Work, Migration and Health Forum 2018 1 · Rm. HS574 (Fifth floor east) ... 4:55pm – 5:00pm Closing remarks (HS610) ... A case study from the City of Guelph and Wellington

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Work, Migration and Health Forum 2018 1

WELCOME! Welcome to the Work, Migration and Health Forum 2018, the result of a unique collaboration between academia – the Dalla Lana School of Public Health (DLSPH) at the University of Toronto and the Global Migration and Health Initiative (GloMHI) – and practice – the Occupational Health Clinics for Ontario Workers (OHCOW), a partner in the Ministry of Labour’s Occupational Health & Safety Prevention System. Built on the experience of a decade of OHCOW events focussing on agricultural worker health, we are now jointly broadening our attention to include Canada as a whole, and to learn and reflect on the experiences and challenges faced by temporary foreign workers in all sectors, as well as newcomers, refugees, working international students, undocumented migrants and other groups. And while the emphasis is on Canada, we are also recognizing the need to frame our national reality in the context of the global forces that impact labour and mobility, often resulting in precarity. As in the past, the Forum is an opportunity for migrant workers, community organizers, advocates, policy makers, and scholars to meet and learn from each other. We believe that the complexity of factors influencing work dynamics and precarity, and their impact on health, are best understood by weaving together multiple perspectives, approaches and disciplines. The Forum is the result of a significant collective effort that goes well beyond the work of the Planning Committee. We especially thank the DLSPH for their facilities, hospitality, and support. We are also grateful to the members of our Advisory Committee, to our volunteers, and to our sponsors for their generous contributions. We acknowledge the interest and commitment of our presenters who, by choosing to share their work and experience, have given us the opportunity to build a program that, we believe, is creative in its breadth and depth and progressive in fostering linkages and momentum to make a difference moving forward. We hope you will find the next two days informative, stimulating, and productive. On behalf of the Planning Committee, Andrea A. Cortinois Valerie Wolfe

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Planning Committee Members Andrea A. Cortinois, DLSPH/GloMHI Eduardo Huesca, OHCOW Marium Jamil, GloMHI Stephanie Mayell, GloMHI Michelle Tew, OHCOW Marija Vasilevska, DLSPH Valerie Wolfe, OHCOW Ellena Andoniou, Consultant

Advisory Committee Members Anne-Emanuelle Birn Paul Bozek Donald Cole Erica Di Ruggiero Denise Gastaldo Jenna Hennebry Farah Mawani Janet McLaughlin (Chair) Stephanie Nixon Faraz Vahid Shahidi Anelyse Weiler Basak Yanar

Volunteers Larissa B. de Souza Nicola Gailits Chelsea Hui Juan Gao Rahmat Geleto Leigh-Ann Haataja Hiba Ibrahim Joseph Ko Mobeen Lalani Raina Loxley Amanda McClung

Usharani Rathinam Harunya Sivanesan Anjum Sultana Talya Tovar Mary Tress Quinn Underwood Isabel Urrutia Bernice Yanful Special thanks to Mavic Galicia



Organizers

Sponsors

Venues May 7 Ontario Institute for Studies in Education (OISE) University of Toronto Auditorium G162 (Main level) 252 Bloor Street West Toronto ON M5S 1V6 (St. George subway station) May 8 and 9 Dalla Lana School of Public Health (DLSPH) University of Toronto Auditorium 610 (Sixth floor) 155 College Street Toronto ON M5T 3M7 (Queen’s Park subway station)



GENERAL INFORMATION

Parking Parking is available at the University of Toronto St. George Campus. It is, however, limited and quite expensive. The best way to reach the Forum venue is by subway (Queen’s Park station for the DLSPH and St. George station for OISE). OISE has underground parking while the campus parking lots closest to DLSPH are the King’s College Circle Parking Lot and the Hart House Circle Parking. For more information, please go to: map.utoronto.ca/access/parking-lots.

On-Site Registration Registration desks will be available on May 7 at OISE and on May 8 and 9 in the lobby of DLSPH. On May 8 and 9, if you are a presenter, please hand your memory stick to the volunteer helping you with registration, specifying the number(s) of your session(s). Memory sticks will be returned at the end of each session. Labelling your memory stick is advised.

Sessions On May 8 and 9, all sessions will take place at the DLSPH (155, College Street) or at the Faculty of Pharmacy (144 College Street). The two buildings are very close to each other (less than a ten-minute walk). To reach the Faculty of Pharmacy from the DLSPH, please see the map on the next page. Signage will be in place in both buildings. Dalla Lana School of Public Health (DLSPH) Rm. HS124 (Ground floor east) Rm. HS208 (Second floor west) Rm. HS574 (Fifth floor east) Rm. HS610 (Sixth floor west – Auditorium) Rm. HS696 (Sixth floor west)

Faculty of Pharmacy Rm. PB255 (Second floor ‘pod’)



Internet Access Complimentary wireless access to the Internet is available at all Forum locations. Please, use the following parameters. Network: UofT Username: wmhforum2018 Password: forum2018

Breaks and Food Coffee breaks and meals will be served in the lobby just outside the sixth floor Auditorium (HS610). Catering will include vegetarian and vegan options. Food and drinks are not allowed in the Auditorium and in the session rooms. Additional space for eating and networking is available in the lounge located on the seventh floor of the DLSPH (west side).



If You Need Help For any kind of help during the event, please contact the nearest volunteer. Volunteers wear a name tag with the word “VOLUNTEER” clearly visible on it, in red. At all times, a volunteer will be available in each session room.

Abstracts A complete program, including a list of all accepted abstracts, can be downloaded from the event website: www.wmhforum2018.ca.

Blank Pages for Notes A few blank pages for notes have been added at the end of this program.



PROGRAM AT A GLANCE

May 7 (OISE, 252 Bloor Street West, Auditorium G162, Main level) 5:15pm – 6:00pm Registration 6:00pm – 7:00pm Public Lecture 7:00pm – 7:30pm Q&A Period 7:30pm – 9:00pm Reception and entertainment

May 8 (DLSPH, 155 College St. & Faculty of Pharmacy, 144 College St.) 8:00am – 8:30am Registration (Main floor lobby) 8:30am – 8:50am Welcome and opening remarks (HS610) 8:50am – 10:30am Opening plenary (HS610) 10:30am – 11:00am Health and networking break (6th floor lobby) 11:00am – 12:30pm Concurrent sessions #1 (Multiple rooms) 12:30pm – 1:30pm Networking lunch (6th floor lobby) 1:30pm – 3:00pm Concurrent sessions #2 (Multiple rooms) 3:00pm – 3:30pm Health and networking break (6th floor lobby) 3:30pm – 5:00pm Concurrent sessions #3 (Multiple rooms)

May 9 (DLSPH, 155 College St. & Faculty of Pharmacy, 144 College St.) 8:00am – 8:30am Registration (Main floor lobby) 8:30am – 10:30am Opening plenary (HS610) 10:30am – 11:00am Health and networking break (6th floor lobby) 11:00am – 12:30pm Concurrent sessions #4 (Multiple rooms) 12:30pm – 1:30pm Networking lunch (6th floor lobby) 1:30pm – 3:00pm Concurrent sessions #5 (Multiple rooms) 3:00pm – 3:15pm Health and networking break (6th floor lobby) 3:15pm – 4:55pm Closing plenary and wrap up (HS610) 4:55pm – 5:00pm Closing remarks (HS610)



COMPLETE PROGRAM

May 7 Pre-Forum Public Lecture Ontario Institute for Studies in Education (OISE), University of Toronto Auditorium G162 (main floor), 252 Bloor Street West 05:15pm - 06:00pm Registration

06:00pm - 06:10pm Welcome and opening remarks

06:10pm - 07:10pm Lecture

Ms. Fay Faraday, LLB, MA – Innovation Fellow, Metcalf Foundation; Visiting Professor, Osgoode Hall Law School, York University; Packer Visiting Chair in Social Justice, York University, Toronto

Changing Course: Putting People First in Migration Session Chair: Dr. Denise Gastaldo, Associate Professor,

Faculty of Nursing and Dalla Lana School of Public Health, University of Toronto

07:10pm - 07:40pm Q&A period

07:40pm - 09:00pm Reception and entertainment



May 8 Forum – Day One Dalla Lana School of Public Health (DLSPH), University of Toronto Auditorium HS610 (sixth floor), 155 College Street 08:00am - 08:30am Registration and coffee

08:30am - 08:50am Welcome and opening remarks

Speaker introduction

08:50am - 10:30am OPENING PLENARY – FROM GLOBAL CHALLENGES TO LOCAL SOLUTIONS

Dr. Santino Severoni, Coordinator, Public Health and Migration, Division of Policy and Governance for Health and Well-being, World Health Organization (WHO), EURO Office, Copenhagen

Migration and Health: A Global Way Forward – Lessons from WHO EURO

Dr. Janet McLaughlin, Associate Professor, Health Studies, and Research Associate, International Migration Research Centre, Wilfrid Laurier University, Waterloo, Ontario

Health and Work among Structurally Vulnerable Migrants in Canada: The Myth, the Reality, and the Innovation

Ms. Nadira Begum, Community Action Leader, Access Alliance, Toronto, Ontario

Promoting Decent Work for Racialized Immigrant Women from the Ground Up

10:30am - 11:00am Health and networking break



11:00am - 12:30pm CONCURRENT SESSIONS #1

1.1 Exploring Vulnerability and Precarious Work; HS610; Chair: Valerie Wolfe New approaches to defining vulnerability P. Smith Changing workplaces review: Results and recommendations C.M. Mitchell Continuing the conversation and ideas for action K. Bell 1.2 Health and Social Services for Migrant Workers (1): Settlement Services; HS696; Chair: Anne-Emanuelle Birn ‘Refugee settlement is a two-way street’: A qualitative study of refugee health and settlement in Southern Ontario E. Bartel; E. MacEachen; C. Janes; M. Cooke Newcomer employment – Innovative solutions to labour market challenges: A case study from the City of Guelph and Wellington County S. Rahmaty Occupational health and safety awareness for young and migrant workers D. D’Souza; B.H. Chen 1.3 Work, Migration, Gender and Sexuality (1); HS574; Chair: Ananya Banerjee Caught in the same webs: Service providers’ insights on gender-based, structural violence among female temporary foreign workers in Canada D. Cole; C. Robillard; J. McLaughlin

‘We are the weather-proof employees’: Labour mobility challenges for temporary foreign nurses in Halifax S. Nourpanah; P. Gardiner Barber Refugee women stories of resettlement B. Sethi Uncovering the gender code in Nepal’s labour migration governance: Restrictions, resistance, and masculine sovereignty H. KC 1.4 Health and Social Services for Migrant Workers (2): Successes and Challenges; HS124; Chair: Michelle Tew A band aid won’t stop a gushing wound – Health care exclusions and migrant organizing in Ontario: Listening to the voices of workers – Panel Organizer: C. Ramsaroop Participants: T. Corea; L. Ferguson; R. Fortune; T.A. Hines; R. Maise; S.H. Mun Primary health care services for migrant agricultural workers living in Niagara: Utilizing the model of health and well-being D. Tzemis; K. Hunter; B. Evink; J. Stranges; C. McGrath Addressing migrant agricultural workers’ health and well-being in Durham Region: Mapping Brock Community Health Centre’s efforts to provide inclusive and accessible services L. Fernandes-Heaslip



1.5 Work, Migration, Mental Health and Well-being (1): Focussing on the Agricultural Sector – Part A; HS208; Chair: Eduardo Huesca Healing through dance and movement with migrant farm workers H. Miranda Stress, nerves and resilience: Mental health among Seasonal Agricultural Worker Program (SAWP) workers in Ontario S. Mayell Appreciating the rich landscape of mental health self-care strategies of Mexican seasonal agricultural workers in Canada A. Escrig Pinol; D. Gastaldo; A.A. Cortinois; J. McLaughlin Exploring psychological distress in seasonal agricultural workers: Challenges and opportunities E.A. Martell; G. Rodriguez; J. Noble

