230488 Access to primary health care for racial minority women in Canada: Opportunities for social work and social justice to impact barriers and facilitators of effective health care

Tuesday, November 9, 2010 : 1:00 PM - 1:15 PM

Charmaine Williams, PhD , Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
Notisha Massaquoi, MSW, PhD Candidate , Women's Health In Women's Hands Community Health Care Centre, Toronto, ON, Canada
Melissa Redmond, MSW, PhD Candidate , Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
Despite the availability of universal health care in Canada, research suggests that racial minority women do not have equitable access to health care. This study explored factors that contribute to disparity in primary care access for racial minority women, identified opportunities for improving service access and piloted an access program. In Toronto, Canada, 226 women representing 4 ethnic groups (African, Caribbean, Latin American, South Asian), various social categorizations (homelessness, physical disability, HIV–positive status, lesbian/bisexual identity) and mostly immigrant and low-income were surveyed about access to health care. Survey items addressed service use, health care access barriers and facilitators of access. The most highly endorsed barriers to care were finances for travel, distance and/or hours of service, staffing concerns (gender, language, respect), and competing personal commitments. Participants reported that access was facilitated primarily by members of informal support networks, social workers and community-based nurses. Qualitative data suggested that social justice interventions were key to improving women's experiences in the health care system. The data were used to develop a model and pilot program that was delivered at a social service agency for 3 months. The program provided health care, anti-oppression training for service providers, rights education for clients and the services of a ‘navigator' to facilitate access to other services. Evaluation data from 130 clients indicated the service was highly effective in increasing access to multiple services. This study identifies promising system-level and individual interventions that may be effective in increasing health care access for racial minority women.

Learning Areas:
Advocacy for health and health education
Diversity and culture
Implementation of health education strategies, interventions and programs
Provision of health care to the public
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Identify individual and system characteristics that contribute to disparity in primary care access for racial minority women. Compare and contrast barriers to health care and facilitators of health care access for racial minority women, particularly those that are immigrant and low-income. Discuss site-specific and transferable interventions that may increase access to health care for racial minority women.

Keywords: Access to Health Care, Immigrant Women

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the principal investigator on this study and I am a social worker who has practiced in the community and currently conduct research on access and equity in health and mental health care for people diagnosed with mental illness, and ethnic and racial minority populations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.