Beef industry believes 'cut-in-Canada' solution is key to survival (Canadian Press)
Yahoo! News: Canada - Canadian Press: "Canadian Press - CALGARY (CP) - If Stan Eby has his way, the only way cattle will be leaving Canada is in a box. After two years with no international markets for live cattle - and no end in sight - the embattled beef industry believes a cut-in-Canada solution is the key to survival."
Sunday, May 15, 2005
Saturday, May 14, 2005
Immigration Canada
Immigration Canada: "National reactions to immigration
National reactions to immigration - From Wikipedia, the free encyclopedia.
Throughout the world, immigration is a controversial issue. All developed nations put restrictions on how many people can immigrate to them. These are usually justified on economic grounds with worries that many poor workers would lower wages and the nation's standard of living. Sometimes the justification for limiting immigration is cultural. The latter is heard most strongly in homogenous old world (European) nations where citizenship was long tied to a person having deep historical roots in the country. Western European nations, Japan, and other countries have long been deeply concerned about their national culture being subsumed. This concern can be especially high when the immigrants are of differing race or religion than the majority.
Immigration into European countries has a long tradition, though until the 1970s and 1980s the levels were relatively modest. Recent increases in immigration have led to the development of political parties in Europe which are almost solely concerned with limiting immigration. In Hong Kong population growth is driven by new immigrants from mainland China, while the natural growth is negative.
Only five countries in the world 'actively encourage' large numbers of immigrants: The United States, Israel, Canada, New Zealand, and Australia. These nations still restrict the numbers of people allowed to immigrate, but in most of these countries, population growth is almost entirely due to the relatively large level of immigration. Many other countries permit immigration in particular circumstances, e.g., to fill jobs where a skill is not available locally, for wealthy investors or business leaders, in cases of marriage, multiple citizenship or asylum, or under multilateral agreements such as within the European Union or between New Zealand and Australia.
source: http://en.wikipedia.org/wiki/Immigration"
National reactions to immigration - From Wikipedia, the free encyclopedia.
Throughout the world, immigration is a controversial issue. All developed nations put restrictions on how many people can immigrate to them. These are usually justified on economic grounds with worries that many poor workers would lower wages and the nation's standard of living. Sometimes the justification for limiting immigration is cultural. The latter is heard most strongly in homogenous old world (European) nations where citizenship was long tied to a person having deep historical roots in the country. Western European nations, Japan, and other countries have long been deeply concerned about their national culture being subsumed. This concern can be especially high when the immigrants are of differing race or religion than the majority.
Immigration into European countries has a long tradition, though until the 1970s and 1980s the levels were relatively modest. Recent increases in immigration have led to the development of political parties in Europe which are almost solely concerned with limiting immigration. In Hong Kong population growth is driven by new immigrants from mainland China, while the natural growth is negative.
Only five countries in the world 'actively encourage' large numbers of immigrants: The United States, Israel, Canada, New Zealand, and Australia. These nations still restrict the numbers of people allowed to immigrate, but in most of these countries, population growth is almost entirely due to the relatively large level of immigration. Many other countries permit immigration in particular circumstances, e.g., to fill jobs where a skill is not available locally, for wealthy investors or business leaders, in cases of marriage, multiple citizenship or asylum, or under multilateral agreements such as within the European Union or between New Zealand and Australia.
source: http://en.wikipedia.org/wiki/Immigration"
Friday, May 13, 2005
Canada Overview
Canada Overview - From Wikipedia, the free encyclopedia.
The capital of Canada is Ottawa, home of the nation's Parliament. Both the Governor General of Canada, who exercises the personal prerogatives delegated by the Monarch, and the Prime Minister, who is the head of government, have official residences in Ottawa.
Originally a union of former French and British colonies, Canada is a Commonwealth Realm, and a member of La Francophonie and the Commonwealth of Nations. Canada is officially bilingual:
French is the majority language of Quebec, and is widely spoken in New Brunswick; it is also spoken in Eastern, Northern and Southwestern Ontario and in specific communities throughout Atlantic Canada and the West.
English is the majority language elsewhere with the exception of certain communities, and the territory of Nunavut where the majority of the population speak Inuktitut.
Canada is a technologically advanced and industrialized nation, largely self-sufficient in energy due to its relatively large deposits of fossil fuels, nuclear energy generation, and hydroelectric power capabilities. Its economy has traditionally relied heavily on the abundance of natural resources and trade, particularly with the United States, with which it has a long, extensive relationship (see U.S.-Canada relations). Although the modern Canadian economy has become widely diversified, exploitations of natural resources remain an important driving force of many of country's regional economies.