12:30pm - 01:30pm Networking lunch

01:30pm - 03:30pm CONCURRENT SESSIONS #2

2.1 Globalization, Work and Precarity (1); HS208; Chair: Uttam Bajwa Migrant labour in petro-capitalism: Union interactions with foreign workers in Saskatchewan A. Stevens Reliance on immigrants as personal support workers: Job characteristics, health consequences, and future directions K. Zagrodney Migration, work and rural livelihood in Honduras W. Dodd; S. Humphries; M. Gomez; D. Cole

Constructing precarity: Farm politics, control, and the working lives of Mexican migrants in Canada’s Seasonal Agricultural Worker Program (SAWP) M. Graham



2.2 Health and Social Services for Migrant Workers (3); PB255; Chair: Tracey Feener-Snow Injured migrant workers and the Workplace Safety & Insurance Board (WSIB): Advocacy, health care and research on the frontlines - Panel Organizer: J. Ponting Participants: S. Hun Mun; S. Mayell; M. Tew; Ralston 2.3 Work, Migration, Gender and Sexuality (2); HS124; Chair: Andrea A. Cortinois Gender injustices in immigration policies and precarious work pathways for racialized immigrant women - Panel Organizer: Y. Shakya Participant: R. Bhuyan; S. Dhunna; P. Juan; T. Mbulaheni; M.E. Panlaqui; N. Pendon; G. Polanco; T. Shomali ; L. Valmadrid Session 2.4 has been canceled

2.5 Non-obvious Work-related health concerns: What can we learn?; HS696; Chair: Valerie Wolfe Access to health care for migrant pregnant women and children in Quebec: From research to intervention S. Lagrange; M. Leaune-Welt; V. Ridde; P. Cloos; J. Ayo; J. Hanley; M. Ouimet; M. Munoz; V. Houle Sexual and reproductive health of adolescents with refugee backgrounds during resettlement S. Sanchez Provider experiences of palliative care with undocumented immigrants with cancer in Toronto, Canada L. Seto Nielsen; A. Bonin Work-Related Asthma (WRA) among employers and immigrant workers E. Wilmot

03:00pm - 03:30pm Health and networking break




3.1 Worker Compensation Systems: Support Services and Predictors of Success; HS124; Chair: Michelle Tew Using ‘big data’ for research on work, immigration and health in Canada M. Koehoorn; N. Saffari; K. McGrail; S. Premji; U. Bultmann; C.B. McLeod ‘Aren’t we crippling them even more?’: Advocating diversity and intercultural practice in monocultural organisations D. Côté; J. Dubé; S. Gravel An overview of Workplace Safety & Insurance Board (WSIB) services for foreign agricultural workers and people with language needs K. Wood-Larue; S. Mamo 3.2 Health and Social Services for Migrant Workers (4): Community and Health Services Challenges; HS696; Chair: Stephanie Mayell Creating inclusive communities for migrant farm workers E. Haley; M. Tress The Migrant Work Ministry of the Anglican Church in the Durham-Northumberland and Beaverton Deaneries A.M. Nunez; L. Fernandes-Heaslip Care interrupted: Poverty, in-migration, and primary care in rural resource towns K. Rice; F. Webster Health wanted: Health, housing, and occupational safety challenges amongst migrant workers in Saskatchewan F. Akhtar; A. Stevens

3.3 Work, Migration, Gender and Sexuality (3); HS208; Chair: Andrea A. Cortinois Trans Latinas Rompiendo Barreras / Overcoming Barriers: An initiative to foster self-care, social and economic inclusion among immigrant women - Panel Organizer: C. Bilbao-Joseph Participants: U. Bajwa; G. Betancourt; D. Gastaldo 3.4 Health and Social Services for Migrant Workers (5); HS574; Chair: Leslie Piekarz Joining forces to improve working conditions for nail technicians: Perspectives from a worker leader, health promoter, community legal worker, and academic researcher – Panel Organizer: C. Ahrens Participants: V. Arrandale; Y. Chen; J. Liang 3.5 Work, Migration, Mental Health and Well-being (2): Focussing on the Agricultural Sector – Part B; PB255; Chair: Eduardo Huesca Introduction to a discussion-based collaborative session E. Huesca Farmers’ health and well-being in the context of changing farming practices M. Bondy; D.C. Cole Mental health issues and challenges in the agricultural and horticultural sectors: A review of support initiatives S. Miller



May 9 Forum – Day Two Dalla Lana School of Public Health (DLSPH), University of Toronto Auditorium HS610 (sixth floor), 155 College Street 08:00am - 08:30am Registration and coffee

08:30am - 08:40am Speaker introduction

08:40am - 10:30am OPENING PLENARY – UNCOVERING PRECARITY AND THE NEED FOR SUPPORT

Ms. Sara Mojtehedzadeh, Work and Wealth Reporter, Toronto Star, Toronto

Temporary Employment Agencies and the Experience of Newcomers and Refugee Workers

Dr. Basak Yanar, Research Associate, Institute for Work and Health, Toronto

Safe Employment Integration of Recent Immigrants and Refugees

Mr. Ron Kelusky, Chief Prevention Officer, Ontario Ministry of Labour

Prevention System Initiatives to Address Vulnerability in Ontario Workplaces

10:30am - 11:00am Health and networking break



11:00am - 12:30pm CONCURRENT SESSIONS #4

4.1 Globalization, Work and Precarity (2); HS574; Chair: Lori Ross Unexpected encounters: Migrant workers in rural Manitoba C.A. Bryan The cost of sacrifice: Consequences of repeated separations on Mexican and Jamaican migrant agricultural workers’ families B. Vasilevska; J. McLaughlin; D. Wells; A. Lyn Looking back, looking forward: The health of Chinese migrant workers on the Canadian Pacific Railway S. de Sequeira Cultural safety: Exploring the applicability of the concept to migrant health research J. Osei-Twum; R. Monchalin; A.T. Banerjee 4.2 Advocacy, Empowerment and Policy Change (1); HS610; Chair: Laila Rahman Legal challenges alongside migrant workers: Limits and successes in the Ontario context - Panel Organizer: M. Yachin Participants: F. Faraday; J. Esmonde; S. Martinez; C. Ramsaroop; G. Vaccarelli 4.3 Legal Status, Work Permits and Health (1); HS124; Chair: Andrea A. Cortinois WELLESLEY INSTITUTE SPONSORED PANEL – Toronto as a Sanctuary City: Opportunities for health and inclusion for residents without status Organizers: A. Aery; R. Cheff Participants: M. Dalmacio; F. Rico-Martinez; C. Tranter

4.4 Work, Migration, Mental Health and Well-being (3); PB255; Chair: Tracey Feener-Snow The impact of precarious labour on non-specific psychiatric morbidity: A longitudinal study of 23,651 adults N. Fink; A. Chum; J. Lechaud; P. O’Campo Opportunity costs: Underemployment, a determinant of mental health inequities between immigrant and Canadian-born labour force participants F.N. Mawani Understanding Syrian refugee adolescents’ conceptualizations of mental health and well-being: An exploratory analysis T. Filler The Centre for Addiction and Mental Health (CAMH) Immigrant and Refugee Mental Health Project (IRMHP): A service provider resource A. Ashraf



12:30pm - 01:30pm Networking lunch


5.1 Advocacy, Empowerment and Policy Change (2); PB255; Chair: Eduardo Huesca From service provision and research to collective organizing: How to centre and support migrant worker leadership - Workshop Organizer: S. Hussan OHIP for All: Fighting for access to care for all residents of Ontario K. Jegatheeswaran; C. Watson 5.2 Work, Migration, Gender and Sexuality (4); HS124; Chair: Laila Rahman Applying an intersectional lens to understand the impact of employment precarity on the health and well-being of immigrant families of children with developmental disabilities in the Greater Toronto Area (GTA) - Panel Organizer: N. Khanlou Participants: S. Chang; A. Khan; L.M. Vazquez 5.3 Legal Status, Work Permits and Health (2); HS574; Chair: Leslie Piekarz The effect of lack of citizenship on the wages of low-skilled non-permanent resident workers in Canada N.M. Palacio

Migrant domestic workers, Canadian law and modern slavery H. Deegan; E. Depatie-Pelletier; N. Laflamme; L. Hortas-Laberge Permanent temporary migrants and the hog processing industry in Manitoba: The impact of noncitizen status on workplace experience J. Bucklaschuk 5.4 Occupational Health and Safety Systems: Prevention Opportunities? HS610; Chair: Patricia Philips Occupational health and safety of temporary foreign agricultural workers: An overview of risks, issues, policy and interventions J. McLaughlin; M. Tew; J. Hennebry Occupational health and safety issues experienced by temporary foreign workers in low- and high-skilled occupations in Canada L. Cedillo; K. Lippel; D. Nakache Carrot or stick? A narrative review of occupational health and safety inspectors’ decision-making approaches B. Straker; E. MacEachen Immigrants’ access to workers’ compensation S. Premji; E. MacEachen; A. Kosny; R. Saunders; D. Côté

03:00pm - 03:15pm Health and networking break



Forum – Day Two Dalla Lana School of Public Health (DLSPH), University of Toronto Auditorium HS610 (sixth floor), 155 College Street 03:15pm - 04:55pm CLOSING PLENARY AND WRAP UP – REALITY CHECK:

TEMPORARY FOREIGN WORKER EXPERIENCE AND ACTION ACROSS CANADA

Mr. Byron Cruz, Outreach Worker, Sanctuary Health, Vancouver, British Columbia

Seasonal Agricultural and Undocumented Workers in British Columbia: Health Issues, Challenges Accessing Care, and a Call for Change

A Representative of the Caregivers’ Action Centre

Caregivers’ Experience: Current Campaigns for Fair Employment, Immigration Status, and Access to Settlement Services

Mr. Syed Hussan, Coordinator, Migrant Workers Alliance for Change

Migrant Workers’ Priorities for Change and Ways to Support Them: A Cross-Country Check Up

Dr. Jenna Hennebry, Associate Professor of Communication Studies, Wilfrid Laurier University and Balsillie School of International Affairs, Waterloo, Ontario

Wrap Up - Where Do We Go from Here? 04:55pm - 05:00pm Closing Remarks

Dr. Adalsteinn Brown, Interim Dean, Dalla Lana School of Public Health



ABSTRACTS Complete list of abstracts in alphabetic order by first author/organizer. An asterisk after the title indicates an invited/non-peer-reviewed abstract. Organizers: Anjana Aery, Junior Fellow; Rebecca Cheff, Researcher, Wellesley Institute Participants: Monika Dalmacio, RN, Non-Insured Walk-in Clinic Coordinator & Health with Dignity Program Health Coach, Access Alliance Multicultural Health and Community Services; Francisco Rico-Martinez, Co-Director, FCJ Refugee Centre; Claire Tranter, RN, On Board Coordinator, Primary Health Care Initiatives, Access Alliance Multicultural Health and Community Services Toronto as a Sanctuary City: Opportunities for health and inclusion for residents without status* As Canada's first Sanctuary City, the City of Toronto has committed to providing access to city services without fear to all residents regardless of immigration status. However, non-status workers and residents in Toronto continue to face health risks, exploitative workplaces, and barriers to essential services. We will present new Wellesley research that outlines how Toronto’s sanctuary city commitment can be advanced to support the health of non-status residents. We are joined by community partners who will discuss their ongoing work advocating for and providing services to non-status residents in the city. This dynamic, cross-sectoral panel will focus on the actions that diverse stakeholders – service providers, researchers, residents and the municipality alike – can take to improve access to services and support the health and inclusion of Toronto workers and residents without status. Organizer: Cate Ahrens Participants: V. Arrandale; Y. Chen; J. Liang Joining forces to improve working conditions for nail technicians: Perspectives from a worker leader, health promoter, community legal worker, and academic researcher* Nail salons are a rapidly growing segment of the service sector. Salons employ a large number of immigrant women from China and Vietnam who face many challenges at work, including employment standards and health and safety concerns. This panel will include the perspectives of worker leaders, health promoters, community legal workers and academic researchers who have been active in addressing health, employment and other issues faced by nail technicians in the Greater Toronto Area (GTA). Each panelist offers distinctive experiences in their respective field to improve nail technicians’ working conditions. All panelists are member of the Healthy Nail Salon Network (HNSN), a collaborative group established in 2014 to improve the health of nail technicians working in Toronto. Since 2014, the HNSN has been leading the Nail Salon Workers’ Project to improve nail technicians understanding of the hazards in their workplace that can impact their reproductive, respiratory, musculoskeletal and skin health. The HNSN is also supporting members in undertaking new initiatives. The Nail Technicians Network (NTN) is a grassroots network that has been initiated by nail technicians and community agencies to understand the concerns of nail technicians and provides services and community referrals to meet their needs. Research funded by the Ontario Ministry of Labour is seeking to better understand the occupational exposures of nail technicians, particularly exposure to chemicals. The session caters to community workers, researchers and policy makers who are interested in learning and sharing experiences on community-based research and organizing of immigrant workers in precarious employment.



