Addressing stigma-related barriers to care

Addressing social and cultural stigma-related barriers to care: New research and tools from Toronto, Canada’s Access Alliance

Access Alliance – Published in International Federation of Community Health Centres (IFCHC) Newsletter (Aug 2021)

On Wednesday, August 4, Access Alliance Multicultural Health and Community Services (Access Alliance), an IFCHC member Community Health Centre based in Toronto, Canada, announced the release of Tackling TB Stigma: A Cross-Sectoral Approach to Reducing Tuberculosis (TB) Stigma and Improving TB Care for Vulnerable Newcomer Populations in Canada. The report was the result of comprehensive, community-driven research that sought to examine TB-related stigma and highlight recommendations for effectively addressing stigma around diseases.

“The findings in this report are drawn from the unique experiences of newcomers to Canada, their descriptions and observations of the particular kinds of stigma they’ve faced, and their experiences of what has worked to help them address tuberculosis and other health challenges,” said Cliff Ledwos, Director of Primary Care and Associate Executive Director at Access Alliance. “Coordinated collaboration across health and social sectors that interact with newcomers, to ensure timely and sustained access to wraparound health services, is one of the big keys to ensuring that stigma and other barriers to health and wellbeing are addressed, and people can get the supports they need.”

Access Alliance has recently applied for additional funding to action recommendations from the report, including the development of a centralized intake system to support community members in connecting to the wraparound services that result in positive health outcomes and equitable care. In addition, the report demonstrates that when the research process is community-led, the information that is generated from research can provide immediate benefits. Wilma Miravalles, one of the community research participants, was a direct beneficiary of knowledge collected for the report.

Born in the Philippines, Wilma has first-hand experience of the impacts that TB stigma can have on an individual. “I have a family member that has TB and we always distanced ourselves from him—being in this study really opened my mind, and I shared the information with my family in the Philippines,” said Wilma Miravalles, Community Research Participant. “If I had this knowledge about TB I would say that I would have acted differently as it relates to TB. All this information about TB changed our mind—I had so much fun doing the study because I learned a lot.”

While the report highlights TB and its impact on newcomer populations, disease-related stigma and the factors that pose barriers to accessing comprehensive healthcare go beyond TB. Access Alliance is currently producing an issues report on reducing inequities in cervical cancer screening among newcomer women, which explores self-screening as an alternate modality to Pap tests. While the report has not yet been published, research has found that stigma surrounding the topics of sexuality and sexual health, among other factors, result in newcomer and immigrant women having a significantly higher risk of being under-screened for cervical cancer compared to Canadian-born women.

In the case of both TB and Cervical Cancer screening, community-based and culturally responsive care pathways are necessary to ensure positive health outcomes for immigrant and newcomer communities. Developing these pathways will result in systemic change, and meaningfully engaging community members in the research that is required to develop effective programs can provide immediate benefits for those individuals and their peers.

Additional products, including Fact Sheets for key stakeholders, are available in English and French on Access Alliance’s Tackling TB Stigma page.