(Transportation and translation services are vital parts of the multicultural seniors program at Pinecrest Queensway CHC. Photo credit: Pinecrest-Queensway Community Health Centre)

By Jason Rehel, story producer and editor, AOHC

New provincial legislation directs Ontario’s Local Health Integration Networks (LHINs) to reduce health disparities by supporting programs that directly address the determinants of health. In the months to come, we will bring you stories drawn from the front lines of our health system that show the impacts health promotion and health equity programs have when they’re embedded in Comprehensive Primary Health Care.

A safe home for her family. Opportunities for her children. And the chance to contribute to her new community. Those were Samar Tabbara’s main goals when she arrived in Ottawa from Oman (via Lebanon, where she was born) 20 years ago. A teacher raising a young family, Tabbara vividly recalls her family’s struggles: learning to cope with mental health issues, doubts about their decision to move, and trying to connect with others while still mastering English.

“There wasn’t as much information given to newcomers, and we were not connected,” Tabbara says. “You could feel burned out and alone. I remember I used to take depression pills."

For many new immigrants, social isolation can become a prolonged reality, with stark effects on their health and overall wellbeing. For new immigrants who come to Canada as seniors, often to live with adult children, the risk of becoming isolated is also high.

“People who live alone and have few social supports often don’t have anyone they can trust if problems arise with their health,” says Dr. Laura Muldoon, a family physician at Somerset West Community Health Centre in Ottawa, which addresses social isolation through a number of targeted programs.

“Just the stress of being alone can lead to worsening of mental illness and physical health, too,” Muldoon adds. “I often see people whose isolation has led to worsening of conditions like diabetes, high blood pressure and COPD. Sometimes people are very anxious about leaving their home, and may not even seek help for very serious conditions such as cancer.”

For Tabbara, volunteering -- first at her kids’ schools and in her neighbourhood, and eventually at Pinecrest-Queensway Community Health Centre (CHC) – is way to stay connected to her community and its resources, but also to help newcomers who face barriers due to social isolation in the same ways she did.

“I volunteer to know where I am,” the 58-year-old grandmother says. “I know how isolation can lead to depression. When people become frustrated and stressed, they can become hard on themselves, on their families, on their health. So I like to teach people how to use the system.”

Healthy Aging for Multicultural Seniors

At Pinecrest-Queensway CHC in Ottawa, Tabbara works as an outreach volunteer for the “Healthy Aging for Multicultural Seniors” program. The program features monthly health seminars and regular group outings to museums and parks in Ottawa. Translators, public transportation assistance and a phone outreach program make it possible to combat isolation experienced by these seniors (anyone 55 and over) from newcomer backgrounds, including Syrian refugees, regardless of language or mobility barriers.

Participants are referred through Primary Care physicians at Pinecrest-Queensway CHC, and also through neighbourhood outreach initiatives. For her part, Tabbara enthuses about the weekly (or sometimes more often) calls she makes to Saada, an 80-year-old Muslim woman living on her own in downtown Ottawa, which offer Tabbara the chance to share her own experiences in a meaningful way.

“Sometimes she even confuses me with her daughter,” Tabbara says. “We speak in Arabic, and she tells me stories. She trusts me, and I know I am like family to her.”

Belonging and Community as Foundations of Health & Wellbeing

For newcomers especially, the chance to participate in programs that benefit health and wellbeing and promote social connections can be a big boost to their sense of belonging. In order to bridge barriers such as language ability, cultural understanding and safety, and experiences of racism, translators and translated materials such as brochures are vital parts of Pinecrest-Queensway CHC’s Multicultural Seniors program. And because many of the seniors don’t drive and have difficulty navigating transit, again due to language reasons, providing transportation assistance is another key enabler.

But Pinecrest-Queensway CHC must rely on year-to-year funding from United Way in Ottawa for the critical elements of translators and transportation. After 2018, when the current stream of funding expires, the Multicultural Seniors program, that’s helped hundreds of isolated seniors over 12 years, could disappear. With a new mandate from the government to support health promotion at the local level, LHINs can ensure the program continues to help newcomer seniors for years to come, says Adrianna Tetley, CEO of the Association of Ontario Health Centres.

“Comprehensive Primary Health Care isn’t just about access to doctors, nurses and diagnostic tests to help people recover when they’re sick,” says Tetley. “Truly wraparound care aims to keep people well to begin with by addressing the determinants of health. Health promotion programs such as Multicultural Seniors actively promote a deeper sense of belonging in the community by involving people directly in the programs and services that contribute to their wellbeing. Delivering effective primary care in combination with health promotion programs could be a game-changer for our health system by taking the battle against chronic illness and disease far further upstream than we’ve ever seen in Ontario before, and helping to reduce the burden on other parts of the health system at the same time.”

(The opportunity for newcomer seniors to take part in health promotion seminars on diabetes and other topics is one of the many benefits the program offers, with referrals often coming through the centre’s Primary Care providers. Photo credit: Pinecrest-Queensway Community Health Centre)