Farha Akhtar, Research Coordinator, Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon Andrew Stevens, Associate Professor, Faculty of Business Administration, University of Regina, Regina, Saskatchewan Health wanted: Health, housing, and occupational safety challenges amongst migrant workers in Saskatchewan For nearly a decade, employers in Saskatchewan have relied on migrant workers to fill alleged labour shortages in sectors such as food services, hospitality, agriculture, and construction. Many of these workers are employed in low-wage and low-skill occupations across the province. This represents a departure from the use of the foreign worker programs to recruit highly skilled labour for the province’s health care system and other knowledge-intensive industries. Using data obtained through access to information requests, government documents, and semi-structured interviews with gatekeepers and foreign workers (n=43), the paper explores the largely ignored world of foreign labour in Saskatchewan through a social determinant of health framework. The existing literature finds that migrant workers throughout North America are particularly vulnerable to factors such as poor housing conditions, workplace safety, and access to health services. Research also suggests that the legal status of migrant workers makes them particularly vulnerable to workplace exploitation. The paper demonstrates that the "temporary" nature of their legal status in the province increases the vulnerability of foreign workers, and raises similar barriers when accessing health services, housing, and OHS. The latter is especially pertinent since foreign workers experience high rates of workplace injuries in a province that possesses one of the highest work-related injury and fatality rates in Canada. Here, the authors conclude by identifying prescriptions for labour organizations, housing authorities, and policy makers where access to public services intersect with the world of work and employment. Aamna Ashraf, Manager, Health Equity Department, Centre for Addiction and Mental Health (CAMH), Toronto The Centre for Addiction and Mental Health (CAMH) Immigrant and Refugee Mental Health Project (IRMHP): A service provider resource* Newly-arrived immigrants have better mental and physical health than the Canadian-born population. Many refugees have undergone difficult and traumatic pre-migration experiences that constitute salient risks to their mental health. With time in Canada, however, both immigrants’ and refugees’ mental and physical health declines. Evidence suggests that some subgroups are at greater risk for deteriorating mental health than others. A one-size-fits-all approach to service models is not effective. An 18-month long research project at CAMH sought to learn about what service providers across Canada are doing to support the mental health of refugees and what resources are needed to improve service delivery. The main recommendation was that building knowledge and partnerships among service providers is essential to better support complex and changing refugee mental health needs during settlement. In turn, the Refugee Mental Health Project was introduced in 2012 to enhance the capacity of settlement, social and health care providers to support mental health needs in the post-migration context and has trained and brought together over 7,000 (from 2012-2017) service providers across Canada. This project is currently expanding to the Immigrant and Refugee Mental Health Project, expected to launch in the fall, 2018. The presentation objectives are three-fold: (1) highlight the mental health needs and service gaps for immigrants and refugees (2) outline the importance of employment as a key social determinant of mental health, and (3) introduce the Immigrant and Refugee Mental Health Project and its components as a promising practice to assist service providers in supporting mental health.



Emma Bartel; Dr. Ellen MacEachen; Dr. Craig Janes; Dr. Martin Cooke University of Waterloo "Refugee settlement is a two-way street": A qualitative study of refugee health in southern Ontario Beginning life in a new country means adjusting to new systems of law, education, work, and health. Individuals who arrive in Canada as refugees face unique challenges in each of these domains; so do, however, the organizations and institutions that are key to their success. Few studies have examined health from the perspective of refugees themselves, or the ad-hoc health clinics that seek to serve them. This qualitative research study consisted of semi-structured interviews with twenty-one participants including refugees, refugee claimants, and representatives from refugee-focused health care clinics across southern Ontario. Findings show staff at refugee-focused health clinics recognize there are aspects of refugee health that are different from other populations in Canada and have developed strategies to manage these differences. Relatively simple modifications to practice such as alternate hours of operation, having access to interpretation, and hosting a variety of services not typical of primary practice under one roof, are described by staff and patients as creating a good fit between the health organization and the refugee patients they support. Overall, this study finds that settlement requires responsiveness from both refugee arrivals, and the communities that support them. This presentation includes further examples of health system practice and explores how other sectors such as work and education can learn from these strategies. Organizer: Celeste Bilbao-Joseph, Centre for Spanish Speaking People, Toronto Participants: Uttam Bajwa, Research Associate, Dalla Lana School of Public Health; Gerardo Betancourt, PhD Student, Centre for Spanish Speaking People, Toronto; Denise Gastaldo, Associate Professor, Faculty of Nursing, University of Toronto Trans Latinas Rompiendo Barreras / Overcoming Barriers: An initiative to foster self-care, social and economic inclusion among immigrant women Objectives: 1. To describe Trans Latina immigrants' experiences of social and economic exclusion in Toronto; 2. To present the rationale for the intervention TRANS LATINAS ROMPIENDO BARRERAS and its key components (content and process) to train peer-leaders; 3. To describe the results of the intervention evaluation in terms of self-care, social inclusion and economic inclusion; 4. To explore the sustainability phase of the project, which includes peer-led sessions on self-care, mental and physical health promotion, and networking. Format: Four presentations by community leaders and academics of approximately 10-15 minutes each followed by a dialogue with those attending. Discussions will focus on (a) social determinants of health of immigrant transwomen in the Greater Toronto Area (GTA); (b) partnership between Centre for Spanish Speaking People and academics to create a series of workshops to promote the health and well-being of immigrant transwomen; (c) evaluation tools and key results of the evaluation, including the impact of different migratory status among group members; (d) challenges and opportunities to create a peer-led initiative that will reach a larger group of women in the GTA. After the four presentations, the panel will invite the audience to share similar struggles and successes working with other immigrant groups, in particular in terms of employment, access to services and social integration. Madeleine Bondy, Dalla Lana School of Public Health Donald C. Cole, Dalla Lana School of Public Health and Occupational Health Clinic for Ontario Workers Farmers’ health and well-being in the context of changing farming practices* Farming is well recognized as one of the most stressful occupations in Canada. Research has documented that farmers face a multitude of stressors, experience increased mental health problems and suicides, and are less likely to seek help. On the other hand, many farmers are highly



resilient, managing their stressors and running thriving farms, which are good for their families and the broader environment. Farming continues to change, with steady industrialization and globalization. This presentation will highlight current literature around farmers’ mental health and changing farming practice. It will draw upon a study that the authors are conducting in Southwestern Ontario’s Grey Bruce region which aims to understand how farmers and clinicians interpret the health and wellbeing of farmers in the midst of ongoing change. Catherine A. Bryan, Assistant Professor, School of Social Work, Dalhousie University, Halifax, NS Unexpected encounters: Migrant workers in rural Manitoba The establishment of a temporary foreign workforce in the town of Douglas in Manitoba’s Central-West signals the convergence of analogous, yet previously disarticulated, histories of accumulation, dispossession, migration, and displacement. Drawing on these histories (their accompanying discourses and adjoining narratives) in conjunction with multi-sited ethnographic fieldwork, this paper offers the example of Douglas as a tenuous counter-point to the accounts of exclusion that dominate the scholarship on Temporary Foreign Labour in Canada. Here, the intention is neither to deny the problematic parameters of the Temporary Foreign Worker program, nor the routinely exploitative conditions engendered by those parameters. Rather, by foregrounding the possibility of exploitation—the logical but far from inevitable outcome of this contemporary convergence of history, this paper provides insight into how individuals and communities may contest and even redress the extreme precarity and insecurity engendered by (multi-sited) national policies that would position some people, over others, as infinitely available and flexible labour. At the same time, reflecting the vulnerability of that position and its profitability for employer, this paper argues that even the most well-intentioned policy and employment practices have their short-comings, and that they may—involuntarily or otherwise—reinforce migrant worker vulnerability. In sum, the paper contextualizes and complicates the arrival and presence of these workers in Douglas, their integration within the town, and their relationship to their employer. Jill Bucklaschuk, Postdoctoral Researcher, Winnipeg, MB Permanent temporary migrants and the hog processing industry in Manitoba: The impacts of noncitizen status on workplace experiences Since they often work in jobs that occupy the least desirable and most flexible segments of the labour market, temporary migrants hired through the lower skilled stream of Canada's Temporary Foreign Worker Program have limited access to workplace protections and are treated as contingent labour. Policy mechanisms further entrench inequality and vulnerability through a lack of supports and circumscribed access to permanent residency. As such, temporary migrants are located in positions where they experience poor workplace conditions and inadequate supports, which negatively impacts their well-being. Derived from data gathered through in-depth interviews with thirty-six temporary migrants and their families, this presentation investigates migrants' experiences of working in the hog processing industry, which is one of the most injurious sectors in the labour market. Focused on migrants living and working in two Manitoban communities, this research is situated within a context where they are both unionized and have access to permanent residency through the Provincial Nominee Program. However, despite the conditions of this context, temporary migrants continue to face threats to their well-being. Migrants experience many injuries and stresses that are further compounded by constrained access to supports and security. The author concludes that noncitizen status interacts with the nature of hog processing work to negatively impact migrants as their precariousness and inequality is reinforced and exploited in the workplace through disciplinary actions and exclusionary practices. Obtaining permanent residency does not necessarily remedy the effects of precarious legal status and migrants continue to bare the burdens of their once temporary status.



Leonor Cedillo, Research Associate, University of Ottawa Katherine Lippel, Faculty of Law (Civil Law Section), University of Ottawa, Canada Research Chair in Occupational Health and Safety Law Delphine Nakache, School of International Development and Global Studies (SIGDS), University of Ottawa Occupational health and safety issues experienced by temporary foreign workers in low- and high-skilled occupations in Canada The occupational health and safety (OH&S) challenges for Temporary Foreign Workers (TFWs) in Canada were studied, based on the secondary use of data from 97 interviews drawn from a study of TFWs in Low and High Skilled occupations in three Canadian provinces. Interviewees reported concerns regarding OH&S and employment standards (ES) violations in the construction, meat processing, hotel and fast food sectors. The results show: precarious migration status affecting voice; the contrasting experiences between being unionized and working for a large employer, versus working in non-unionized and isolated workplaces; and the way in which regulatory effectiveness is undermined. The direct causes of vulnerability in these categories of TFWs are: closed work permits, making them completely dependent on a single employer; their hope of bringing their families to live; insufficient and uncertain support if they lose their job; and being dispersed throughout the labour market and therefore invisible to inspectorates. This vulnerability manifests in a variety of results: contract violations; increased workload without an increase in pay; and violation of OH&S rules without oversight. We recommend assessment of migration rules to preserve voice and facilitated communication between immigration and OH&S authorities. Donald C Cole, Dalla Lana School of Public Health and Occupational Health Clinic for Ontario Workers Chantal Robillard, Université du Québec à Montréal Janet McLaughlin, Wilfrid Laurier University Caught in the same webs - Service providers’ insights on gender-based, structural violence among female temporary foreign workers in Canada Background: Female migrants to Canada face forms of exploitation, sexual, physical or psychological abuse which may remain hidden and leave perpetrators unpunished. Aim: To analyse how migration and labour policies and practices around Canada’s Temporary Foreign Worker Programs set the conditions for structural violence among migrant women. Methods: We used an intersectional feminist framework to guide data collection and analysis. Semi-structured interviews involved 47 service providers and decision makers from Quebec and Ontario. Participants worked in health and social services, anti-violence against women organizations, settlement agencies, legal aid, ethno-specific community and advocacy groups, shelters, and unions. Interviews were audio recorded and transcribed in the language of the interview (English or French). A multi-level coding framework was developed by two bilingual analysts, using constant comparison and iterative methods in analysis. Results: Service providers’ experiences revealed how they and their clients are caught in similar webs, constrained by structural and practical barriers that both generate migrants’ vulnerabilities to abuse and violence, and then prohibit the provision of effective and meaningful support to survivors. Service providers’ insights shed light on power differentials among various institutions, and between migrants and Canadians, that limit female temporary foreign workers’ access to services, and ultimately produce circumstances that generate structural violence and vulnerability to abuse. Conclusions: Current structures governing temporary foreign work infringe on migrant women’s human rights and limit services providers’ ability to protect and support these women’s safety and dignity.



