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Canadian Journal of Public Health

, Volume 98, Issue 5, pp 369–373 | Cite as

Status and Health Security: An Exploratory Study of Irregular Immigrants in Toronto

  • Laura SimichEmail author
  • Fei Wu
  • Sonja Nerad
Article
  • 2 Downloads

Abstract

Background

This qualitative study explores experiences of living without regular immigration status and implications for health security among irregular migrants in Toronto. Irregular migrants include those who lack secure status in Canada, including visitors who overstay visas; refugee claimants awaiting status determination; and failed claimants remaining in the country without authorization, awaiting deportation or following alternative procedures when judicial appeal is impossible.

Methods

In-depth, semi-structured interviews were conducted with irregular migrants recruited at a downtown community health centre. Interview transcripts were coded and analyzed using grounded theory and qualitative analytical techniques. The theoretical framework employed anthropological metaphors of liminality and examined psychosocial factors associated with stress.

Findings

Experiences of the study sample counter popular assumptions about irregular immigrants. The majority of study participants came to Canada to escape violence as well as lack of economic opportunity in home countries in Latin America, and most have tried to follow correct immigration procedures. Most are parents working in low-paying, exploitative jobs. They have attempted to lead productive and meaningful lives, but lack social support beyond the immediate family. They showed signs of suffering from trauma, depression, chronic stress, family separation and stress-related physical illnesses. Despite expressing self-esteem and using personal coping skills effectively, many reported unmet health needs and described barriers to help-seeking. Beyond the individual, the greatest impact of living without status appeared to be on the family, especially the children.

Conclusions

More comprehensive information about this growing population is needed for health promotion, provision of mental health services and fair policy formulation.

MeSH terms

Immigration legal status community health care mental health 

Résumé

Contexte

Cette étude qualitative examine les expériences des personnes vivant à Toronto et n’ayant pas le statut d’immigrant régulier ainsi que les répercussions que cela peut avoir sur leur santé. Les immigrants irréguliers sont ceux qui n’ont pas de statut au Canada. Ils comprennent les visiteurs qui ne repartent pas une fois leur visa de séjour expiré, les demandeurs du statut de réfugié en attente d’une réponse et les demandeurs de statut de réfugié qui n’ont pas été acceptés et qui restent au pays sans autorisation, qui attendent d’être déportés ou qui ont recours à d’autres procédures parce qu’ils ne peuvent pas faire appel de la décision.

Méthodes

Des entrevues approfondies et semi-structurées ont été effectuées auprès d’immigrants irréguliers dans un centre de santé communautaire du centre-ville. Des transcriptions des entrevues ont été codées et analysées à l’aide d’une théorie à base empirique et de techniques analytiques qualitatives. Le cadre théorique reposait sur les métaphores anthropologiques de liminalité et examinait les facteurs psychosociaux associés au stress.

Résultats

Les expériences constatées dans l’échantillonnage de l’étude contredisent les suppositions généralement entretenues sur les immigrants irréguliers. La majorité des participants sont venus au Canada pour fuir la violence et l’incertitude économique de leur pays d’origine d’Amérique latine et la plupart ont essayé de suivre les procédures d’immigration en règle. Ce sont pour la plupart des parents qui sont exploités dans des emplois peu rémunérés. Ils ont tenté de mener une vie productive et constructive, mais ne bénéficient pas d’un soutien social autre que celui de leur famille immédiate. Ils présentent des symptômes de traumatismes, de dépression, de stress chronique, de séparation familiale et de maladies physiques liées au stress. Bien qu’ils affichent une bonne estime de soi et qu’ils aient de bons mécanismes d’adaptation, ils sont nombreux à déclarer avoir des besoins non comblés en matière de santé et faire face à des obstacles au moment de chercher de l’aide. Au-delà des répercussions sur le plan personnel, le fait de vivre sans statut semble surtout avoir des effets négatifs sur la famille, et plus particulièrement sur les enfants.