Canada has 10 provinces and 3 territories.
source: http://en.wikipedia.org/wiki/Canada
The capital of Canada is Ottawa, home of the nation's Parliament. Both the Governor General of Canada, who exercises the personal prerogatives delegated by the Monarch, and the Prime Minister, who is the head of government, have official residences in Ottawa.
Originally a union of former French and British colonies, Canada is a Commonwealth Realm, and a member of La Francophonie and the Commonwealth of Nations. Canada is officially bilingual:
French is the majority language of Quebec, and is widely spoken in New Brunswick; it is also spoken in Eastern, Northern and Southwestern Ontario and in specific communities throughout Atlantic Canada and the West.
English is the majority language elsewhere with the exception of certain communities, and the territory of Nunavut where the majority of the population speak Inuktitut.
Canada is a technologically advanced and industrialized nation, largely self-sufficient in energy due to its relatively large deposits of fossil fuels, nuclear energy generation, and hydroelectric power capabilities. Its economy has traditionally relied heavily on the abundance of natural resources and trade, particularly with the United States, with which it has a long, extensive relationship (see U.S.-Canada relations). Although the modern Canadian economy has become widely diversified, exploitations of natural resources remain an important driving force of many of country's regional economies.
Canada has 10 provinces and 3 territories.
source: http://en.wikipedia.org/wiki/Canada
Canada Geography
Canada - Geography - From Wikipedia, the free encyclopedia.
Canada occupies the northern half of North America. It is bordered to the south by the contiguous United States, separated by the International Boundary, and to the northwest by Alaska. The country stretches from the Atlantic Ocean and Davis Strait in the east to the Pacific Ocean in the west; hence the country's motto. To the north lie the Beaufort Sea and Arctic Ocean; Greenland lies to the northeast. Since 1925, Canada has claimed the portion of the Arctic between 60 degrees west longitude and 141 degrees west longitude ([3]); that is, Canada's territorial claim extends to the North Pole. The northernmost settlement in Canada (and in the world) is Canadian Forces Station (CFS) Alert on the northern tip of Ellesmere Island -- latitude 82.5°N -- just 834 kilometres from the North Pole.
Canada is the world's second-largest country in total area, after Russia, covering approximately 41% of the North American continent. Much of Canada's territory lies in Arctic regions, however, and thus Canada has only the fourth most usable land behind Russia, China and the United States. The population density is 3.2 people per square kilometre, which is extremely low compared to other countries. Eighty percent of Canadians live within 200 km of the United States along their international border, the location of the country's most temperate climates and arable soil. While Canada covers a larger geographic area than its nearest neighbour, it has only one-ninth its population. Vast and sparsely populated, Canada has historically depended economically on exporting its abundant natural resources.
The most densely-populated part of the country is the Great Lakes-Saint Lawrence River Valley in the east. To the north of this region is the broad Canadian Shield, an area of rock scoured clean by the last ice age, thinly soiled, rich in minerals, and gouged with lakes and rivers— over 60 percent of the world's lakes are located in Canada. The Canadian Shield encircles the immense Hudson Bay.
The Canadian Shield extends to the Atlantic Coast in Labrador, the mainland part of the province of Newfoundland and Labrador. The island of Newfoundland, North America's easternmost region, is at the mouth of the Gulf of Saint Lawrence, the world's largest estuary, and the first region to be settled by Europeans. The Canadian Maritimes protrude eastward from the southern coast of the Gulf of Saint Lawrence, sandwiched between the Gulf to the north and the Atlantic to the south. The provinces of New Brunswick and Nova Scotia are divided by the Bay of Fundy, an arm of the Atlantic that experiences the world's largest tidal variations. Prince Edward Island is Canada's smallest province.
To the west of Ontario, the broad, flat Canadian Prairies, consisting of the provinces of Manitoba, Saskatchewan and Alberta, spread towards the Rocky Mountains, which divide the provinces of Alberta and British Columbia.
Northern Canadian vegetation tapers from coniferous forests to tundra and finally to Arctic barrens in the far north. The northern Canadian mainland is ringed with a vast archipelago containing some of the largest islands on Earth.
Canada has a reputation for cold temperatures. Indeed, the winters can be harsh in many regions of the country, with risks of blizzards and ice storms and temperatures reaching lows of -50°C in the far North. Southern British Columbia is an exception: it enjoys a very temperate climate with much milder winters than the rest of the country.
