Culture, Community and Health: CAMH Research Annual Report 2002

Culture, Community and Health Studies (CCHS) is an integrated research, training, and consultation program. It focuses on resettlement and health of immigrants and refugees; health of First Nations peoples; cultural influences on the expression and course of illness and on the response to care; and developing models of care that are sensitive and responsive to the needs of Canada's multicultural society.

Our team includes scholars from the academic disciplines of psychiatry, sociology, clinical and developmental psychology, social epidemiology, anthropology, demography, medicine, nursing and public health. cchs underwent its second external review in 2001. External reviewers were Dr. Lawrence Kirmayer (McGill University), Dr. William Sack (Oregon Health Sciences University), and Dr. Evelyn Bromet (State University of New York). As in our first review in 1997/1998, the reviewers in 2001 were unanimously enthusiastic about our accomplishments, and recommended the further expansion of CCHS.

Research

Over the past five years, CCHS has attracted over $17 million in external research funding, mainly from peer-reviewed sources. Ongoing projects include studies of the health and development of immigrant and refugee children; resettlement impact and quality of life of immigrants and refugees; the role of resettlement stress in the risk of tuberculosis among immigrants and refugees; mental health in Toronto's Ethiopian and Tamil communities;the long-term effects of exposure to warfare; the mental health effects of poverty among immigrant and non-immigrant children; youth acquisition of ethnocultural identity; the mental health effects of discrimination; the role of social support in immigrant and refugee resettlement; and cultural influences on the experience and consequences of life-threatening illnesses.

Funding sources include the Canadian Institutes of Health Research, the Social Sciences and Humanities Research Council, Citizenship and Immigration Canada, Health Canada, Human Resources and Development Canada, Centre of Excellence for Research on Immigration and Settlement, and Canadian Heritage.

Recent research highlights include:

The paradoxical finding that, although immigrant families are three times more likely to be poor than non-immigrant families, immigrant children have fewer mental health and behavioural problems than their non-immigrant counterparts.

The prevalence of depression among Ethiopians in Toronto roughly equals that found among the general population of Ontario, but is three times higher than the rates in Ethiopia.

Social adversity and low education are strongly associated with depression among women in rural Pakistan.
About one-quarter of visible minority immigrants experience discrimination and those experiences jeopardize mental health.

Although female immigrants are less likely than males to receive language training in Canada, they benefit more from such training.

Education and Training

CCHS is dedicated to educating and training future generations of health researchers and health care providers who will contribute to the scholarly underpinnings for effective policy and practice. Each year, we train residents in psychiatry.

During the last academic year, Dr. Lisa Anderman was a post-doctoral fellow jointly sponsored by cchs and the Psychological Trauma Clinic at Mt. Sinai Hospital. Under Dr. Morton Beiser's supervision, she continued her study of cross-cultural perceptions of mental health. Dr. Anderman and Dr. Tat Lo presented a well-received course in cultural competence for residents. Rani Srivastava, Director of Clinical Resources in the Faculty of Nursing at the University of Toronto, is completing a PhD at the Institute of Medical Science (IMS) under the supervision of Dr. Beiser. Dr. Kenneth Fung continued his work with Dr. Beiser on a study of alexithymia among Chinese people, in fulfilment of the requirements for a masters degree from IMS. Dr. Gerald Devins continues to supervise graduate students through IMS, including Monica Bettazzonni (enhancing quality of life in schizophrenia through day-hospital programs), Sonia Sarkissian (illness intrusiveness, self-concept, and quality of life in epilepsy) and Kirsten Woodend (gender differences in illness intrusiveness and quality of life after the first myocardial infarction). Kenneth Mah continues his CIHR post-doctoral fellowship for his research on cognitive-behavioural intervention in hematologic cancer patients treated by blood and marrow transplantation.

Consultation

The CCHS unit provides community, policy and scientific consultations at national and international levels. As part of a Statistics Canada initiative, Dr. Anneke Rummens consulted on how to ask questions about ethnicity. Dr. Violet Kaspar served as a member of a National Research Council panel, Race, Ethnicity, and Health (Washington, D.C., 2001), and also served as a consultant in a Health Canada workshop for curriculum development on Health Issues, Immigration and Cultural Diversity (Ottawa, on, 2001). Dr. Owens Wiwa participated in a speaker's platform held in Belgium (2001) to advise Greenpeace and other environmental movement and human rights organizations.

Visiting Scholars

Dr. K.A.S. Wickrama, associate professor with the Department of Human Development and Family Studies and the Institute for Social and Behavioral Research at Iowa State University (Ames, IA) visited the cchs unit for research collaboration and consultation on latent growth curve analysis for longitudinal data.

International Initiatives

The CCHS unit has been working toward developing a memo of understanding involving the University of Port Harcourt, the University of Toronto, and the Centre for Addiction and Mental Health. In the past year, this initiative, which resulted in the establishment of a Centre for Stress and Health in the Niger Delta region of Nigeria, received funding from IRDC. Another research initiative involves collaboration between the University of Toronto and the American University of Beirut for a comparative study of adolescent mental health.

CCHS as a Resource for the Wider Community

Dr. Beiser, in collaboration with the Toronto Centre of Excellence for Research on Immigration and Citizenship and Classroom Connections, developed two resource kits under the collective title Strangers Becoming Us. These curricula educate elementary and high-school students about the social, cultural and economic impacts of immigration on Canada, and about the mental health and other effects of resettlement on immigrants and refugees. In 2000/2001, these were distributed to all publicly funded schools across Canada.

In the aftermath of the tragedy of September 11, 2001, the Canadian government distributed Strangers Becoming Us to the schools once again, as a tool to help children and school personnel deal with the repercussions of that singular event.

Alone in Canada, our self-help information guide developed by Dr. Laura Simich for new immigrants, is now available in English, French, Chinese, Tamil, Somali, Arabic, Spanish, Urdu, and Farsi.