Health Sciences Capstone Projects

Purpose: To review and document the challenges faced by different stakeholders - refugees, humanitarian organizations and host countries of refugees in accessing and providing continuity of care (management, informational and relational) for chronic non-communicable diseases among refugees. Method: A scoping review of the literature was conducted. Grey literature sources and academic databases such as PubMed, CINAHL, Web of Science, PsycINFO, Global Health, ELDIS Gateway to Development Information, Canadian Health Research Collection were searched from January 2006 to July 2016, focusing on refugees (and other key words) and chronic non-communicable diseases. Thematic analysis of the articles was conducted inductively. Results: The search yielded a total of 3,771 articles, of which, 40 articles met the inclusion criteria and were included in the final review. The emergent themes were categorized under the three areas of continuity of care for each stakeholder in the humanitarian context. Some emergent themes or challenges include language barriers, low socio-economic status, lack of sustainable financing and international aid, clinical management failures, competing priorities, low education and literacy levels, lack of research and robust data. An awareness of these challenges provides opportunities for reform of research, policy and clinical practice to ensure the prompt, optimal and sustained care of chronic non-communicable diseases among the refugee population. Conclusion: The findings of this review highlights the interconnected challenges of accessing and providing continuity of care for chronic non-communicable diseases among refugees. Further and more contextualized research of the topic and actions are to be taken to overcome the identified challenges and gaps in order to create a more holistic approach to the effective planning, implementation and delivery of health care services to refugees with chronic non-communicable diseases.

A growing public health literature indicates that neighbourhood environment plays an important role in older adults’ health. However, investigation on neighbourhood health impacts on Chinese immigrant older adults – a growing socially marginalized population in Canada – is currently missing. This study helps to fill this gap by exploring the multiple dimensions on how neighbourhood environmental factors affect Chinese immigrant older adults’ different health aspects. The purpose of this study was to understand Chinese immigrant seniors’ perspectives on healthy and harmful spaces located within their immediate neighbourhood, and the accessibility of these spaces among Chinese older adults. A Photovoice research method was used with 6 Chinese immigrant older adults from a middle-class neighbourhood in Vancouver, Canada. Research findin gs showed that neighbourhood attributes related to the built physical environment, social environment, and public/community service environment affect Chinese older adults’ physical health, diet, mental health, social health, and mobility. This study highlighted the complex interactions between different aspects of neighbourhood factors and Chinese older adults’ agency in obtaining health-benefiting resources. Future studies need to expand the concept of individual health to better understand the different interactive pathways between neighbourhood environmental factors and other health aspects.