Engendering Migrant Health: An Embodied Approach, Dr Denise Spitzer, University of Ottawa

Engendering Migrant Health:an embodied approach

Dr. Denise L. Spitzer

Canada Research Chair in Gender, Migration and Health

Institute of Women’s Studies & Institute of Population Health

University of Ottawa

CANADA

Presentation to “Migrants and the Right to Health”

Birbeck College, University of London

London, UK May 27-28, 2010

IntroductionPreface

WorkPaid/Unpaid

WorryGendered tasks related to kin-work

Weariness Erosion of hopes and dreams

Multiple languages/multiple lensesLanguage of the body (embodiment)Language of population health (policy)

Primary research, epidemiological studies, social science literature

Overview of Presentation

Migrant Canada

Population Health

Embodiment

Work, Worry & Weariness

Focus on Stress

Conclusion

Migrant CanadaOne of most culturally-diverse countries in the world

18% foreign-born 230,000 immigrants/refugees admitted annually

50% + women50% from Asia-Pacific20% from Africa & Middle East9% South & Central America

Healthy immigrant effect Can be short-lived

Non-Europeans Women

Attributed to poor health behaviours, but…

Newcomers less likely to smoke, drink alcohol, or be obese

Population HealthSocial determinants of health

Socioeconomic class, gender, social support, housing, learning opportunities, work environment, etc.

Loss of healthy immigrant effect within population health framework

Foreign-born experience decline in socioeconomic status

Social determinants of health most important to migrant health

Body within population health frameworkMicro: receptacle and exhibit for disease

Meso: interaction with gender, socioeconomic class, ethnicity, etc.

Macro: object of policies/discipline

EmbodimentBody as subject

Site of apprehension of the worldMaking sense of sensation, organize symptoms into under meaningful disease label

Bodies incorporate, are understood and experienced through local and global frameworks that imbue sensations, behaviours and relations with political, economic, biomedical, cultural and gendered meanings.

EmbodimentFlexible, meaning-driven

Population HealthA priori categories that influence health

Work-1Downward Social Mobility

Foreign credentials and work experience

65% fall to low-income within first decade of life in Canada

Women experience most precipitous decline in occupational status

Everyday racism

Precarious employment

De-Skilling and Loss of Professional Identity

Survival jobs

Work-2: FG Participant• It’s really a privilege, serving people but there is that

intimidation, there is that what you call, that pride it must be pride in me. I wouldn’t like to do that, to me and so it came out to the surface that I still look at my job as a nanny as lower than others. So I keep on putting in my mind that no, no, being a nanny is a noble job. Being a housekeeper is a noble job but at time that thought slips in so . . .Well I had expressed my feelings in a way that I still believe in my past. And although I am trying to accept that I am here doing an equally noble job as I had before the fact remains that there is still a difference. So the difference I compensate my longingness to do the past job by doing other things here which is commensurate to the demands of that job.

Work-3Workplace

Control and lack thereof

Care-Work

Home work

Re-negotiating gender roles

Caregiving responsibilities

Smaller family networks

Intersection with public programs

Link with gender and ethnicity

Worry-1o Kin-work

o Worry as work

o Familial Separation

o Sponsorship

o Definitions of family

Worry-2: Aman

Our children, even if they are at university, they live at home. Until they get married, they are with the family. It doesn’t matter what age they are. The mother will cook for them, wash their clothes and take care of him, thinking, my child is at university studying. If we can, we take care of him, wash for him, feed him, and when he gets married, he’s in the hands of his wife. You can raise your brother’s children, your sister’s children, if they need a hand, if they don’t have enough economical support. They are part of your family and they keep with you. That’s part of our culture.

Worry-3: Fatoun

My husband was ambassador to many countries… and now I’m waiting for the welfare cheque. When the war broke out, everyone went to different directions… The best thing that can happen in life is to have your husband and your children with you. I’m thinking too much. My mom died in the war. Most of my family died in the war. I want my husband with me; I don’t have document[s], how can I bring my husband? What can I do for him? I’m thinking too much. I developed diabetes and high blood pressure, high cholesterol. I developed all of these things because I am thinking too much because my husband is not with me.

Worry-4

Intergenerational Issues

Weariness-1

Disappointments and discrepant expectations

Somatic expression

Defy nosological categories

Bodily dissent

Weariness-2: Carolina

I feel it’s because of depression. Being in another country, different clim[ate], different culture, the language, it was too much stress for me…

Interviewer: What makes your diabetes worse?

Worse? Not having job! Yeah, that’s true; is true. Not having job, having emotional problems, and being unstable in job. For example, you are not sure today if you have job tomorrow; you don’t know. Something like that. Coping with many, many things.

Resistance

Resilience

Resistance resources

Buffering stressors

Social networks & social support

Towards an Engendered/Embodied

Migrant HealthBody Talk

Talk about the body = talk about everything (Davis 1997)

General aches & malaise, defying nosological categories can be embodiment of inequality

Testimonials & solidarity

Stress

Relevance to both approaches

“Social experiences become ‘written on the body’ … (Wainright and Calnan 2002 in Freund 2006)

Negates mind/body dichotomies

Psycho-neuroimmunology

Coping with stress

Mei:

Friends, they are the best help, because they have the experience, and they can share information with others. You can judge whether things are helpful or not, that will be the best. But the problem is that the people around you don’t have the information either, they’re also looking for people who have the information. So you need a bigger circle of friends.

Conclusion

Health writ large

Social determinants

Attention to body and intersectional location

Stress

Promote social network/support

Consider impact of policies

Thank you