In the most densely populated regions, summers range from mild to quite hot, attaining highs of well over 30°C in Montreal and 15°C even in Iqaluit, Nunavut. In Vancouver, temperatures usually remain stable at around 5-25°C year round, whereas in parts of the central prairies, they can drop to -40°C in the winter and attain a high of 35°C in the summer. In the Great Lakes region, the most heavily populated area in the country, temperatures can range from -30°C to 35°C. The country experiences four distinct seasons.
source: http://en.wikipedia.org/wiki/Canada
Canada - Geography - From Wikipedia, the free encyclopedia.
Canada occupies the northern half of North America. It is bordered to the south by the contiguous United States, separated by the International Boundary, and to the northwest by Alaska. The country stretches from the Atlantic Ocean and Davis Strait in the east to the Pacific Ocean in the west; hence the country's motto. To the north lie the Beaufort Sea and Arctic Ocean; Greenland lies to the northeast. Since 1925, Canada has claimed the portion of the Arctic between 60 degrees west longitude and 141 degrees west longitude ([3]); that is, Canada's territorial claim extends to the North Pole. The northernmost settlement in Canada (and in the world) is Canadian Forces Station (CFS) Alert on the northern tip of Ellesmere Island -- latitude 82.5°N -- just 834 kilometres from the North Pole.
Canada is the world's second-largest country in total area, after Russia, covering approximately 41% of the North American continent. Much of Canada's territory lies in Arctic regions, however, and thus Canada has only the fourth most usable land behind Russia, China and the United States. The population density is 3.2 people per square kilometre, which is extremely low compared to other countries. Eighty percent of Canadians live within 200 km of the United States along their international border, the location of the country's most temperate climates and arable soil. While Canada covers a larger geographic area than its nearest neighbour, it has only one-ninth its population. Vast and sparsely populated, Canada has historically depended economically on exporting its abundant natural resources.
The most densely-populated part of the country is the Great Lakes-Saint Lawrence River Valley in the east. To the north of this region is the broad Canadian Shield, an area of rock scoured clean by the last ice age, thinly soiled, rich in minerals, and gouged with lakes and rivers— over 60 percent of the world's lakes are located in Canada. The Canadian Shield encircles the immense Hudson Bay.
The Canadian Shield extends to the Atlantic Coast in Labrador, the mainland part of the province of Newfoundland and Labrador. The island of Newfoundland, North America's easternmost region, is at the mouth of the Gulf of Saint Lawrence, the world's largest estuary, and the first region to be settled by Europeans. The Canadian Maritimes protrude eastward from the southern coast of the Gulf of Saint Lawrence, sandwiched between the Gulf to the north and the Atlantic to the south. The provinces of New Brunswick and Nova Scotia are divided by the Bay of Fundy, an arm of the Atlantic that experiences the world's largest tidal variations. Prince Edward Island is Canada's smallest province.
To the west of Ontario, the broad, flat Canadian Prairies, consisting of the provinces of Manitoba, Saskatchewan and Alberta, spread towards the Rocky Mountains, which divide the provinces of Alberta and British Columbia.
Northern Canadian vegetation tapers from coniferous forests to tundra and finally to Arctic barrens in the far north. The northern Canadian mainland is ringed with a vast archipelago containing some of the largest islands on Earth.
Canada has a reputation for cold temperatures. Indeed, the winters can be harsh in many regions of the country, with risks of blizzards and ice storms and temperatures reaching lows of -50°C in the far North. Southern British Columbia is an exception: it enjoys a very temperate climate with much milder winters than the rest of the country.
In the most densely populated regions, summers range from mild to quite hot, attaining highs of well over 30°C in Montreal and 15°C even in Iqaluit, Nunavut. In Vancouver, temperatures usually remain stable at around 5-25°C year round, whereas in parts of the central prairies, they can drop to -40°C in the winter and attain a high of 35°C in the summer. In the Great Lakes region, the most heavily populated area in the country, temperatures can range from -30°C to 35°C. The country experiences four distinct seasons.
source: http://en.wikipedia.org/wiki/Canada
Thursday, May 12, 2005
How are new refugees doing in Canada?
How are new refugees doing in Canada? Comparison of the health and settlement of the Kosovars and Czech Roma
Canadian Journal of Public Health, Sep/Oct 2003 by Redwood-Campbell, Lynda, Fowler, Nancy, Kaczorowski, Janusz, Molinaro, Elizabeth, Et al
ABSTRACT
Background: In 1999, a group of Kosovars arrived in Hamilton, Ontario, with a coordinated international pre-migration plan, as part of the United Nations Humanitarian Evacuation Program. Since 1997, a substantial number of Roma refugees from the Czech Republic also arrived in Hamilton, with no special pre-migration planning. This study examined whether the organized settlement efforts led to better adaptation and perceived health for the Kosovars, using the Czech Roma as a comparison group.
