This presentation provides critical insights on mental health, addictions, chronic disease, and sexual health in South Asian communities. Nasim Haque, MD, DrPH Director of Community Health www.wellesleyinstitute.com Follow us on twitter @wellesleyWI

1. CASSA-CAMH Conference
A Diagnosis for Equity: A Dialogue on Mental
Health, Additions, Chronic Disease, and
Sexual Health in South Asian Communities
Panel Discussion: Health Equity in South Asian Communities
Nasim Haque MD. DrPH.
Wellesley Institute
October 24, 2011
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2. Questions to address
1. What does health equity mean in your sector?
2. What are some of the health disparities that
affect South Asian communities in your sector?
3. How can all sectors work together?
October 24, 2011
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3. WHO WE WORK WITH
SJT Community Forum &
Expo: March 20, 2008
Our Research Interest:
neighbourhood & its influence
on immigrant health &
wellbeing i.e. SDoH
© Wellesley Institute

4. St. James Town
Of 64%
̴ 20% S.Asians Population &
̴ 20% Filipino
̴ 9 % Chinese
Neighbourhood
•14,666 Residents on 0.23 km2 of Land
•64,636 People / km2
•(Unofficial Estimate: 25,000)
•64% Immigrants
•18 Aging High-Rise Buildings
10/
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•Over 50 languages spoken 31/
© Wellesley Institute 201

5. What is Health Equity?
Health equity is:
“Fair” distribution of:
• Health
• Health care resources
• Opportunities according to population need
Equal opportunities to economic and social conditions to all
population irrespective of CAGEs
The notion is based on the principle of social justice
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6. Average Income of South Asians by Gender and
Agegroups vs. Overall Canadian population
- by age group and sex, $46,955
$40,450 $40,199
$36,865
$34,712
$31,396
$27,935
$26,767
$26,306
$23,970
$22,350 $22,857 $22,885
$19,511
$19,461
South Asian Men
$15,012
South Asian Female
$11,273 Overall Canadian Men
$10,286 Overall Canadian Female
$9,046
$8,971
15 to 24 25 to 44 45 to 64 65 and over Total
(Census 2001)

7. Rate of Preventive Health Services Utilization by
South Asians vs. White
88.4%
83.6%
78.4%
65.7% 66.7%
48.4%
White
44.7%
South Asian
29.2%
General Practitioner Prostate-Specific Antigen Blood Test Mammogram Pap smear
(CCHS 2001)

8. Prevalence Rate of Heart Disease by Ethnic Group
Ontario, 1996-2007
5.4%
5.2% 5.2% 5.2%
5.1%
4.7%
4.2%
3.8%
3.4%
3.2%
All
2.7% Male
2.5%
female
White South Asian Chinese Black
(CMAJ, MAY 18, 2010:182(8))

9. Age-adjusted, Sex-Specific Prevalence Rate of Diabetes
Among Recent Immigrants by Region of Origin vs. Long-
Term Residents of Ontario
CMAJ May 18, 2010 182(8)

10. St. James Town Initiative
A few examples from our research in
St. James Town
Research Question:
“What impact do neighbourhood factors have on your health and
wellbeing?”
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11. ECONOMIC ATTRIBUTES
This tiny tunnel connects one of the poorest neighbourhoods in Canada, St. James Town, to one
of the most affluent, Rosedale. The short journey of crossing the bridge is actually painful,
arduous, and for the most part, impossible for the most, if not all, of the individuals living in SJT.
Despite being highly educated, newcomers have difficulty gaining recognition, and
consequently, employment (SJT resident)
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© Wellesley Institute

12. PHYSICAL ATTRIBUTES
•
As a child, one way I kept myself occupied with my time was through playing basketball. It not only
kept me off the streets, but also wasted the majority of my time, keeping me active. If more
community programs ran such activities, it would bring the community closer and keep children off
the streets away from any type of violence. These activities are strengths in our community as
children are kept away from trouble. (Youth,SJT. 2010) © Wellesley Institute

13. ECONOMIC ATTRIBUTES
Food Quality
How much can we trust our food supply? We don’t only care
about the price of goods, we also pay attention to our health.
We want to get good service when we go to the supermarket.
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© Wellesley Institute

14. The fruit stand within the neighbourhood is a delight to the residents. Having access
to familiar foods is very important for the well-being of new immigrants. It is a
source of strength when feeling alone or isolated in a new place.

15. Findings: Social Support
Impact of migration & settlement
“Since the place is too small here, we don’t move
around much at home…….Also when we’re stuck within
the walls of our homes we feel an emptiness in life that
causes a lot of depression. ….We feel some kind of
loneliness.”
(Tamil female)

16. Experience of discrimination as a stressor
and barrier to accessing services
“When I visited a dentist, the doctor looked at
me in a suspicious manner….I was asked many
questions …….It was insulting my self-respect”
(South Indian resident)

17. How to Tackle Health Equity
• Need to broaden our lens
• Appreciate that many factors contributing to health are
outside the direct realm of health service domain
• Recognize that living conditions, working conditions,
education, social cohesion and government policies
influence individual and community health
• Emphasize: Health is everyone’s business.
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18. How to Tackle Health Equity
Need to restructure our questions. For example, instead of asking:
(1) How can we promote healthy behaviour (indv. responsibility)?
Equity question: How can we plan and restructure neighbourhoods
to ensure healthy spaces and places?
(2) How can we reduce disparities in the distribution of diseases?
Equity question: How can we eliminate inequities in the
distribution of resources and power that shape health outcomes?
(3) What social programs and services are needed to address health
disparities?
Equity question : What types of institutional, and social changes
are necessary to tackle health inequities?
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19. Achieving Health Equity
Short- and long-term actions are required :
• Make local and sub-population level data readily available
• Focus on groups experiencing major barriers to health
• Promote equal opportunities for all people to be healthy
• Distribute social and economic resources in a manner that
will improve health equity across subpopulations
• More collaboration between public and private sectors
• More cross- and multi-sectoral collaboration
October 24, 2011 |
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20. Following - Up
• These speaking notes, reports using Photovoice and
other participatory research methodologies, and
policy briefs aimed at advancing health equity and
social determinants of health are available on our
site at www.wellesleyinstitute.com and
www.sjtinitiative.com
• My email is nasim@wellesleyinstitute.com
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21. ST. JAMES TOWN INITIATIVE
THANK YOU
For more info, visit www.SJTinitiative.com or www.wellesleyinstitute.com
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