Daniel Côté, PhD, Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail (IRSST) Jessica Dubé, PhD, Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail (IRSST) Sylvie Gravel, PhD, Université du Québec à Montréal (UQAM) “Aren’t we crippling them even more?”: Advocating diversity and intercultural practice in monocultural organisations Despite the lack of statistical surveillance, the Québec Workers’ Compensation Board estimates that nearly half of the injured workers receiving compensation in the city of Montréal were born abroad, while they only represent about one third of this city’s population. As part of a new thematic research program at the Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail (IRSST), a systemic and exploratory study was conducted to help understand the process of rehabilitation and RTW in increasingly diverse multi-ethnic environments. AIM: The aim of this study was to identify the occupational health and safety, rehabilitation and return to work trajectories of the targeted workers. The research set out to determine turning points in the rehabilitation and return-to-work process, specific forms of interaction where problems arise or, conversely, solutions which were used to overcome obstacles. METHODOLOGY: This qualitative exploratory research draws inspiration from two techniques in critical social sciences: explicitation interviewing techniques and the critical incident methodology. A purposive sample of 40 individuals was recruited. The data were analysed following a grounded theory approach to capture the complexity of participants' experiences according to their respective roles and positions. RESULTS: The data was organized around five major emerging themes: 1) occupational integration trajectories and perceived injustice; 2) the combination of different forms of stigma; 3) the importance of trust in the therapeutic process; 4) practical requirements of intervention in multi-ethnic contexts; and 5) language and cultural barriers. DISCUSSION: Using a systemic approach to the analysis of the data, the research was able to identify different analytic levels: macroeconomic, organizational, political-ideological, and existential. This presentation identifies future research priorities to help support vulnerable workers and the development of organizations who set out to use intercultural methodologies in order to promote inclusive practices in the workplace and beyond. Desiree D. D’Souza, Community Outreach Coordinator Bill Hong Chen, Regional Community Coordinator Workplace Safety & Prevention Services Occupational health & safety awareness for young & migrant workers* More and more people are immigrating to Canada, and most of them live and work in Ontario. Migrant workers, together with young workers constitute the main potions of Ontario’s vulnerable workers. These workers are facing a number of health and safety related challenges at their workplaces. Social service providers are in the front line of serving these vulnerable workers, therefore, these providers should be aware of basic occupational health & safety knowledge in order to better assist their clients. As a health and safety association that has been in existence for over 100 years, WSPS has created a solution to increase awareness among vulnerable workers. The presenters for the experience/practice-oriented presentation will present components of the solution and how it can benefit social services, migrants/new comers and young workers. Stephanie de Sequeira, Dalla Lana School of Public Health Looking back, looking forward: The health of Chinese migrant workers on the Canadian Pacific Railway The mid-nineteenth century brought a wave of Chinese migrant workers to Canada to build the Canadian Pacific Railway. These workers arrived to Canada to be treated as an expendable source of labour by industrialists and the government, and second-class peoples by the White



Canadian population. The aim of this project is to show how racism due to nationalism influenced the attitudes held by the government and industrialists towards the Chinese workers effected the health of the Chinese workers and influenced the perceptions of health of Chinese individuals by the White Canadian population. This project uses historical methods, such as the use of newspaper articles and government documents from the time-period, to examine the history of health of migrant workers in Canada by highlighting the experiences of the Chinese migrants who worked on the Canadian Pacific Railway. Furthermore, the project compares the health and experiences of the Chinese migrant workers in the late 1800s to the health and experiences of migrant workers in the Seasonal Agricultural Worker Program today. The intent of the presentation is to incite critical discussion around what we can learn from the Canadian history of migrant health, and how we ensure equitable health and social wellbeing for migrant workers today. Hannah Deegan, Legal Project Coordinator Eugénie Depatie-Pelletier, President and Chief Executive Officer Natalie Laflamme Laurence Hortas-Laberge Association for the Rights of Household Workers (ARHW) Migrant domestic workers, Canadian law and modern slavery Temporary labour migration programs around the globe are often characterized by employer-tying policies, which restrict workers’ ability to change employers. This report canvasses the types of employer-tying policies present in Canada’s temporary labour migration program for foreign caregivers and the impact of those policies on workers’ right to liberty and security of person. Analyzed on the basis of constitutional legal principles, emanating from both Canadian courts and other jurisdictions with similar constitutional frameworks, employer-tying policies are found to be incompatible with workers’ fundamental right to security of the person. Continuing with an analysis focused on the right to physical and psychological integrity, the report outlines policies - in particular, the issuance of open work permits - that would facilitate the respect of migrant domestic workers’ fundamental rights. Warren Dodd, School of Public Health and Health Systems, University of Waterloo Sally Humphries, Department of Sociology & Anthropology, University of Guelph Marvin Gomez, Fundacion para la Investigacion Participativa con Agricultores de Honduras (FIPAH) Donald Cole, Dalla Lana School of Public Health, University of Toronto Migration, work, and rural livelihoods in Honduras Background: Internal and international migration are important and necessary livelihood strategies for many rural households in Honduras. However, the determinants, motivations, and outcomes from migration differ among migrant-sending households and between migrant and non-migrant households. Aim and Methods: Drawing on 248 household surveys (including 1,161 individuals) from 22 communities in rural central Honduras, this study explored the determinants, motivations, and outcomes of migration among migrant and non-migrant households. Results: Of the 248 households included in the study, 19.0% had at least one migrant member. The majority of migration from this area was internal (83.6%) to urban centres such as San Pedro Sula. Migrants were employed in a number of industries including construction, maquiladoras, agriculture, and the service sector. All (100%) migrant households indicated that a main motivation for migration was a lack of local rural employment opportunities. Migrant households received remittance transfers an average of 9.1 times (SD: 3.8) per year and most (85.4%) used this money to meet immediate needs rather than long term savings. However, remittance amounts varied widely between migrant households (range $3.33 USD - $333.20 USD per month). Family responsibilities (100%) and agricultural responsibilities (59.2%) were the most commonly cited reasons for not migrating among non-migrant households.



Overall, 35.5% of all households (migrant and non-migrant) indicated that someone in the household would likely migrate in the next five years. Conclusions: Recognition of the differential determinants, motivations, and outcomes of migration among migrant and non-migrant households is critical to understanding the relationship between migration and rural livelihoods in Honduras. Astrid Escrig Pinol, Doctoral Candidate, Dalla Lana School of Public Health, University of Toronto Denise Gastaldo, Associate Professor, Faculty of Nursing, University of Toronto Andrea A. Cortinois, Assistant Professor, Dalla Lana School of Public Health, University of Toronto Janet McLaughlin, Associate Professor, Wilfrid Laurier University, Waterloo, ON Appreciating the rich landscape of mental health self-care strategies of Mexican seasonal agricultural workers in Canada Precarious work, living, and migration conditions place Mexican men and women in the Canadian Seasonal Agricultural Worker Program (SAWP) in a situation of high vulnerability that translates into increased mental health risks. In 2016, close to 24,000 Mexican workers came to Canada through the SAWP. This critical ethnography focuses on the experiences of Mexican migrant agricultural workers (MAWs). In the summer of 2017, the researcher lived in the Niagara region, Ontario, where she was actively involved in community activities in support of a large population of MAWs. Data was generated from informal conversations with over 50 workers, community members and leaders, and service providers; and from participant observation at more than 30 community events and community initiatives to support MAWs. When analyzed through a post-colonial feminist lens, findings reveal that Mexican MAWs employ a range of self-care strategies to manage the impact on their mental health of the precarious conditions and prolonged family separation. These strategies include for instance: preserving cooking and eating habits from home; engaging in regular physical exercise, such as biking, running and dancing; developing and strengthening social networks; and practicing religion and spirituality. Findings also suggest that gender and ethnicity are two key factors influencing self-care practices. These results underscore the importance of supporting culturally and contextually relevant strategies to promote MAWs’ health. Thus, health promotion policy and program initiatives may benefit from incorporating successful self-care strategies currently practiced among MAWs. Loretta Fernandes-Heaslip, Health Promoter, Brock Community Health Centre, Beaverton, ON Addressing migrant agricultural workers' health and well-being in Durham Region: Mapping Brock Community Health Centre's efforts to provide inclusive and accessible services* Brock Community Health Centre’s (CHC) experiences in Durham Region offer a unique perspective on its education and growth journey while embracing the principle of inclusivity, accessibility and client-centred care. Over the years, the CHC explored approaches to address internal administrative barriers, limitations of operating out of temporary locations, accessibility, and challenges around recruitment and staffing, and a traditional model of practice. CHC’s face numerous practical barriers to reaching populations that are underserved in rural communities, including: social isolation, stigma, access, proximity to home, hours of service, and transportation. Moreover, further barriers associated with language, culture, geographic isolation precarious work, and separation from home (i.e. family, language, food, culture and climate) pose significant challenges in the context of migrant agricultural workers. Each agricultural season since 2013, Brock CHC has continually expanded its work to inform, educate and involve staff at the CHC and the broader community to welcome, serve and support migrant agricultural workers during their stay in the community. Regional and local community collaborations proved key to overcoming barriers in access, which naturally extended to address a number of other factors affecting workers’ health and well-being. Another key to success was the creation of opportunities to build and cultivate relationships with and among community agencies, volunteers and local businesses. The



relationships across sectors has supported our collective efforts to build health literacy among the migrant agricultural workers – this work continues. Talia Filler, McMaster University Understanding Syrian refugee adolescents’ conceptualizations of mental health and well-being: An exploratory analysis Background: Since 2011, over 40,000 Syrian refugees resettled to Canada and of that, 52% were under the age of 19, with many falling into the adolescent age group. As adolescents transition from childhood to adulthood, they experience a number of physical, psychosocial and cognitive changes, increasing their risk for mental health challenges. Studies suggest that refugee adolescents are at an even greater risk, as normal adolescent stress is compounded with pre-flight, flight and resettlement stress. Aim: The purpose of this study is to explore how Syrian refugee adolescents conceptualize mental health and wellbeing. Methods: Data was collected using fifteen semi-structured interviews with Syrian refugee adolescents and service providers in the Greater Toronto Area. Interviews were recorded and transcribed verbatim. Data analysis was informed by grounded theory. Results: This study provides insights into the varying perspectives of mental health and wellbeing and the importance of how these terms are framed when working with Syrian adolescents. This study also provides key viewpoints on mental health risk and resilience factors adopted by both service providers and Syrian adolescents, identifying where they overlap and where they diverge. For instance, service providers emphasize the importance of social supports being of the same cultural background as the Syrian adolescents they work with, whereas Syrian adolescents do not. Conclusion: This study highlights the factors that influence how Syrian refugee adolescents conceptualize mental health and wellbeing, while providing recommendations for future mental health framing and support. Nicholas Fink, Department of Psychology, York University, Toronto Antony Chum, Department of Health Sciences, Brock University, St. Catharines, ON James Lechaud, Center for Urban Solutions, St. Michael’s Hospital, Toronto Patricia O’Campo, Dalla Lana School of Public Health, University of Toronto The impact of precarious labour on non-specific psychiatric morbidity: A longitudinal study of 23,651 adults Background: Recent studies have highlighted concerns regarding the impact of precarious employment on workers’ well-being. Given the net growth of non-standard and precarious employment across the majority of OECD countries, large scale studies that track the impact of these labour markets trends on mental health at the population level are necessary to produce evidence to inform public health policies. Compared to previous studies, our study provides methodologically stronger evidence using a longitudinal design and large sample size. Aim: To identify and assess the relationship between precarious labour and mental health. Methods: Using a panel sample of 23,651 adults from the UK Household Study “Understanding Society”, non-specific psychiatric morbidity and psychological well-being and functioning (.ie. the GHQ-36 and SF-12 questionnaires) and dimension of precarious labour (i.e. job insecurity, low job autonomy, part-time status, and temporary contract) were captured at 3 time points between 2010-2016. Results: Preliminary analyses shows that after controlling for sex, marital status, age, managerial status, and education, job insecurity and low work autonomy adversely impacted mental health (i.e. increased GHQ, as well as decreased SF-12 score). Over the three time points, job insecurity was associated with an increase in GHQ score by 1.73 and low work autonomy was associated with an increase in GHQ score by 0.85 (p<0.05). When using SF-12 as an outcome, these variables were still significant. Conclusions: Certain dimensions of precarious employment were found to adversely impact mental health over time. In further analyses, we will analyse whether