Conclusions

Il nous faut recueillir davantage d’information sur cette population croissante aux fins de la promotion de la santé, de la prestation de services de santé mentale et de l’élaboration de politiques équitables.

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References

  1. 1.
    McKee M, Janson S. Forced migration: The need for a public health response Eur J Public Health 2001;11:361.CrossRefGoogle Scholar
  2. 2.
    Torres AM, Sanz B. Health care provision for illegal immigrants: Should public health be concerned? J Epidemiol Community Health 2000;54:478–79.CrossRefGoogle Scholar
  3. 3.
    Ku L, Matani S. Left out: Immigrants’ access to health care and insurance. Health Affairs 2001;20:247–56.CrossRefGoogle Scholar
  4. 4.
    Roer-Strier D, Olshatin-Mann O. To see and not be seen: Latin American illegal foreign workers in Jerusalem. Int Migration 1999;37(2):414–36.CrossRefGoogle Scholar
  5. 5.
    Goldman DP, Smith JP, Sood N. Legal status and health insurance among immigrants. Health Affairs 2005;24:1640–53.CrossRefGoogle Scholar
  6. 6.
    Goldman D, Smith J, Sood N. Immigrants and the cost of medical care. Health Affairs 2006;25:1700–11.CrossRefGoogle Scholar
  7. 7.
    Wayland S. Unsettled: Legal and Policy Barriers for Newcomers to Canada, A joint initiative of Community Foundations of Canada and the Law Commission of Canada, 2006. Available online at https://doi.org/www.cfc-fcc.ca (Accessed May 28, 2006).Google Scholar
  8. 8.
    Gagnon A. Responsiveness of the Canadian health care system towards newcomers. Discussion paper no. 40, Commission on the Future of Health Care in Canada, 2002.Google Scholar
  9. 9.
    Sales R. The deserving and the undeserving? Refugees, asylum seekers and welfare in Britain. Critical Soc Pol 2002;22(3):456–78.CrossRefGoogle Scholar
  10. 10.
    Steel Z, Frommer N, Silove D. Part I-The mental health impacts of migration: The law and its effects. Failing to understand: Refugee determination and the traumatized applicant. Int J Law Psychiatry 2004;27:511–28.CrossRefGoogle Scholar
  11. 11.
    Papademetriou D. The global struggle with illegal migration: No end in sight. Migration Information Source, September 1, 2005. Washington, DC: Migration Policy Institute.Google Scholar
  12. 12.
    Oxman-Martinez J, Hanley J, Lach L, Khanlou N, Weerasinghe S, Agnew V. Intersection of Canadian policy parameters affecting women with precarious immigration status: A baseline for understanding barriers to health. J Immigrant Health 2005;7(4):247–58.CrossRefGoogle Scholar
  13. 13.
    Caulford P, Vali Y. Providing health care to medically uninsured immigrants and refugees. CMAJ 2006;174:1253–54.CrossRefGoogle Scholar
  14. 14.
    Gushulak B, Macpherson D. Health issues associated with the smuggling and trafficking of migrants. J Immigrant Health 2000;2:67–78.CrossRefGoogle Scholar
  15. 15.
    Kirby M. Final Report: Out of the Shadows at Last: Transforming Mental Health, Mental Illness and Addiction Services in Canada. Standing Senate Committee on Social Affairs, Science and Technology, Canada, 2006.Google Scholar
  16. 16.
    Mehta C, Nik T, Mora I, Wade J. Chicago’s Undocumented Immigrants: An Analysis of Wages, Working Conditions, and Economic Contributions. Centre for Urban Economic Development, University of Illinois at Chicago, 2002.Google Scholar
  17. 17.
    Berk M, Schur C. The effect of fear on access to care among undocumented Latino immigrants. J Immigrant Health 2001;3:151–56.CrossRefGoogle Scholar
  18. 18.
