Rooted Elsewhere: Understanding the impact of immigration on health and wellbeing from the perspective of Black immigrant women in Ontario

Abstract

Introduction Canada has long relied on immigration to shape its demographic landscape, social fabric, and economic development. Historically, immigration policies have favoured white European settlers, but changes to the Canadian Immigration Act opened pathways for more diverse populations, including Black immigrants from the Caribbeans and various African countries. However, Black immigrants, particularly women, continue to face systemic inequities in healthcare, employment, housing, and other areas of life. Black immigrant women often carry the compounded weight of racialized and gendered expectations as they navigate caregiving responsibilities, financial pressures, and resettlement barriers in their new socio-cultural context in Canada. When combined, these social determinant of health can negatively impact their health and resilience as they resettle in Canada. Canadian immigrants are rigorously vetted for the positive educational, health and economic impact they can make to the economy however, their health start to decline after their arrival to the country. Though studies abound establishing patterns linking unmet needs, structural and institutional inequity to immigrant health, for Black immigrant women, health is further shaped by intersecting forces such as race, gender, and migration. While quantitative studies have captured broad patterns in immigrant health, they often fail to capture the lived experiences behind those numbers. This study offers critical insight into the social and emotional complexities of resettlement, health-seeking behaviours, and identity negotiation of immigrants and their impact on physical and mental health. It contributes to a growing body of qualitative scholarship that centres the voices of Black immigrant women in Canada, by offering a deeper understanding of how immigration and resettlement experiences shape their health and well-being. Research Aim This thesis explores the multifaceted immigration and resettlement experiences of Black immigrant women in Ontario, Canada, with a focus on the implications for their physical and mental health. To capture the depth and complexity of the participants’ experiences, this thesis is separated into three papers, each drawing from the same research question but having their own distinct aim. Paper one examines the resettlement challenges specifically encountered by Black immigrant women as they settle and integrate into the Canadian society. It highlights how meeting Canadian immigration eligibility criteria does not ensure effective integration into the Canadian society. It showcases specific resettlement challenges and the resultant impact on their health and wellbeing. Paper two captures the employment experiences of Black immigrant women in the Ontario labour market and produces a three-stage employment narrative common to all participants. Also, paper two highlights the physical and mental health impact associated with the three different stages, along with the different coping strategies deployed by the women. Paper three explores how Black immigrant women make sense of their immigration and resettlement experiences and how the meanings they ascribe to their experiences impact on their health and wellbeing. These meanings significantly influence their choices and behaviors and profoundly impacts their self-identity and engagement with the Canadian society. Methods This thesis employs a qualitative approach to immigrant health research. Purposive sampling recruited a total of twenty-two Black immigrant women living in Ontario, aged 18-54 years. The women participated in virtual and in-person semi-structured interviews that lasted between 45 minutes to two hours. Three analytical approaches were used. First, thematic analysis was utilized in paper one to systematically code and interpret the broader resettlement challenges encountered by participants, such as the persistent devaluation of foreign credentials, experiences of racialized housing discrimination and negative dietary acculturation. Paper two drew on Reissman and Polkinghorne’s narrative analysis approaches to construct a framework that mapped participants’ employment stories across three distinct phases: the initial entry to the labour market, the early employment period, and the longer-term navigation of workplace environment. Paper three used Interpretative Phenomenological Analysis (IPA) to delve into how participants made meaning of their immigration and resettlement experiences within their cultural and socio-political contexts. Findings Findings from the thematic analysis of paper one illuminate how structural and systemic barriers were internalized by the participants, and contribute to their heightened stress, feelings of marginalization, and prolonged sense of frustration which are closely tied to both physical and mental health outcomes. The themes in paper one are: 1.) Hopes and aspiration for a better life, 2.) Facing reality, and 3.) Intentionality. Also, paper one shows that the combination of resilience level and the ability to leverage social capital determine participants’ ability to effectively integrate into the Canadian society. Participants’ employment narratives in paper two expose the emotional strain and disrupted career trajectory experienced by the participants as they tried to continue their professional path after arriving in Canada. Paper two highlights how participants experience structural and social exclusion at the workplace and the resulting negative impact on their physical and mental health. Most importantly, paper two develops a three-stage narrative model of early employment of newcomer Black immigrant women in Ontario. This model links the devaluation of credential and professional experience and racialized gatekeeping of employment to health outcomes in Black immigrant women. Further, this narrative model highlights not only the challenges encountered during the different stages of the employment journey but also how these experiences can contribute to the onset and progression of imposter syndrome (IS). The Interpretive phenomenological Analysis (IPA) method used in paper three foregrounds the embodied and affective dimensions of resettlement by showing how the participants’ identities, aspirations, and understandings of their health evolved in response to both visible and invisible pressures from their immigration. Paper three shows how participants sense of immigration was different before and after their arrival in Canada. Further, it shows that how they internalised and made sense of their experiences determined the decisions and actions they take which in turn impacted on their health and wellbeing. By privileging participants sense-making, paper three reveals the Black immigrant woman’s nuanced portrait of resilience and negotiation of self identity in their destination country. Conclusion Paper one highlights the feelings of disadvantage and stress expressed by all the participants as a result of their resettlement experiences of dietary acculturation, housing and healthcare discrimination. It showcases the results of the intersectionality of the participants identities and how social capital influences the extent to which participants are were able to navigate their resettlement challenges. Paper two portrays how people internalise the devaluation of their educational and professional qualifications because of systemic barriers and sexism and racism in Canadian workplaces. Further, Paper two identifies how participants experience of the imposter syndrome has far-reaching effect on their physical and mental health. Also, it shows that somatic symptoms can be easily developed as a result of workplace stress, and if they are misdiagnosed or overlooked, can lead to more serious and chronic health conditions. Paper three shows that beyond physical relocation, immigration is a deeply emotional and psychological journey shaped by the intersecting forces of gender, race and identity. Participants’ experience of racial trauma and systemic exclusion resulted in a sense of resignation to conserve their emotional energy. However, they demonstrate resilience through positive reframing and biographical reinvention to reconstruct their self identity in order to live and thrive in Canada as an immigrant. Overall, the contributions of this thesis include: 1. A methodological contribution showing productive complementarity between Interpretative Phenomenological Analysis Narrative Inquiry, and Thematic Analysis for capturing both idiographic depth and substantive patterns across the dataset. 2. A theoretical refinement by demonstrating how the Intersectionality lens, backed by the Critical Race Theory, and Migration and Integration theories can be used to capture and categorize data for analytic navigation and story telling. 3. An empirical contribution by way of a three-stage narrative employment model for newcomer Black immigrant women in Ontario that links credential devaluation and racialized gatekeeping to health impacts. Ultimately, this thesis affirms that immigration and resettlement, for Black immigrant women, is not just about relocating and fitting in a new country but is about renegotiating their entire self-identity in environments with limited socio-cultural and professional support. When these are not appropriately addressed, will impact negatively on their health and wellbeing in their destination country.