newcomer/immigrant status interacts with the relationship between precarious employment and mental health. Mac Graham, Doctoral Candidate, University of Toronto Constructing precarity: Farm politics, control, and the working lives of Mexican Migrants in Canada’s Seasonal Agricultural Worker Program This paper explores the working lives of Mexican labor migrants who come to Canada under the Seasonal Agricultural Worker Program (SAWP). Based on ethnographic fieldwork conducted with Mexican migrants in Canada and Mexico, I examine how a set of informal rules regarding migrants’ conduct undermines the effectiveness of the formal protections outlined in the SAWP, which are meant to honor the rights of migrants according to a bilateral agreement between the Canadian and Mexican governments. This paper uses the author’s research into migrant experiences at a broccoli farm in Southern Ontario as an example of how these informal rules manifest themselves in localized divisions of labor, which encourage competition between migrants for access to better working conditions and more working hours. These conditions allow Canadian employers to effectively control an easily malleable workforce and create an atmosphere in which agency and resistance is nearly impossible. Within this context, this paper argues that together, these factors contribute to precarity, and increase feelings of marginalization and psychological stress amongst workers. Most importantly, migrants become unwilling to risk bringing serious problems to the attention of their local Mexican consulate for fear of losing their jobs or being blacklisted from participating in the SAWP in the future. Ella Haley, Sociology, Athabasca University Mary Tress, Assistant Project Manager, Langford Conservancy Creating inclusive communities for migrant farm workers* Objective: A number of individuals, churches and organizations in south-western Ontario (Niagara, Simcoe/Waterford in Norfolk County, Brantford, and the Hamilton and Niagara Regions) are dedicated to creating welcoming communities for migrant workers and providing key supports for them. Our objective is to build a supportive network, so that we can learn from and emulate some of the best practices in migrant worker outreach. Another key objective is to support the members of our caring network, to ensure that they have the necessary resources they need to do their community outreach work. Description of the experience: We have been forming a supportive networking group of migrant worker outreach members, from various sectors. We meet and share our stories, discuss gaps in community outreach and discuss our needs as volunteers. We analyze our shortcomings and seek to learn from other communities on how we can best foster inclusive communities for migrant farmworkers. Findings, Observations and Recommendation: While a lot of good work is being done in various regions for migrant workers, there are often key community champions who carry unsustainable workloads, risk burnout and have no-one to fill their shoes if they are not there. We have all seen the gap left by Stan Raper’s sudden death. These obstacles fall across all sectors of migrant worker engagement. The key needs for those providing outreach for migrant workers are funding, social media skills, time, and volunteers. We are forming a support network to help dedicated community champions and organizations to collaborate, problem-solve and continue to share best practices.



Workshop Leader: Syed K. Hussan, Coordinator, Migrant Workers Alliance for Change (MWAC) From service provision and research to collective organizing: How to centre and support migrant worker leadership* This workshop will share a spectrum of centering worker leadership developed by Migrant Workers Alliance for Change that invites participants, whether they are researchers, service providers, community or legal workers, activist organizations, labour unions, or migrant worker organizations, to analyse their current structure and learn ways to ensure greater migrant worker leadership, within the funding and structural confines of their work. Kizanee Jegatheeswaran, OHIP for All Member, University of Toronto Faculty of Medicine Chelsia Watson, OHIP for All Member, York University Department of Health Science and Kinesiology OHIP for All: Fighting for access to care for all residents of Ontario* Background and Purpose: Every year, there are over 500,000 migrants living in Ontario who are denied health coverage based on their immigration status, including certain temporary foreign workers and international students, new immigrants, those awaiting a response to humanitarian or sponsorship claims, non-status individuals, and even returning Canadian citizens. These individuals are regularly turned away from care, charged fees upfront, pursued by collections agencies, and some have died as a result. Aim: To address this, a movement of health care workers, social service providers, students, health activists and migrants are advocating to expand access to healthcare for all residents in Ontario, regardless of immigration status. Methodology: On June 28, 2016, the campaign launched in seven cities across Ontario. A variety of approaches were used to raise awareness, including mainstream media engagement, a strong social media platform, migrant community engagement, and direct lobbying with the various provincial political parties. Results: The campaign has had significant media coverage and been endorsed by over 50 health and social service organizations, including the Registered Nurses’ Association of Ontario, the Association of Ontario Midwives, the Association of Ontario Health Centres, the Ontario Council of Agencies Serving Immigrants, Ontario Federation of Labour, and the Ontario Medical Students’ Association. An open letter to the province has been signed by over 1300 individuals. Conclusions: For too long, migrants in Ontario have been denied access to health coverage and services. We invite others to put an end to this and join in the fight for OHIP for All. Hari B. KC, Doctoral Candidate, Balsillie School of International Affairs, Wilfrid Laurier University, Waterloo, ON Uncovering the gender code in Nepal's labour migration governance: Restrictions, resistance, and masculine sovereignty Nepal has a policy in place that restricts women migrants from going to some Middle East countries for employment. Despite the state's claim that such a restrictive policy discourages women's migration and ultimately prevents them from being exploited abroad, this has produced the opposite effects. Large numbers of Nepali women now resort to illegally operating brokers/employment companies to migrate but doing so puts them at greater risks of exploitation. For many women who consider migration as an alternative to the lack of employment and loss of traditional livelihoods at home, labour migration is just like "jumping from the frying pan into the fire." For some women, however, labour migration has become a source of gaining economic independence and empowerment. The aim of this research is twofold: First, to examine how the local conjoins the trans-local in creating new forms and patterns of women migrants' vulnerabilities; and Second, to analyze what governance interventions can improve the lived-experiences of women migrants. Based on the feminist epistemology as a broader theoretical framework, and using the qualitative data gathered in Nepal through participant observation and in-depth interviews, I have drawn two conclusions. First: Nepal's discriminatory restrictive labour migration



policy is a phenomenon resulting from what I call a "masculine sovereignty" that operates in tandem with the non-local market forces in creating new forms of women's vulnerabilities. Second: addressing the labour migration governance gaps at the national level is crucial to improve migrant women’s lived-experiences, and global governance can be a tool toward that goal. Organizer: Nazilla Khanlou, York University, Toronto Participants: Attia Khan; Luz Maria Vazquez; Chang Su, York University, Toronto Applying an intersectional lens to understand the impact of employment precarity on the health and well-being of immigrant families of children with developmental disabilities in the Greater Toronto Area (GTA) Learning Objectives: 1. Educational – Introduce intersectionality as a framework to understand health disparities; 2. Informational – Describe intersecting factors impacting on the health and wellbeing of immigrant families of children with developmental disabilities; 3. Skill-related – Apply an intersectional approach to health promotion practice. Outcomes: The audience will have a better understanding of intersectionality in the context of immigration, employment and disability. Structure: Period 1 (50 min) – Speakers will introduce intersectionality and its applicability drawing from three community-based studies in the Greater Toronto Area (GTA); at the end of this period presenters will ask the audience to apply the approach using specific steps provided by the speakers; Period 2 (15 min) – The audience will break up into small groups of 4-5 persons; each group will (a) introduce their group members and (b) identify one case example from their practice setting which can be informed by an intersectionality approach; one member of each group will facilitate the discussion and report back to the larger group in Period 3; Period 3 (15 minutes) – Each group will present their application of an intersectionality approach to their selected practice example; Period 4 (10 minutes) – General discussion and session wrap up. Targeted audience: researchers, policy makers, immigrant families, service providers, health professionals. Mieke Koehoorn, Professor and Head, Occupational and Environmental Health Division, School of Population and Public Health, University of British Columbia, Vancouver, BC N. Saffari; K. McGrail; S. Premji; U. Bultmann; C.B. McLeod Using 'big data' for research on work, immigration and health in Canada Background: While there is information on immigration and employment patterns, less is known about the impacts of work on immigrant health. Emerging evidence by the investigators indicates differential work disability experiences for immigrant workers. Aim: To link population-based (‘big’) data to investigate work disability experiences and determinants of these experiences among immigrants, and to inform policies and procedures to reduce differences in disability experiences where they exist. Methods: As part of an upcoming program of research, all workers in British Columbia with a workers’ compensation claim from 1991-2015 will be linked with Citizen and Immigration Canada data for immigration characteristics and with Ministry of Health data for health characteristics, via PopulationDataBC. This research database, illustrating the power of ‘big data’ to inform evidence needs, will represent approximately 860,000 workers (10% immigrants) for comparing work disability experiences over a 25-year period. Results: Previous work by investigator Saffari identified immigrants as having longer work disability durations (1 to 6 days longer) than Canadian-born workers, after adjusting for age, sex, occupation, injury type, injury year, and previous claims. These findings provided the rationale for linking health, compensation and immigration data to investigate possible explanations for the observed work disability differences. Conclusions: Future analyses using the linked, population-based research database will investigate if observed disability differences are explained, in part, by differences in health care and rehabilitation services utilization, modified return-to-work opportunities, or injury severity/longer-term



health consequences. Potential Conflict of Interest: The investigators receive WorkSafeBC funding in support of policy-relevant research using claims data. Solène Lagrange, Research Coordinator, Research Institute of public health, University of Montreal, QC Marianne Leaune-Welt, Social Worker, Doctors of the World, Montreal Prof. Valéry Ridde, Institut de Recherche et Dévélopement (IRD), France Prof. Patrick Cloos, School of public health, University of Montreal Prof. Joséphine Ayo, Public Health Agency of Canada Prof. Jill Hanley, School of social worker, McGill University Dr. Marie-Jo Ouimet, Conseil Cri de la Santé et des Services Sociaux de la Baie James Dr. Marie Munoz, Direction Régionale de la Santé Publique, Montreal Véronique Houle, Director of Operation at Doctors of the World Access to healthcare for migrant pregnant women and children in Quebec: From research to intervention* Access to health care is challenging for migrants without medical insurance (MWMI). Migrants without medical insurance (MWMI) often have a precarious migratory status (undocumented, denial of asylum application, students, visitors, temporary workers, etc). This situation can have deleterious short- or longer-term impact on pregnant women and children (pregnancy’s and childbirth’s complications, low birth-weight, poorer mental health of the mothers and children, etc.). Since 2011 Doctors of the World (DOW), a medical non-governmental organization, provides confidential primary health care in Montreal to these particular vulnerable populations. Our presentation aims at discussing from a research and interventional points of views the lack of access to healthcare for migrant pregnant women and children without medical insurance in Montreal. Between 2016 and 2017, we carried out a survey with the participation of Doctors of the World (DOW) with 871 migrants without medical coverage in Montreal. The half of the sample was recruited at the Doctors of the World's clinic and the other half in public and private spaces (e.g., churches, community organizations, public outdoor events). Among the participants, 45 were pregnant, and 130 had at least one child less than six years old. Through semi-structured interviews, 9 pregnant women described their experiences of help seeking during pregnancy and give birth. During this presentation, we would like to report on this situation and to highlight the effects on the health of the children without health insurance via empirical and theoretical data. Research data will be discussed in light of Doctors of the World's clinic and advocacy work. Eliseo Martell MPH, MSc, Health Promoter, Seasonal Agricultural Workers Health Program Guillermo Rodriguez, MSW, RSW Janet Noble, MSW, RSW Grand River Community Health Center, Brantford, ON Exploring psychological distress in seasonal agricultural workers: Challenges and opportunities Seasonal agricultural workers (SAW) are exposed to a set of stressors such as: (1) Away from home and family, (2) Social isolation and limited social support, (3) Language and cultural barriers, (4) Hours and conditions of work, (5) Housing conditions and, (6) Limited time and opportunities for leisure and social activities. To learn more about SAW mental health, Grand River Community Health Centre implemented a survey with seasonal agricultural workers attending the Health Clinics in Simcoe and Brantford. After implementing a literature review and, consulting with health professionals, the Centre decided to use the Kessler Screening Scale for Psychological Distress (K6). This scale is a quantifier of non-specific psychological distress. It also has consistent psychometric properties across major socio-demographic sub-samples. This presentation describes the criteria followed when choosing K6 Scale, the methodology used when implementing the survey and, the



