Discrimination and the health of immigrants and refugees: exploring Canada's evidence base and directions for future research in newcomer receiving countries

Abstract

Research and practice increasingly suggests discrimination compromises health. Yet the unique experiences and effects facing immigrant and refugee populations remain poorly understood in Canada and abroad. We review current knowledge on discrimination against newcomers in Canada, emphasizing impacts upon health status and service access to identify gaps and research needs. Existing knowledge centers around experiences within health-care settings, differences in perception and coping, mental health impacts, and debates about "non-discriminatory" health-care. There is need for comparative analyses within and across ethno-cultural groups and newcomer classes to better understand factors shaping how discrimination and its health effects are differentially experienced. Women receive greater attention in the literature given their compounded vulnerability. While this must continue, little is known about the experiences of youth and men. Governance and policy discourse analyses would elucidate how norms, institutions and practices shape discriminatory attitudes and responses. Finally, "non-discriminatory health-care" interventions require critical evaluation to determine their effectiveness.