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Anne Christian

Integration, Healthcare, and Well-Being: A Case-Study of Sri Lankan Immigrants in the Toronto CMA Using a Mixed-Methods Approach ©2016

The main goal of this research paper is threefold. The first aim is to examine the spatial accessibility to amenities that assist with South Asian immigrant integration and health, including mainstream supermarkets, South Asian supermarkets, physicians, Tamil-speaking physicians, South Asian clothing establishments, and parks and recreational space. The second goal is to examine the lived experiences of Sri Lankan immigrants in regards to their health, resettlement experiences, challenges in using family physicians and healthcare services in Canada, and changes in physical and mental health during post-migration. The third aim is to explore the connections between the spatial accessibility scores to the different amenities in relation to the lived experiences of Sri Lankan immigrants. This was accomplished through cumulative accessibility measures, the two-step floating catchment area (2SFCA) method, bivariate correlation analysis, an in-depth analysis of focus group discussions, and a cross-tabulation of the spatial accessibility scores and focus group data.

The quantitative measures identified a correlation between Sri Lankan immigrants and Tamil-speaking physicians, and parks and recreational space. The 2SFCA analysis identified areas within the Toronto CMA with varying access to different amenities. Focus group discussions revealed a number of challenges in adopting to the Canadian society: lack of timely access to physicians, the presence of chronic conditions, weight gain, diet changes, language difficulties, lack of education transferability, and difficulties in finding stable and adequate employment. The integration of the quantitative and qualitative analyses and qualitative GIS analysis indicated the differences between perceived and measured accessibility, the importance of secure, accessible and acceptable fresh foods, the significance of Tamil-speaking physicians, and the importance of community integration for an immigrant’s overall health and well-being. This study reinforces the need for the reallocation of resources in underserviced areas, the role of healthcare providers in providing adequate care, and the need for collaborative work among key stakeholders.