Methods: Adult members of 50 Kosovar (n=157 individuals) and 50 Czech Roma (n=76 individuals) randomly selected families completed a questionnaire on sociodemographics, health, well-being, and perceived adaptation to Canada. Differences between groups were examined using univariate and multivariate analyses. Comparison was made to the Ontario population where possible.
Results: There were more Kosovars than Czech Roma over the age of 50 (22.1% vs 10.5%, p=0.03). Nearly one quarter (21.7%) of the Kosovars had a score indicating post-traumatic stress disorder (PTSD) on the Harvard Trauma Questionnaire (HTQ), compared to none of the Roma (p
Conclusions: The health and adaptation of the Kosovars was not better than that of the Czech Roma. Reasons for this finding may include differences in demographics, the presence of PTSD, and differing length of time since arrival in Canada.
As part of its role in the United Nations Humanitarian Evacuation Program,1 Canada received approximately 5,000 refugees from Kosovo in the spring of 1999, 500 of whom arrived in Hamilton, Ontario. The majority of Kosovars destined for Hamilton came directly into community "settlement" houses set up in two local hotels. The refugees received social supports and sponsor groups were assigned to each family. Unlike with the usual arrival of refugees in Canada, there was a coordinated effort by health and other professionals to assist with the health and settlement needs of this large influx of Kosovar refugees. Since 1997, Hamilton has also received approximately 500 Roma refugees from the Czech Republic. In contrast, the Czech Roma were self-selected asylum seekers who applied individually for refugee status. As such, there was no pre-migration organizational planning for this group.
Studies examining refugee health profiles are often conducted in the context of international refugee camps,2,3 and relatively little information pertains to refugee groups in receiving host countries.4 One recognized barrier to settlement is the common presence of mental health difficulties, and often there is little data on the post-arrival physical health and self-perception of health of refugees.4,5 Many host countries have poor criteria for assessing how well refugees have integrated,6 compounding the difficulties in evaluating health. Canada has been a leading country in 'best settlement practices',7 encompassing areas such as language, employment and cultural orientation.
As a result of the special settlement efforts, we hypothesized that the Kosovars would report better adaptation and perceived health compared to other recent refugees. We compared the Kosovars and Czech Roma to generate their respective health profiles and highlight issues that may be helpful for planning future humanitarian efforts.
This paper describes the results of a questionnaire administered to individuals in randomly selected Kosovar and Czech Roma families regarding their health and adaptation to Canada. Comparisons were also made to the Ontario general population, where possible.
METHODS
Sample selection
The Settlement and Integration Services Organization in Hamilton (SISO), a community-based agency that serves local immigrant and refugee groups, used their records of all Kosovar and Czech Roma families that were active with the organization in the spring of 2001. All Kosovar families who arrived as part of the UN evacuation program and the majority of Czech Roma families (> 80%) in Hamilton were listed and active with SISO at the time of the study (personal communication, SISO director). The Czech Roma list contained 423 members of 166 families, with 268 individuals aged 18 and older. The Kosovar list contained 480 members of 161 families, with 350 individuals aged 18 and older. The majority of the Czech Roma study participants (90.8%; 69/76) arrived in Hamilton in 1997, six arrived in 1999 or 2000, and one arrived in 1994. The majority of the Kosovar study participants (87.3%; 137/157) arrived in the spring or summer of 1999 and 18/157 arrived in 2000 (two did not indicate their arrival date). Two individuals representing the refugee groups, and who were affiliated with SISO, conducted the fieldwork. One was a refugee physician from Kosovo and the other was active in settlement activities for Czech Roma in Southern Ontario. To maintain confidentiality before consent was obtained, a list of random numbers was supplied by the researchers to SISO and assigned to the list of families. The fieldworkers then contacted the randomly selected families. All families on the list, including family members aged 18 or older, were eligible. Families were approached until 50 from each group agreed to participate. The fieldworkers contacted the families, explained how they obtained the family name and phone number, and invited the family to participate. The person with whom the fieldworker arranged the interview consented verbally for all family members, and at the time of questionnaire administration, each family member over 18 years of age gave written consent.
The questionnaire was self-completed in most cases, however the fieldworker assisted participants where necessary. The questionnaire took approximately 30 minutes to complete. The Hamilton Health Sciences Research Ethics Board approved the study.