    Reijneveld S, Verheij R, van Herten L, de Bakker D. Contacts of general practitioners with illegal immigrants. Scand J Public Health 2001;29:308–13.CrossRefGoogle Scholar
  19. 19.
    Law S, Hutton M, Chan D. Clinical, social and service use characteristics of Fuzhounese undocumented immigrant patients. Psychiatric Services 2003;54(7):1034–37.CrossRefGoogle Scholar
  20. 20.
    Aroian K. Health risks and problems encountered by illegal immigrants. Issues in Mental Health Nursing 1993;14:379–97.CrossRefGoogle Scholar
  21. 21.
    Koser K. Asylum policies, trafficking and vulnerability. Int Migration 2000;38(3):91–111.CrossRefGoogle Scholar
  22. 22.
    Chaivin P. Out-of-status person’s access to health care: A cross-sectional survey in 19 cities of 7 European countries, Paper presented at the 5th International Urban Health Conference, Amsterdam, The Netherlands, October 2006.Google Scholar
  23. 23.
    Friere M. Issues of Access to Services for Undocumented Individuals and their Children, Testimony of M. Friere, Chief Psychiatrist, Toronto Board of Education, Presentations to the Advisory Committee on Immigration and Refugee Issues in Toronto, Toronto City Hall, May 3, 1999.Google Scholar
  24. 24.
    Nyers P. Access not fear: Non-status immigrants and city services: A preliminary report, 2006. (unpublished).Google Scholar
  25. 25.
    Khanlou N, Mill C. Precarious immigration status: Exploring impacts on health, Paper presented at the 10th International Metropolis Conference, Toronto, October 2005.Google Scholar
  26. 26.
    Chavez L. Shadowed Lives: Undocumented Immigrants in American Society. Fort Worth, TX: Holt, Rinehart and Winston, 1992.Google Scholar
  27. 27.
    Nijhawan M. Deportability, medicine, and the law. Anthropology & Med 2005;12(13):271–85.CrossRefGoogle Scholar
  28. 28.
    Denzin N, Lincoln Y. Introduction: Entering the field of qualitative research. Handbook of Qualitative Research. Thousand Oaks, CA: Sage Publications, 1994;3.Google Scholar
  29. 29.
    Silove D, Coello M, Tang K, Aroche J, Soares M, Lingam R, et al. Towards a researcher-advocacy model for asylum seekers: A pilot study amongst East Timorese living in Australia. Transcultural Psychiatry 2002;39(4):452–68.CrossRefGoogle Scholar
  30. 30.
    Patton, MQ. Qualitative Evaluation and Research Methods, 2nd ed. Newbury Park, CA: Sage Publications, 1990.Google Scholar
  31. 31.
    Beiser M. The health of immigrants and refugees in Canada. Can J Public Health 2005;96(Suppl. 2):S30-S44.Google Scholar
  32. 32.
    Grove N, Zwi A. Our health and theirs: Forced migration, othering and public health. Soc Sci Med 2006;62:1931–42.CrossRefGoogle Scholar
  33. 33.
    Watters C, Ingleby D. Locations of care: Meeting the mental health and social care needs of refugees in Europe. Int J Law Psychiatry 2004;27:549–70.CrossRefGoogle Scholar
  34. 34.
    Fassin D. Social illegitimacy as a foundation of health inequality: How the political treatment of immigrants illuminates a French paradox. In: Castro A, Singer M (Eds.), Unhealthy Health Policy: A Critical Anthropological Examination. Walnut Creek, CA: Altimira Press, 2004.Google Scholar

Copyright information

© The Canadian Public Health Association 2007

Authors and Affiliations

  1. 1.Social Equity and Health ResearchCentre for Addiction and Mental HealthTorontoCanada
  2. 2.Culture, Community and Health Studies, Department of PsychiatryUniversity of TorontoCanada
  3. 3.Community Health ProgramsAccess Alliance Multicultural Community Health CentreTorontoCanada

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