challenges encountered during its administration, and the outcomes and learning for future 2018 clinics. Stephanie Mayell, Doctoral Student, University of Toronto “This is a slavery system that breaks bodies”: Structural vulnerability, injury, and medical repatriation among Jamaican Seasonal Agricultural Worker Program (SAWP) workers Designed to address annual labour shortages in Canadian agriculture, the Seasonal Agricultural Worker Program (SAWP) is a transnational labour agreement between Canada, Mexico, and various commonwealth Caribbean countries. In 2015, more than 40,000 agricultural labourers travelled to Canada on temporary employment contracts under the SAWP. Workers arrive in Canada healthy, as they are medically pre-screened in their sending countries as a prerequisite of participation in the SAWP. While in Canada, SAWP workers are indentured to one employer for up to eight months; employers are required to provide housing, and they are empowered to send workers home anytime without explanation. SAWP workers labour under a lesser set of employment protections than do Canadian residents, which increases their vulnerability to the occupational health and safety risks inherent to farm work. As tax-payers, SAWP workers are legally entitled to health care in Canada, particularly in the case of illness or injury; however, in practice sick and injured workers are routinely repatriated with no health care or entry into the provincial workers' compensation system. The common practice of medical repatriation has given rise to pervasive fears of getting sick or injured (or worse) in Canada, as the known consequences are physical disability, abject poverty, and death. Drawing on more than four years of research and volunteer experience with Jamaican SAWP workers in Ontario and Jamaica, this presentation explores the practices of medical screening and medical repatriation as the hopeful beginning and potentially devastating ending to the seasonal migratory journey of Jamaican SAWP workers. Stephanie Mayell, Doctoral Student, University of Toronto Stress, nerves, and resilience: Mental health among Seasonal Agricultural Worker Program (SAWP) workers in Ontario In 2015, approximately 40,000 migrant agricultural workers from Mexico and various Caribbean countries travelled to Canada under the Seasonal Agricultural Worker Program (SAWP), and more than half (24,000) worked on farms in Ontario. Employed on temporary labour contracts, SAWP workers are separated from their families and home communities for up to eight months of the year. Although workers generally arrive in Ontario physically healthy, the social determinants of health associated with seasonal farm work in Canada render SAWP workers structurally vulnerable to a variety of poor health outcomes, including negative mental health experiences (e.g. psychological distress). This presentation details the major stressors that SAWP workers encounter while working in Ontario, as well as the common coping strategies workers engage in. Notably, the mental and emotional health of SAWP workers varies, and workers’ experiences, expressions, and communication of poor mental health symptomatology are shaped by socio-cultural factors; thus, insights surrounding cultural conceptions of mental health and idioms of distress will also be presented. To this end, in this presentation I draw on anthropological data, ethnographic research I conducted with Jamaican SAWP workers in 2015, as well as four seasons of clinical observations. To conclude, the importance of accessible primary health care, church communities, and local support networks in Ontario will be discussed, and practical suggestions aimed at improving the mental health of this population will be advanced.



Dr. Farah N. Mawani, CIHR-Dignitas-UAlberta Health System Impact Fellow Opportunity costs: Underemployment, a determinant of mental health inequities between immigrant and Canadian-born labour force participants Aim: This study examined the association of underemployment (operationalized as unemployment or overqualification) to fair/poor self-rated mental health (SRMH) in: 1. labour force participants in Canada, and 2. between a. immigrants vs. Canadian-born labour force participants, and b. recent immigrant (<10 years in Canada) vs. long-term immigrant (� 10 years in Canada) labour force participants. Methods: The study sample included 53 409 labour force participants aged 18-64yrs surveyed in the Canadian Community Health Survey (CCHS) 2.1 (2003). Logistic regression analyses were performed to estimate odds ratios associating underemployment with fair/poor self-rated mental health for the full study sample, then stratified by a. immigrant status, and b. length of time in Canada. Results: Underemployment was positively associated with fair/poor mental health for the overall sample of labour force participants in Canada. In analyses stratified by immigrant status, the association of unemployment to fair/poor mental health was similar (Canadian-born AOR 2.60; Immigrant AOR 2.42). There was a significant association of overqualification to fair/poor mental health for immigrants (AOR 1.63), but not for Canadian-born individuals (AOR 1.03), and differences between the groups were significant. Unemployment had a higher magnitude of association (AOR 3.41) than overqualification (AOR 1.52) to fair/poor SRMH for long-term immigrants, while overqualification had a higher magnitude of association (AOR 2.04) than unemployment (AOR 1.15) to fair/poor SRMH for recent immigrants arriving between 1993-2003. Conclusions: The findings suggest a different experience of underemployment, and the need for tailored interventions for long-term and recent immigrant labour force participants to prevent fair/poor mental health. Janet McLaughlin, Associate Professor, Wilfrid Laurier University, Waterloo, ON Michelle Tew, Occupational Health Nurse, Occupational Health Clinics for Ontario Workers Jenna Hennebry, Associate Professor, Wilfrid Laurier University, Waterloo, ON Occupational health and safety of temporary foreign agricultural workers: An overview of risks, issues, policy and interventions* Background: Temporary foreign agricultural workers (TFAWs) may face numerous occupational health and safety (OHS) risks, due to the nature of agriculture, limited legislative protections, and the intersection of their precarious migration and employment status. Aim: The aim of this presentation is to summarize the key OHS risks and issues among TFAWs. Methods: This presentation provides highlights from several research studies and clinical data sources, including OHCOW clinical data, surveys with nearly 600 TFAWs in Ontario, and qualitative interviews with workers and other stakeholders. Results: Principal OHS risks include: ergonomic, chemical exposures, work sanitation/hygiene, climatic exposures, and long/variable hours of work. Unsafe transportation and poor/variable living conditions constitute additional risks. Primary issues include those relating to: musculoskeletal, dermal, eye, gastrointestinal and respiratory health. The broader context of workers' limited rights relating to restricted employment contracts and exclusion from certain legislative protections compound and underlie their vulnerabilities. Despite legal inclusion and community initiatives, barriers to health care and workers' compensation persist. Conclusions: TFAWs endure multiple levels of vulnerability to OHS issues. These include: the risks inherent within agriculture; agricultural workers’ exclusions from key legal protections; and precariousness of migrant workers’ temporary employment and migration status. Fundamental structural changes are needed to address inherent and compounded vulnerabilities.



Sandy Miller, Account Manager, Industry & Partner Relations – Agriculture, Workplace Safety and Insurance Board (WSIB) Mental health issues and challenges in the agricultural and horticultural sectors: A review of support initiatives* This presentation will review mental health challenges facing Ontario farmers, and share information on initiatives Workplace Safety & Prevention Services (WSPS) has been working on in support of the mental health of this community. Heryka Miranda, MA, Community cultural worker/Artist/Reseacher Healing through dance and movement with migrant farm workers* Coming to work on Canadian farms for 8-to-ten months out of the year leaves migrant farm workers feeling lonely and homesick. The precariousness that is produced by employment programs under the Canadian Temporary Foreign Worker Program such as the Seasonal Agricultural Worker Program leaves migrant farm workers vulnerable to exploitation and isolation in their host rural communities. Mexican and Guatemalan migrant farm workers are further isolated due to language barriers. To address these problems, this research is based upon Dance and Movement Therapy (DMT), which is founded on the fundamental premise that, through dance, individuals both relate to the community they are part of on a large or smaller scale and are simultaneously able to express their own impulses and needs within that group. This phenomenological study explored the experiences in the Niagara region of Mexican and Guatemalan migrant farm workers’ participation in experiential “dance for relaxation” community arts sessions. Approaches used in the sessions were grounded in DMT and a Movement-Based, Expressive Arts Therapy (MBEAT) framework. In post-session verbal reflections using a focus group style of inquiry and individual interviews, migrant farm workers provided evidence regarding the effectiveness of DMT and MBEAT. Shiva Nourpanah Pauline Gardiner Barber Dalhousie University "We are the weather-proof employees": Labour mobility challenges for temporary foreign nurses employed in home care in Halifax Background: Labour mobility, ranging from international border crossings to local, frequent daily movements, is on the rise, with some claiming it has become a "central" feature of the labour landscape. Although celebratory accounts of globalization laud this increasing facilitation of movement, feminist political economy and critical transnationalism urge an understanding of the gendered and racialized inequalities embedded in such mobilities. The analysis of the labour mobilities undertaken by temporary foreign nurses employed in home care in Canada provides the opportunity to study these inequalities in a particular labour context where demographic trends and healthcare restructuring construct critical healthcare labour shortages. Aim: To understand the various patterns of labour mobility and challenges associated with them, as undertaken by temporary foreign nurses engaged in home care work. Methods: This study draws on in-depth qualitative interviews with nine foreign nurses, who entered Canada on temporary permits, and work in home care. Results: Temporary foreign nurses undertake complicated work-related movements at international and local levels. Analysis of their varied patterns of labour mobilities sheds light on a multiplicity of challenges crystallized in their livelihood experiences. Challenges include the hardships of familial separation, financial insecurity, job precarity, changing immigration and credential policy scenarios, as well as the daily occupational hazards faced by home care workers. Yet workers persist in balancing the short-term purpose of gaining employment and entry into Canada with long-term ambitions of achieving familial, residential and career stability. Policy-makers must carefully consider the challenges associated with the complex labour mobilities



undertaken by this particular subset of home care workers. Additionally, the deskilling of foreign nurses constitutes wasted human potential in a moment of intensive labour shortage. Augusto M. Nunez, Migrant Worker Pastor, Anglican Church o Canada, Peterborough, ON Loretta Fernandes-Heaslip, Brock Community Health Centre The Migrant Work Ministry of the Anglican Church in the Durham-Northumberland and Beaverton Deaneries* Working in Canada for up to eight months of the year, migrant agricultural workers struggle with psychological stressors associated with separation from family, work, health, and social isolation. Across Ontario, churches are leading sources of social and emotional support for migrant agricultural workers; churches are often the only connection migrant agricultural workers have to the communities in which they work. The experiences of The Migrant Work Ministry of the Durham-Northumberland and Beaverton Deaneries offers unique insights on how church leaders, congregations, and community members can work together to address the spiritual and health needs of local migrant workers. The Migrant Work Ministry aims to provide local migrant agricultural workers with a place in their parishes and communities for workers to share faith and life. Our ministry aims to increase community awareness of the presence of local migrant agricultural workers and their needs, and to develop volunteer-led programming for outreach at the parish level. To achieve these goals, we work with a local network of volunteers and community agencies to host a variety of events throughout the season, including accessible church services in Spanish, recreational and sporting events, social gatherings and day-trips, and health fairs. Key to the success of our ministry’s programming is ongoing collaboration with partners across Durham Region, working together to increase local workers’ access to church services and health care. Jo-Ann Osei-Twum, MPH Student Renée Monchalin, PhD Student Ananya Tina Banerjee, Assistant Professor Dalla Lana School of Public Health, University of Toronto Cultural safety: Exploring the applicability of the concept to migrant health research* Originating from Indigenous scholarship, cultural safety is a concept that recognizes the ways in which colonialization and racism create power imbalances that perpetuate disparities in health and access to health services. While cultural competence in research with migrant groups is a worthwhile goal, it assumes a "one-size-fits-all" research approach and cannot meet the needs of an increasingly diverse Canadian population. This runs the risk of misunderstanding culture as static, resulting in the objectification of migrants based on appearance, language, country of origin, and religion. Through recognizing the intersections and impacts of colonial and cultural histories, researchers should strive to explore the applicability of cultural safety with migrant communities. This approach is timely as both race and ethnicity are increasingly being used as variables in migration health research. At the same time, evidence-based research has predominantly been descriptive and often unable to inform strategies to improve health care. Culturally safe research is crucial for enhancing community ownership of the research process. It has the potential to promote effective and meaningful pathways to self-determination. Through participation, partnership, protection, and power sharing, applying concepts of a cultural safety model may ensure the social value of research for migrant communities. This presentation will provide an overview of cultural safety, its key tenets, and how this concept may be embedded in health research with migrant communities.