Data collection instruments
The questionnaire was developed by the research team and included demographic information, social support, general health, presence of stress, specific health conditions, tobacco and alcohol use, and health care services utilization questions. In order to compare to normative Canadian data, general health, specific health conditions, presence of stress, tobacco and alcohol use, and some demographic questions were taken directly from the Ontario Health8 and the Canada Health9 surveys. In addition, the Harvard Trauma Questionnaire (HTQ)10 was used to assess mental health status in relation to experiences in the home country. The HTQ was designed to measure symptoms associated with post-traumatic stress disorder (PTSD) in refugees. Existing translations of some of the questions were obtained from the Czech Ministry of Health and from other researchers who had translated and back-translated the HTQ into Albanian.3 The fieldworkers translated remaining questions. Fieldworkers conducted pilot interviews with two families from each group to pre-test the questionnaires.
Statistical analyses
Data were entered and analyzed using SPSS v 10.0.5 (SPSS Inc., Chicago IL). Univariate analyses were performed to compare socio-demographic characteristics, self-reported health and well-being, perceived adaptation, and variables relating to mental and physical health between the Kosovar and Czech Roma refugees using the Chi-square test or Student's t-test, as appropriate. A score of > or =2.5 on Harvard Trauma Questionnaire was used to indicate the presence of PTSD.10 For variables that were significantly different between the two groups in univariate analyses (p
Ontario population results from the 1996/97 National Population Health Survey12 or the 1990 Ontario Health Survey8 are presented, where available.
RESULTS
Sample description
The response rate for the families was 97.1% (100/103). Two Kosovar families refused and one Czech Roma family had moved out of the city. The demographic characteristics of the two groups are shown in Table I. On average, the mean size of the Kosovar families was significantly larger than the Czech Roma, there were significantly more Kosovars over the age of 50, and the Kosovars were more likely to have come from smaller towns or villages compared to the Czech Roma.
Health and well-being
A higher proportion of Kosovars compared to Czech Roma (11.5% vs. 1.3%) reported that their health was poor. The proportions of respondents who reported excellent or very good health was similar for the Kosovars (45.9%) and the Czech Roma (48.7%) (Table II). A similar pattern was seen for satisfaction with health, happiness with life, life stress, and adaptation to Canada, with more Kosovars choosing responses at the extreme ends of the scales compared to the Czech Roma (Table II). The responses to all of these variables were significantly different between the two groups by univariate analysis. The prevalence of PTSD was 21.7% (34/157) in the Kosovars, and 0% in the CzeIn comparison to the Ontario population (10.3%), more Kosovars (26.8%) reported fair or poor health, however the proportions reporting excellent health were similar (24.0% for Ontario vs 25.5% for the Kosovars). In contrast, the Czech Roma were similar to Ontario for fair or poor health, but a lower proportion (10.5%) reported excellent health. A similar pattern was seen for satisfaction with health. The Kosovars were more likely and the Czech Roma less likely than the Ontario population to report that life was stressful. The frequency of reporting three or more chronic conditions was lower in both the Kosovars (10.3%) and Czech Roma (2.7%) compared to the Ontario population (20.1%).
DISCUSSION
Our initial hypothesis that the Kosovar group would have better self-perceived health and settlement experiences than the Czech Roma group, as a result of the extra services received, was not supported. These results may be partially explained by differences between the groups in terms of age and the presence of PTSD symptoms. The Kosovars were older, more likely to lack formal education, and tended to come from smaller towns and villages. These factors have been reported to interfere with adaptation to a new country.11,13 We speculate that differences in demographics may be the result of the immigration approach, in that the refugee families included older Kosovars, who likely would not have come to Canada on their own. These differences may also explain the different response profiles between the Kosovars and the Czech Roma on several variables. For example, a higher proportion of Kosovars reported both 'excellent' and 'poor' health compared to the Czech Roma respondents. The Czech Roma, in contrast, less frequently provided responses on the extreme end of the scales, with most of their responses being in the middle of the scales. The dichotomy of the responses to the question of 'adaptation to Canada' within the Kosovar group may be partly explained by the contrast of 'euphoria' and PTSD symptoms described in the resettlement and integration literature.14,15 This 'euphoria' stage is sometimes observed soon after leaving a war zone but may be suppressed by those with PTSD. The more frequent reporting of poor health in the Kosovars may also be related to PTSD. Nearly one quarter of the Kosovars in this study were experiencing PTSD, an even higher proportion than recently reported ethnic Albanians living in Kosovo (17.1%) in 1999.3 That study also found that three quarters of respondents reported lacking food or water, and almost half reported ill health without access to medical care during the time of aggression. These physical and mental hardships experienced by the Kosovars would be expected to have an impact on their perceived current health and well-being.
