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Public Policy and Administration


Joyce Haines


Immigrants to Canada report better health status than the Canadian-born population when they first arrive in Canada, a phenomenon called the Healthy Immigrant Effect. However, by the fourth year after immigration, immigrants report a health status that is worse than that of the Canadian-born population. Visible minority immigrant women report the largest deterioration in health. The purpose of this qualitative study was to explore the lived experiences of visible minority immigrant women with encounters with the Canadian healthcare system to examine the multiplicative impact of gender, ethnicity, and immigration on their health. This phenomenological study, guided by Crenshaw's feminist intersectionality framework, explored the perspectives of a purposive sample of 8 immigrant women in Ottawa, Canada, about their encounters with the healthcare system. Data were collected through individual interviews. These data were inductively coded and subjected to thematic analysis following the process outlined by Smith et al. for interpretative phenomenological analysis. Key findings of the study revealed that immigrant women define health more holistically and have expectations of the encounters with healthcare that are not met due to barriers that impact them accessing healthcare services, experiencing healthcare services, and following the recommended options. The positive social change implications of this study include recommendations for public health to consider immigration and racism as determinants of health; and for Health Canada to undertake system-level lines of inquiry to shed light on the ways structural discrimination and racism have had an impact on immigrant women's social and health trajectory.