Nelson Mauricio Palacio The effect of lack of citizenship on the wages of low-skilled non-permanent resident workers in Canada My PhD dissertation research explores the effects of lack of citizenship on the wages of low-skilled Non-Permanent Residents (NPRs) in Canada—a category that includes temporary foreign workers, refugee claimants, and people with temporary resident visas on humanitarian grounds. The research uses the 2006 census and quantitative methods (cross-tabulation and regression analysis) to evaluate wage differences between low-skilled workers without citizenship and low-skilled workers with citizenship or permanent resident status. Differences are calculated at the industry sector level and occupation level. The analysis further considers a set of intrinsic characteristics of low-skilled workers (including sex, level of education, official language ability and country of birth) and their occupations (provincial location, rural/urban setting). Empirically, this research confirms that there is a penalty attached to lack of citizenship for low-skilled workers. In absolute terms, low-skilled NPRs earn low wages. In relative terms, these NPRs earn less than both the Canadian-born and immigrants low-skilled workers employed in the same occupations. Among low-skilled NPRs themselves, the Canadian labour market exhibits a hierarchy of wages and labour experiences on the lines of workers' country of birth, province of residence, and rural/urban place of work. Among low-skilled workers born in the same country, wages improve when either citizenship or the rights attached to permanent residence are acquired. The research recommends the implementation of a pathway to citizenship for low-skilled workers, especially low-skilled temporary foreign agricultural workers. Organizer: Jessica Ponting, IAVGO Community Legal Clinic Participants: Sang Hun Mun, IAVGO Community Legal Clinic and Injured Workers Action for Justice; Stephanie Mayell, PhD Student, University of Toronto; Michelle Tew, Occupational Health Clinics for Ontario Workers; Ralston, Injured Workers Action for Justice and Justicia for Migrant Workers Injured migrant workers and the Workplace Safety & Insurance Board (WSIB): Advocacy, health care and research on the frontlines This panel will consider the realities that migrant workers face when they get injured on the job. It will focus on the need for equitable access to health care and workers compensation from a legal, clinical, advocacy and research perspective. In particular, Mayell will discuss structural vulnerability, injury, and medical repatriation among Jamaican Seasonal Agricultural Workers Program (SAWP) workers. Tew will discuss the challenges injured migrants have accessing health care and Workplace Safety and Insurance Board (WSIB) benefits from a clinician's perspective. Ponting will discuss migrant workers’ interactions with WSIB and recent changes to the WSIB's provision of health care. Mun and Ralston will discuss the role of lived experience and grassroots organizing in pushing for needed change. Stephanie Premji, School of Labour Studies and Department of Health, Aging and Society, McMaster University, Hamilton, ON Ellen MacEachen, University of Waterloo, Waterloo, ON Agnieszka Kosny, University of Toronto Ron Saunders, Institute for Work and Health, Toronto Daniel Côté, PhD, Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail (IRSST) Immigrants’ access to workers’ compensation Background. Previous research has shown that immigrants face disproportionate occupational hazards and health problems and barriers accessing workers’ compensation. However, most of the research on workers’ compensation access has framed barriers in individual terms (e.g. language and cultural barriers, lack of knowledge about rights, etc.). Aim. Our study sought to document



systemic barriers to workers’ compensation for immigrants. Methods. We conducted semi-structured interviews with 14 immigrant workers and 23 key informants in the Greater Toronto Area. The interviews were recorded, transcribed, coded and analyzed with NVIVO. The study’s aim was to untangle the policies and practices that impact access to workers’ compensation for linguistic minorities; however, given that linguistic minority and immigrant status are often experienced concurrently, our analyses provided rich results on the experiences of immigrants more broadly. Results. We describe systemic access barriers reflected in policies and practices that fail to adequately take into account immigrants’ social and economic precarity. Namely, we describe how language barriers, lack of information and power, as well as work and employment conditions disproportionately experienced by immigrants (e.g. work that is minimum wage, precarious, fast and repetitive, mismatched, etc.) are inadequately considered by workers’ compensation. Conclusions. Immigrants’ access to workers’ compensation must be understood in the context of layers of vulnerability associated with their precarious social and economic position. We propose recommendations for changes to policies and practices to address these gaps. Sohrab Rahmaty, Immigrant Services Guelph-Wellington Newcomer employment – Innovative solutions to labour market challenges: A case study from the City of Guelph and Wellington Country* It is evidently clear, from industry demands and economic reports, that Canada’s economy and its long-term success depends on immigrants and their successful integration. Due to Canada’s changing demographics and increasing demand for high skilled workers, immigrants are necessary for both the labour and high-tech industries. Settlement services organizations are well placed to assist newcomers find employment and to also provide them with much needed training around health and safety. This presentation will discuss a rather recent and innovative approach to employment services from the Guelph-Wellington area. The Circle of Learning Employment Training and Placement Program focuses on essential skills training through workshops and experiential learning. The program’s involvement and collaboration with employers has proven successful with noteworthy results. This presentation will highlight program findings and recommendations. Organizer: Chris Ramsaroop, Justicia for Migrant Workers (j4mw) Participants: Tania Corea; Leon Ferguson; Rawle Fortune; Tracey Ann Hines; Ralson Maise; Sang Hun Mun Justicia for Migrant Workers Mr. Hun also a member of Injured Workers Action for Justice A band aid won’t stop a gushing wound – Health care exclusions and migrant organizing in Ontario: Listening to the voices of workers.* Access to Canada's healthcare system has been described as a system of apartheid for migrant workers due to their denial to basic healthcare. Mainstream narratives construct unequal access to healthcare as an exception to our generous social safety net. This panel of migrants and frontline activists aims to debunk this myth by situating healthcare exclusions as central to understanding the project of nation building where citizenship is premised on the deliberate exclusion of racialized communities such as migrant workers. This panel will establish a critical framework for the expansion and inclusion of healthcare for those deemed outside the process of legal inclusion.



Kathleen Rice, PhD, Postdoctoral Fellow Fiona Webster, PhD, Associate Professor Dalla Lana School of Public Health, University of Toronto Care interrupted: Poverty, in-migration, and primary care in rural resource towns Internationally, rural people have poorer health outcomes relative to their urban counterparts, and primary care providers face particular challenges in rural and remote regions. Drawing on ethnographic fieldnotes and qualitative interviews with care providers and chronic pain patients in two remote resource communities in Northern Ontario, this article examines the challenges involved in providing and receiving primary care for complex chronic conditions in these communities. Both towns struggle with high unemployment in the aftermath of industry closure and are characterized by an abundance of affordable housing. Many of the challenges that care providers face and that patients experience are well-documented in Canadian and international literature on rural and remote health, and health care in resource towns (e.g. lack of specialized care, difficulty with recruitment and retention of care providers, heavy workload for existing care providers). However, our study also documents the recent in-migration of low-income, largely working-age people with complex chronic conditions who are drawn to the region by the low cost of housing. We discuss the ways in which the needs of these in- migrants compound existing challenges to rural primary care provision. To our knowledge, our study is the first to document both this migration trend, and the implications of this for primary care. In the interest of patient health and care provider well-being, existing health and social services will likely need to be expanded to meet the needs of these in-migrants. Sherald Sanchez, Research Analyst, Centre for Addiction and Mental Health, Toronto Sexual and reproductive health of adolescents with refugee backgrounds during resettlement* BACKGROUND: Over half of the global refugee population is comprised of children and adolescents. Adolescents, who are among the most vulnerable in crisis settings, have specific needs, such as sexual and reproductive health services. Despite this, no recent review of available services exists. OBJECTIVE: The aim of the study is to map the current landscape of services and to summarize findings to policymakers, practitioners and end users – identifying gaps and providing guidance for future work to advance policy and practice. Scoping reviews are useful in identifying available services for dispersed and vulnerable groups. METHODS: A five-stage scoping review was performed of five peer-reviewed research databases, and of the Internet for grey literature. Articles were selected for the review if they were published between 1995 and 2017 and reported on sexual and reproductive health, and if they were empirical research conducted in a high-income country of resettlement. RESULTS: 13 studies were identified in the scoping review process. Results demonstrate a significant lack of sexual and reproductive health services available to address the specific needs of adolescents with refugee backgrounds. Currently, there are no guidelines on the sexual and reproductive health of adolescents with refugee backgrounds. CONCLUSION: Delivery of sexual and reproductive health information and services for adolescents can be challenging in any setting. For adolescents with refugee backgrounds, it is exponentially more challenging due to many complexities. These complexities have implications for both the planning and the delivery of accessible and effective health services. Bharati Sethi, Ph.D, Assistant Professor, School of Social Work, King's College, Western University, London, ON Refugee women stories of resettlement Background: As the migration and resettlement of women from non-European countries to Canada’s small cities and rural regions continues to rise, Community-Based Participatory Research (CBPR) is needed to gather ‘local’ and lived experiences of this population. Such knowledge is



essential to implement gender-sensitive policies that support the adaptation of these women to their host communities. Traditional urban-based re(settlement) policy decisions are often ineffective to retain these populations in smaller cities. Aim: The primary objective of this CBPR study was to explore the work and health experiences of visible minority immigrant and refugee living in a middle-sized region in Ontario, made up of urban and rural areas. In this presentation, the researcher highlights the experiences of six refugee women. Methods: Photovoice- an arts-based methodology- was utilized to explore the post-migratory experiences of fourteen immigrant/refugee visible minority women. In keeping with the tenets of photovoice women were given cameras to record their experiences. Within the qualitative design, intersectionality and constructivist grounded theory guided the theoretical and analytical process. Results: Intersectionality analysis of the women’s photographs, diaries, and interview transcripts suggest that gender, ethnicity, location, and sexuality intersected to marginalize and exclude them from the labour market. The participants demonstrated incredible resilience in the face of post-migration challenges. Conclusions: Migration and resettlement remain a complex policy issue. Findings and implications apply to other smaller centers that are experiencing increased migration due to globalization, political unrest, and changing Canadian immigration policies. Lisa Seto Nielsen, RN, PhD, Assistant Professor, School of Nursing, Faculty of Health, York University Alexandra Bonin, RN, Hospital for Sick Children Provider experiences of palliative care with undocumented immigrants with cancer in Toronto, Canada* Background: Undocumented immigrants are a vulnerable group, often have precarious employment, and limited social and legal protections, which may contribute to inequitable access to health care resources. Research indicates that undocumented immigrants may access health care differently due to language barriers, lack of health insurance, and fear of deportation. A review of the literature indicates there is a lack of research pertaining to the palliative care experiences of undocumented immigrants with terminal cancer. Purpose: To conduct an exploratory qualitative study on the experience of undocumented immigrants with cancer in accessing palliative care in Toronto, Canada. Methods: Interviews were conducted with five health and social service providers who had experience providing care to undocumented immigrants with terminal cancer. Results: Interviews revealed that providers worked precariously outside of and within the formal systems to provide care to undocumented immigrants. Providers indicate that there is no formal system of policies and procedures pertaining to providing palliative care for undocumented immigrants, which means there is minimal to no funding available to support care. Providers felt a moral and ethical obligation to provide palliative care but experienced challenges relating to accessing pain medication, admission to hospices or palliative care units, and psychosocial supports. Conclusions: The findings provide a preliminary understanding of how some undocumented immigrants receive palliative care. It also demonstrates a need to open up a dialogue on formal policy and funding to create pathways for providing care to non-citizens so that they can have access to palliative care and a dignified death.