There were several limitations in this study. We did not adjust for the effect of the clustered design, in which the family was the sampling unit but individual was the unit of analysis, which may have led to overestimates of the statistical significance of differences between groups. The questionnaires were filled out individually, but not in private, and the Kosovars especially may have felt obliged to respond more favourably as a result of the special treatment they received on their arrival. In addition, some of the response patterns suggest that despite our efforts to accurately translate the questionnaire, there may have been differences in the cultural interpretation of the questions or differing experience between the groups in responding to health questionnaires. For example, two thirds of the Czech Roma reported no chronic health problems - more than the Kosovars or the Ontario population - however few of the Roma reported excellent health. Our comparison group for the Kosovars was a different ethnic group and it would have been interesting to compare these Kosovars to another group of Kosovar refugees who had arrived without the special settlement services. Finally, the Czech Roma had been in Canada approximately twice as long as the Kosovars, and many of the differences reported here may disappear over time.
It is almost certain that another global refugee crisis will occur in the future and the international community must be prepared. An organized international evacuation plan could result in improved health and settlement for refugees, however more research is needed on this issue. Our study suggests that the Kosovar evacuation resulted in a demographically different group than the usual 'healthy immigrant' population. Key issues that emerged for the Kosovars were the high prevalence of PTSD and poorer adaptation to life in Canada. As a result of these issues, we could not conclude that the Kosovars fared better than refugees who arrived through the 'traditional' approach. Canada could expand on its current approach and take a leadership role in the future to critically examine the most effective methods for the optimal settlement and health of refugees in an emergency evacuation situation.
Copyright Canadian Public Health Association Sep/Oct 2003
Provided by ProQuest Information and Learning Company. All rights Reserved
Source: http://www.findarticles.com/p/articles/mi_qa3844/is_200309/ai_n9278801
How are new refugees doing in Canada? Comparison of the health and settlement of the Kosovars and Czech Roma
Canadian Journal of Public Health, Sep/Oct 2003 by Redwood-Campbell, Lynda, Fowler, Nancy, Kaczorowski, Janusz, Molinaro, Elizabeth, Et al
ABSTRACT
Background: In 1999, a group of Kosovars arrived in Hamilton, Ontario, with a coordinated international pre-migration plan, as part of the United Nations Humanitarian Evacuation Program. Since 1997, a substantial number of Roma refugees from the Czech Republic also arrived in Hamilton, with no special pre-migration planning. This study examined whether the organized settlement efforts led to better adaptation and perceived health for the Kosovars, using the Czech Roma as a comparison group.
Methods: Adult members of 50 Kosovar (n=157 individuals) and 50 Czech Roma (n=76 individuals) randomly selected families completed a questionnaire on sociodemographics, health, well-being, and perceived adaptation to Canada. Differences between groups were examined using univariate and multivariate analyses. Comparison was made to the Ontario population where possible.
Results: There were more Kosovars than Czech Roma over the age of 50 (22.1% vs 10.5%, p=0.03). Nearly one quarter (21.7%) of the Kosovars had a score indicating post-traumatic stress disorder (PTSD) on the Harvard Trauma Questionnaire (HTQ), compared to none of the Roma (p
Conclusions: The health and adaptation of the Kosovars was not better than that of the Czech Roma. Reasons for this finding may include differences in demographics, the presence of PTSD, and differing length of time since arrival in Canada.
As part of its role in the United Nations Humanitarian Evacuation Program,1 Canada received approximately 5,000 refugees from Kosovo in the spring of 1999, 500 of whom arrived in Hamilton, Ontario. The majority of Kosovars destined for Hamilton came directly into community "settlement" houses set up in two local hotels. The refugees received social supports and sponsor groups were assigned to each family. Unlike with the usual arrival of refugees in Canada, there was a coordinated effort by health and other professionals to assist with the health and settlement needs of this large influx of Kosovar refugees. Since 1997, Hamilton has also received approximately 500 Roma refugees from the Czech Republic. In contrast, the Czech Roma were self-selected asylum seekers who applied individually for refugee status. As such, there was no pre-migration organizational planning for this group.
