintain frequent connections with their home country. Transnational ties shape the use of healthcare locally (in the host country) and transnationally (in the home country), affect our understanding of well-being and influence health outcomes. The study will explore the nature and patterns of transnational health practices (THP) among older immigrants in Toronto and the surrounding suburbs , where immigrants account for 70% of the total older population.

     HP is regarded as a response to lack of healthcare access and unmet health needs related to language, geographic access, cost, wait times and perceived service quality, particularly later in life. THP can be either non-travel-based (importing medicines from home country) or travel-based (medical return to the home country to access care). THP is more prevalent among older immigrants, who tend to face many challenges in health and integration. In Canada, the emphasis on "aging in place" has led to increased dependence on primary care. However, an alarming location and language discordance between culturally competent family physicians and older immigrants has been documented.

     This study will focus on South Asian and East Asian communities, the two largest recent immigrant groups in Toronto, with the highest numbers of older immigrants. It will employ a mixed methods approach combining spatial (secondary data), quantitative (survey), qualitative (focus group) methods to explore health practices and behaviours, both local and transnational, among older immigrants, and examine the barriers and enablers, both spatial and sociocultural, for older immigrants to manage their health.