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What to Do When the World Comes to You: Working with Immigrants in Family Practice

Acknowledgements:

Co-authors:
Gabrielle Inglis, MD, Family Medicine Resident
St. James Town Health Centre and St. Michael's Hospital,
Department of Family & Community Medicine, University of Toronto
Jessica Munro, BN, PHC, NP, Nurse Practitioner
Mt. Sinai Academic Family Health Team,
Department of Family & Community Medicine, University of Toronto
Robin Lennox, MD, Family Medicine Resident
Department of Family Medicine, McMaster University
Yves Talbot, MD, Professor, Department of Family & Community Medicine, University of Toronto; Scholar, Peter A Silverman Centre for International Health, Dalla Lana School of Public Health, Health Policy Management and Evaluation

Reviewers:
Ashna Bowry, MBChB, CCFP, MSc, DTMH
Staff Physician, St Michael's Hospital, Health Centre at 80 Bond
Assistant Professor, Department of Family & Community Medicine, University of Toronto
Associate Staff Physician, Tropical Medicine, University Health Network

Working With Families Institute, Department of Family & Community Medicine, University of Toronto

Attribution-NonCommercial-NoDerivs CC BY-NC-ND

Posted: August 15, 2016    Format: PDF
Working with Immigrants

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Category(s): Behavioural Medicine, Clinical (by topic), Immigrant Health, Population Health
Topic(s): Cross-cultural care, Immigrant health, Working With Families

Description:

Immigrants may have different risk factor profiles based on genetic risks and different environmental exposures, both pre- and post-migration. Discordance in language and culture may challenge the therapeutic relationship. Given the number of new immigrants in Canada, family physicians become responsible for understanding the nuances of dealing with patients who are foreign-born.

The immigrant population is immensely heterogeneous. The majority of immigrants arriving in Canada are accepted as “economic immigrants”. Many have excelled academically, speak multiple languages and may have a job upon arrival. Another 25% of immigrants are sponsored by family members and 10% are refugees.  The risk factor profile of a university professor from Argentina may differ dramatically from a Burmese woman who has languished in a refugee camp for decades. Despite such heterogeneity, there are some commonalities in health risks based on countries of origin and migration histories. For example, there are higher rates of hemoglobinopathies in people of African descent and refugees often have higher risks for infectious disease. This module identifies approaches to specific issues that challenge family physicians caring for immigrant populations.