Studies examining refugee health profiles are often conducted in the context of international refugee camps,2,3 and relatively little information pertains to refugee groups in receiving host countries.4 One recognized barrier to settlement is the common presence of mental health difficulties, and often there is little data on the post-arrival physical health and self-perception of health of refugees.4,5 Many host countries have poor criteria for assessing how well refugees have integrated,6 compounding the difficulties in evaluating health. Canada has been a leading country in 'best settlement practices',7 encompassing areas such as language, employment and cultural orientation.
As a result of the special settlement efforts, we hypothesized that the Kosovars would report better adaptation and perceived health compared to other recent refugees. We compared the Kosovars and Czech Roma to generate their respective health profiles and highlight issues that may be helpful for planning future humanitarian efforts.
This paper describes the results of a questionnaire administered to individuals in randomly selected Kosovar and Czech Roma families regarding their health and adaptation to Canada. Comparisons were also made to the Ontario general population, where possible.
METHODS
Sample selection
The Settlement and Integration Services Organization in Hamilton (SISO), a community-based agency that serves local immigrant and refugee groups, used their records of all Kosovar and Czech Roma families that were active with the organization in the spring of 2001. All Kosovar families who arrived as part of the UN evacuation program and the majority of Czech Roma families (> 80%) in Hamilton were listed and active with SISO at the time of the study (personal communication, SISO director). The Czech Roma list contained 423 members of 166 families, with 268 individuals aged 18 and older. The Kosovar list contained 480 members of 161 families, with 350 individuals aged 18 and older. The majority of the Czech Roma study participants (90.8%; 69/76) arrived in Hamilton in 1997, six arrived in 1999 or 2000, and one arrived in 1994. The majority of the Kosovar study participants (87.3%; 137/157) arrived in the spring or summer of 1999 and 18/157 arrived in 2000 (two did not indicate their arrival date). Two individuals representing the refugee groups, and who were affiliated with SISO, conducted the fieldwork. One was a refugee physician from Kosovo and the other was active in settlement activities for Czech Roma in Southern Ontario. To maintain confidentiality before consent was obtained, a list of random numbers was supplied by the researchers to SISO and assigned to the list of families. The fieldworkers then contacted the randomly selected families. All families on the list, including family members aged 18 or older, were eligible. Families were approached until 50 from each group agreed to participate. The fieldworkers contacted the families, explained how they obtained the family name and phone number, and invited the family to participate. The person with whom the fieldworker arranged the interview consented verbally for all family members, and at the time of questionnaire administration, each family member over 18 years of age gave written consent.
The questionnaire was self-completed in most cases, however the fieldworker assisted participants where necessary. The questionnaire took approximately 30 minutes to complete. The Hamilton Health Sciences Research Ethics Board approved the study.
Data collection instruments
The questionnaire was developed by the research team and included demographic information, social support, general health, presence of stress, specific health conditions, tobacco and alcohol use, and health care services utilization questions. In order to compare to normative Canadian data, general health, specific health conditions, presence of stress, tobacco and alcohol use, and some demographic questions were taken directly from the Ontario Health8 and the Canada Health9 surveys. In addition, the Harvard Trauma Questionnaire (HTQ)10 was used to assess mental health status in relation to experiences in the home country. The HTQ was designed to measure symptoms associated with post-traumatic stress disorder (PTSD) in refugees. Existing translations of some of the questions were obtained from the Czech Ministry of Health and from other researchers who had translated and back-translated the HTQ into Albanian.3 The fieldworkers translated remaining questions. Fieldworkers conducted pilot interviews with two families from each group to pre-test the questionnaires.
Statistical analyses
Data were entered and analyzed using SPSS v 10.0.5 (SPSS Inc., Chicago IL). Univariate analyses were performed to compare socio-demographic characteristics, self-reported health and well-being, perceived adaptation, and variables relating to mental and physical health between the Kosovar and Czech Roma refugees using the Chi-square test or Student's t-test, as appropriate. A score of > or =2.5 on Harvard Trauma Questionnaire was used to indicate the presence of PTSD.10 For variables that were significantly different between the two groups in univariate analyses (p
Ontario population results from the 1996/97 National Population Health Survey12 or the 1990 Ontario Health Survey8 are presented, where available.
RESULTS
Sample description
The response rate for the families was 97.1% (100/103). Two Kosovar families refused and one Czech Roma family had moved out of the city. The demographic characteristics of the two groups are shown in Table I. On average, the mean size of the Kosovar families was significantly larger than the Czech Roma, there were significantly more Kosovars over the age of 50, and the Kosovars were more likely to have come from smaller towns or villages compared to the Czech Roma.
