The Effects of Settlement Location on the Mental Health of Immigrant Women in Canada: A Literature Review

Background: With rates of immigration rising in Canada and worldwide, it is becoming increasingly important to understand the unique challenges faced by immigrant populations. A host of interpersonal, systemic and institutional barriers faced by both women and those settling in rural communities exacerbate mental health issues among immigrant populations. Canada’s vast geography, climate and community characteristics vary greatly, creating unique circumstances for individuals immigrating to this country. Immigrant women face additional barriers as a result of the systemic and institutionalized discrimination faced by women globally with political and economic practices and laws at all levels, cultural norms and societal expectations exacerbate inequitable health outcomes.Methods: This literature review's search strategy and synthesis of relevant articles followed a scoping review protocol outlined by Levac, Colquhoun & O'Brian (2010). The databases used to conduct this literature review were: CINHAL and Scopus. In total, 2836 studies were identified and screened; full-text articles were assessed for 39 studies; 19 studies that met all inclusion criteria were then selected for final review.Results: A review of the literature revealed that settlement location indeed impacts the mental wellbeing of immigrant women. Residing in a rural community was positively correlated with the mental health of immigrant women, regardless of ethnicity, age, age of immigration or family structure. The presence or absence of six main factors resulted in adverse mental health outcomes for immigrant women in rural communities.Discussion: Through a review of the literature, six key factors associated with living in a rural community were found to impact the mental wellbeing of immigrant women accessing to medical services, connection to culture and gender norms, employment and financial security, managing multiple roles, racism, discrimination and stigma, social support networks and social isolation. Each factor is found to have implications on the other, potentially compounding inequities faced by this population if adequate resources are not provided. In order to understand the mechanisms in which these factors affect the mental health of immigrant women and address the associated structural barriers related to rurality and gender, implications and interventions at the policy, practise and research levels must also be considered.Conclusion: As rates of immigration rise and the demography of immigrant populations continue to change, it is becoming increasingly important to understand the unique needs of newcomers, as the health of this growing population will, in turn, influence the health of Canadian communities and the country. Moving forward, it will be necessary for public health professionals, researchers and governing bodies alike to better understand the intersection of these factors and their impact on the mental health of immigrant women in order to avoid perpetuating existing inequities.