Organizer: Yogendra Shakya, PhD, Senior Research Scientist, Access Alliance, Toronto, and Adjunct Assistant Professor, Dalla Lana School of Public Health Participants: Simran Dhunna and Tola Mbulaheni (Promoting Decent Work for Racialized Women Project, Access Alliance); Geraldina Polanco (Assistant Professor of Labour Studies and Sociology, McMaster University, Hamilton, ON); Talayeh Shomali (Justice Projects Coordinator, METRAC); Dr Rupaleem Bhuyan (Associate Professor, Factor-Inwentash Faculty of Social Work, University of Toronto); Novabella Pendon; Lorraine Valmadrid (Migrant Mothers Project); Pearlita Juan; Marie Esel Panlaqui (The Neighborhood Organization) Gender Injustices in immigration policies and precarious work pathways for racialized immigrant women* This panel will discuss how gender insensitive and gender discriminatory dimensions within current immigration policies systemically push racialized immigrant women into low-wage, exploitative, and precarious employment pathways. Drawing on current evidence and critical policy analysis, panel members will unpack the ways in which many of our immigration policies are grounded on, and perpetuate, highly gendered and racialized forms of work and labor division/relations. The panel will particularly focus on policies related to labor migration (e.g., Live-in Caregiver program, low skilled temporary foreign workers program) and gender-insensitive dimensions within past and current immigration policies (such as Conditional Permanent Residence policy). Panel presentations will highlight the ways in which these gender-insensitive and racialized immigration policies (re)produce precarity and vulnerabilities both in terms of immigration status and employment security for racialized immigrant women and their families. While Canadian government has or is in the process of repealing some of these problematic policies (Conditional Permanent Residence policy, medical inadmissibility rule), panel members will highlight urgency for removing xenophobic, racialized and gender-discriminatory dimensions within current immigration policies. Andrew Stevens, Associate Professor, Faculty of Business Administration, University of Regina, Regina, Saskatchewan Migrant labour in petro-capitalism: Union interactions with foreign workers in Saskatchewan Western Canada’s oil exporting economies have come to rely on migrant labour as a cornerstone of economic development. A global division of labour intersecting with the constellation of Canada’s foreign worker programs has shaped the contemporary political economic character of one Canadian province in particular, Saskatchewan. These programs have worked to construct bifurcated labour markets for growing low-wage industries that exist alongside high-wage resource sector employment in the region. And although a majority of these migrant workers end up employed in non-unionized workplaces, foreign workers who secure occupations in health care, construction, warehousing, and manufacturing are often represented by a union. The study explores union attitudes and union-member engagement amongst migrant labour in an attempt to confront anecdotal claims that migrant workers are without an affinity to organized labour and avoid participating in union business and the collective bargaining process. Similarly, this aspect of the research unpacks efforts by unions to educate and integrate migrant labour into their respective organizations. Based on semi-structured interviews with migrant and Canadian workers, organizers, and gatekeepers (n=57), as well as survey findings involving unionized and non-unionized workers (n=250), the Saskatchewan-based research suggests that migrant workers often demonstrate higher support for unions than their Canadian colleagues and yet want to see the collective bargaining process address concerns specific to foreign labour. Findings also speak to the need for unions in the province to develop organizing and engagement models that enhance the participation rate of migrants.



Binah Straker, MA Ellen MacEachen, PhD University of Waterloo, Waterloo, ON Carrot or stick? A narrative review of occupational health and safety inspectors' decision-making approaches This narrative review was conducted to develop an understanding of how occupational health and safety inspectors make decisions about using carrots (education and persuasion approaches) or sticks (enforcement approaches) during workplace inspections. The review included peer-reviewed quantitative, qualitative, and mixed methods research that focused on occupational health and safety inspectors' decision-making approaches, published in English between 2006 and 2016. Twenty-three research studies met the inclusion criteria and proceeded to data extraction and thematic synthesis. The review finds that occupational health and safety inspectors' approaches were influenced by whether the inspection was routine or complaint-based, the inspector's discretion, complexity of the occupational health condition, and the inspector's training. In all, inspector's roles were fluid. Across inspection jurisdictions, they adjusted their carrot or stick strategies to address local situations. Despina Tzemis, Program Manager, Quest Community Health Centre, St. Catharines, ON Kylee Hunter Breanne Evink Jenny Stranges Coletta McGrath Primary health care services for migrant agricultural workers living in Niagara: Utilizing the model of health and well-being* It is estimated that 2 – 3,000 Migrant Agricultural Workers (MAWs) come to Niagara Region to work every year. MAWs are one of the drivers of Niagara's agricultural industry, however, most services in Canada do not accommodate for their unique experiences thus limiting their ability to access basic needs such as healthcare. Factors that act as barriers include delays in obtaining Ontario Health Insurance Plan coverage, transportation and language barriers, and fears related to discrimination or loss of employment. This presentation will provide an overview of Quest CHC's Migrant Agricultural Worker Program and explore how the Model of Health and Wellbeing is key in providing comprehensive and holistic health services. Using a modified problem-based learning approach, participants will work through two case scenarios highlighting the challenges of practicing within a limited resources environment. Upon completion of this presentation, participants will have a better understanding of the role of the Model of Health and Wellbeing in providing care to MAWs. Participants will also have an appreciation for the common health issues experienced by this population and knowledge of the Quest Migrant Agricultural Worker Program. Biljana Vasilevska, Independent researcher Janet McLaughlin, Wilfrid Laurier University, Waterloo, ON Don Wells, McMaster University, Hamilton, ON Andre Lyn, United Way The Cost of sacrifice: Consequences of repeated separations on Mexican and Jamaican migrant agricultural workers’ families Background: The Seasonal Agricultural Worker Program brings thousands of labourers, most of whom are male and fathers, from Mexico and Caribbean countries to Canada each year to perform agricultural work. Staying for as long as eight months each year, and sometimes returning year after year for decades, these workers come with the motivation to improve material conditions for their families. Aim: The purpose of this study was to examine the impacts of repeated family



separations on workers and their families. Methods: We conducted qualitative interviews with workers, the spouses, adult children and community leaders in Canada, Mexico and Jamaica. Interviews were coded using NVivo software and major themes were identified and analysed. Results: Repeated prolonged separations generate negative consequences for workers, for their families abroad, and for the relationships among family members. Primary consequences include: behavioural challenges among children, tension or relationship breakdown between spouses, mental and physical health issues, and, in some cases, family estrangement. Conclusion: Government and program administrators should take family impacts into account when designing international migration programs. A number of changes can be considered to lessen the negative impacts on migrant families. Esi Wilmot, The Lung Association, Ontario Work Related Asthma (WRA) among employers and immigrant workers* Learning Objectives. Upon completion of this presentation, participants will acquire knowledge on: 1. High risk industries with significant numbers of immigrants; 2. How to screen for Work Related Asthma; 3. Prevention of WRA; 4. The Lung Association's WRA educational resources available to immigrant workers; 5. Workplace Safety and Insurance Board (WSIB) claim and return to work initiatives. Research shows that immigrant workers are a high-risk group susceptible to occupational injury and disease - work-related asthma is not an exception. A number of factors such as language and cultural barriers may inhibit proper health and safety training among the immigrant population. Immigrant workers may also dominate high risk industries in which WRA prevalence is high. Examples of such high-risk industries include hair, nail and beauty salons, cleaning and janitorial work industries and agriculture (farms/vineyards/greenhouses). Internationally, work-related exposures cause 10-20% of adult asthma. With more than 300 asthma-causing substances in the workplace, work-related asthma is Canada’s most common occupational lung disease. WRA is however preventable if proper controls (engineering, administrative and personal protective equipment) are used in the workplace to reduce worker exposure. Translation of educational resources to meet the different language needs of immigrant workers is imperative. Additionally, employers need to initiate timely Workplace Safety and Insurance Board (WSIB) compensation claims if workers are affected. Kim Wood-Larue, Director, Case Management Sue Mamo, Director, Return-to-Work Program Workplace Safety and Insurance Board (WSIB) An overview of the Workplace Safety and Insurance Board (WSIB) services for foreign agricultural workers and people with language needs* The Workplace Safety and Insurance Board (WSIB) is here to help people when they get injured or are made ill on the job. The WSIB will provide an overview of their Foreign Agricultural Workers Program and describe the recent service changes. The presentation will also cover the WSIB’s new Return-to-Work Strategy and improved return-to-work services for people with language needs. Organizer: Maryth Yachnin, IAVGO Community Legal Centre Participants: Fay Faraday, Faraday Law; Jackie Esmonde, Income Security Advocacy Centre; Shane Martínez, Martínez Law; Chris Ramsaroop, Justicia for Migrant Workers; Grace Vaccarelli, Human Rights Legal Support Centre Legal challenges alongside migrant workers: Limits and successes in the Ontario context* This panel will explore the potential and limits of legal challenge strategies launched alongside migrant workers. The panelists will reflect on the successes and failures of recent legal challenges in



advancing equity and access to justice for migrant workers. We will focus in particular on recent human rights, health care, employment insurance and workers’ compensation legal challenges. We will explore the institutional and legal structures that actively prevent migrant workers from accessing their rights, and whether legal strategies can be effective in the face of these power imbalances. We will examine the potential of legal challenges as an organizing and outreach tool. By the end of the session, participants will: (1) Be up to date on recent legal challenges by migrant workers, mainly in the Ontario context; (2) Have a better understanding of how law can act as a tool for (or against) social change; (3) Wrestle with the limits of legal strategies and the responsibilities of lawyers when working alongside migrant workers and their allies; (4) Explore opportunities for using the law in driving more equitable and fair policy and law. This panel will be of interest to migrant workers, advocates and activists, policy makers and community workers. Katherine A.P. Zagrodney, Doctoral Candidate, Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto Reliance on immigrants as personal support workers: Job characteristics, health consequences, and future directions Personal Support Workers (PSWs) are unregulated frontline health care workers that provide care to a variety of health care users. PSWs currently make up a large portion of health care workers and projections anticipate an increased demand for PSWs, yet shortages in supply are frequently reported. In the absence of supply of local workers, one solution is to hire immigrant PSWs. Certainly, in comparison to the general working population, PSWs are more likely to be older women of minority and immigrant status. The gendered, minority, and ethnic nature of this labour force arguably contributes to the low human capital, market value and status of PSW work. Indeed, PSW work often involves many precarious features such as low wages, casual or part-time hours, inconsistent unionization, and contract-based employment. Additionally, PSWs often report poor health, heavy workloads, high stress, and musculo-skeletal disorders. PSWs, and particularly immigrant PSWs, are arguably in a disadvantaged position due to factors such as lack of other work opportunities. As demand for PSW work increases, a higher proportion of PSWs may include immigrants. Therefore, this paper critically explores the extent to which evidence-based attention should be directed towards this group through government policy and other initiatives as a basic human rights and safety issue for this particularly disadvantaged group consisting of many immigrant women, facing poor work conditions and associated poor health consequences. Furthermore, from a retention and recruitment perspective, improvements in work conditions should be considered as we anticipate a growing reliance on PSWs and immigrant PSWs.



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Documents

Work, Migration and Health Forum 2018 1 · Rm. HS574 (Fifth floor east) ... 4:55pm – 5:00pm Closing remarks (HS610) ... A case study from the City of Guelph and Wellington