Health and well-being
A higher proportion of Kosovars compared to Czech Roma (11.5% vs. 1.3%) reported that their health was poor. The proportions of respondents who reported excellent or very good health was similar for the Kosovars (45.9%) and the Czech Roma (48.7%) (Table II). A similar pattern was seen for satisfaction with health, happiness with life, life stress, and adaptation to Canada, with more Kosovars choosing responses at the extreme ends of the scales compared to the Czech Roma (Table II). The responses to all of these variables were significantly different between the two groups by univariate analysis. The prevalence of PTSD was 21.7% (34/157) in the Kosovars, and 0% in the CzeIn comparison to the Ontario population (10.3%), more Kosovars (26.8%) reported fair or poor health, however the proportions reporting excellent health were similar (24.0% for Ontario vs 25.5% for the Kosovars). In contrast, the Czech Roma were similar to Ontario for fair or poor health, but a lower proportion (10.5%) reported excellent health. A similar pattern was seen for satisfaction with health. The Kosovars were more likely and the Czech Roma less likely than the Ontario population to report that life was stressful. The frequency of reporting three or more chronic conditions was lower in both the Kosovars (10.3%) and Czech Roma (2.7%) compared to the Ontario population (20.1%).
DISCUSSION
Our initial hypothesis that the Kosovar group would have better self-perceived health and settlement experiences than the Czech Roma group, as a result of the extra services received, was not supported. These results may be partially explained by differences between the groups in terms of age and the presence of PTSD symptoms. The Kosovars were older, more likely to lack formal education, and tended to come from smaller towns and villages. These factors have been reported to interfere with adaptation to a new country.11,13 We speculate that differences in demographics may be the result of the immigration approach, in that the refugee families included older Kosovars, who likely would not have come to Canada on their own. These differences may also explain the different response profiles between the Kosovars and the Czech Roma on several variables. For example, a higher proportion of Kosovars reported both 'excellent' and 'poor' health compared to the Czech Roma respondents. The Czech Roma, in contrast, less frequently provided responses on the extreme end of the scales, with most of their responses being in the middle of the scales. The dichotomy of the responses to the question of 'adaptation to Canada' within the Kosovar group may be partly explained by the contrast of 'euphoria' and PTSD symptoms described in the resettlement and integration literature.14,15 This 'euphoria' stage is sometimes observed soon after leaving a war zone but may be suppressed by those with PTSD. The more frequent reporting of poor health in the Kosovars may also be related to PTSD. Nearly one quarter of the Kosovars in this study were experiencing PTSD, an even higher proportion than recently reported ethnic Albanians living in Kosovo (17.1%) in 1999.3 That study also found that three quarters of respondents reported lacking food or water, and almost half reported ill health without access to medical care during the time of aggression. These physical and mental hardships experienced by the Kosovars would be expected to have an impact on their perceived current health and well-being.
There were several limitations in this study. We did not adjust for the effect of the clustered design, in which the family was the sampling unit but individual was the unit of analysis, which may have led to overestimates of the statistical significance of differences between groups. The questionnaires were filled out individually, but not in private, and the Kosovars especially may have felt obliged to respond more favourably as a result of the special treatment they received on their arrival. In addition, some of the response patterns suggest that despite our efforts to accurately translate the questionnaire, there may have been differences in the cultural interpretation of the questions or differing experience between the groups in responding to health questionnaires. For example, two thirds of the Czech Roma reported no chronic health problems - more than the Kosovars or the Ontario population - however few of the Roma reported excellent health. Our comparison group for the Kosovars was a different ethnic group and it would have been interesting to compare these Kosovars to another group of Kosovar refugees who had arrived without the special settlement services. Finally, the Czech Roma had been in Canada approximately twice as long as the Kosovars, and many of the differences reported here may disappear over time.
It is almost certain that another global refugee crisis will occur in the future and the international community must be prepared. An organized international evacuation plan could result in improved health and settlement for refugees, however more research is needed on this issue. Our study suggests that the Kosovar evacuation resulted in a demographically different group than the usual 'healthy immigrant' population. Key issues that emerged for the Kosovars were the high prevalence of PTSD and poorer adaptation to life in Canada. As a result of these issues, we could not conclude that the Kosovars fared better than refugees who arrived through the 'traditional' approach. Canada could expand on its current approach and take a leadership role in the future to critically examine the most effective methods for the optimal settlement and health of refugees in an emergency evacuation situation.
Copyright Canadian Public Health Association Sep/Oct 2003
Provided by ProQuest Information and Learning Company. All rights Reserved
Source: http://www.findarticles.com/p/articles/mi_qa3844/is_200309/ai_n9278801
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