Examining the health impacts of under/unemployment among highly-skilled recent immigrants in Canada

1. Examining the health impacts of under/unemployment among highly-skilled recent immigrants in Canada Metropolis Brown Bag Seminar August 10, 2010 Jennifer Asanin Dean, PhD Candidate School of Geography and Earth Sciences McMaster University Kathi Wilson, PhD Department of Geography University of Toronto Mississauga

2. Presentation Outline • Immigration in Canada • Employment and Health • Context for this study • Study participants • Results • Importance of findings • Policy recommendtions

3. Immigration in Canada • 200,000+ immigrants/year • 18% of Canada’s total population • 28% in Ontario; ~50% in City of Toronto • 60% population growth, expected to be 100% by 2025

4. Immigration in Canada • Permanent Immigration categories • Economic Immigrants (skilled workers, entrepreneurs) • Family Class (reunification) • Refugees (UN, landed, sponsored) • Other (humanitarian) • Skilled Worker Program • ~50% of all immigrants • ‘Point System’ • ~55% in natural and applied sciences (IT and engineering)

5. Skilled Immigrant Employment • High rates of under/unemployment • 46% say finding employment is biggest settlement challenge (LSIC) • 50% still searching for work 2-4 years after arrival (LSIC) • 60% of immigrants work is jobs for which they are overqualified (TRIEC, 2006) • ‘survival’ jobs (taxi drivers, cashiers, factory workers) • Recognized barriers to employment • Unrecognized credentials (education, employment experience) • Delayed assessment by professional associations • Lack of Canadian work experiences

6. Immigrant Employment in Canada

7. Employment and health • Employment/working conditions - key determinant of health • Those employed have better health than those who are unemployed • Employment fosters health • Selection and ‘Healthy Worker Effect’ • Very little research on immigrants in the Canadian Context • Mainly quantitative research

8. Immigrant health • Healthy Immigrant Effect (HIE) • Upon arrival, immigrants have better health than Canadian-born population • All-cause mortality, chronic diseases, self-reported health, depression, disability • Why? • Selectivity of migration • Medical screening process

9. Immigrant health • Decline of HIE • At par with or lower than Cdn-born population • Increases in BMI, heart disease, arthritis, diabetes • Potential Causes • Acculturation (Adoption of unhealthy behaviours) • Access to health care services (various barriers) • Social determinants of health

10. Research Objectives What is the relationship between under/ unemployment and health among skilled immigrants in Canada? • What are the employment experiences of highly-skilled immigrants? • How do immigrants perceive their health as being influenced by their employment circumstances?

11. Community Partner • Dixie Bloor Neighbourhood Centre (DBNC) • Employment and settlement are among services provided • High risk neighbourhood in Mississauga, ON • Immigrants make up 53% of total population

12. Recruiting participants • Recruitment through a DBNC employment program • Foreign trained professionals, un/under-employed, less than 3 years in Canada • The Mentoring Partnership Program • Toronto Region Immigrant Employment Council (TRIEC) funded by Maytree Foundation

13. Interview Participants • 22 participants • 16 males • Majority 35-54 years old • 9 countries (India, Pakistan) • 17 in Canada less than one year • 20 had university degrees • Top three fields • Business (banking/finance) • Engineering (mechanical) • Computers (IT/programming)

14. Results: Employment Experiences

15. Job expectations • Expectation that employment in field will be easy, fast, inevitable “My expectations are that I’ll be getting good job in my field, since my skills should be internationally accepted. Aviation is the same all over the world… so [my experience] will be accepted is what my expectation is.” (Male, Aviation Maintenance, 10 days)

16. Job expectations • Experience that finding employment in field is a difficult and lengthy process • 12 unemployed • 10 underemployed (6 during interview) • Labourers, cleaners, cashiers, dishwashers “If you start doing survival job then you are not going to get time to search for your good job, core job, that also you don’t want to do. So it’s a little bit of sticky situation.” (Male, Business Developer, 6 months)

17. Taking up ‘survival jobs’ • Fluid nature of survival jobs • Time, money, pride “I hate to say this but I refuse to do that kind of work. I have been an esteemed professional back home and all over the world and I am not doing a labour job. I feel bad to say it but I won’t do it. It is not something I am willing to face. I will leave before I do that kind of work.” (Male, Investment Banker, 3 months)

18. Job expectations • Mismatch between beliefs and realties • Deception on behalf of government and agencies abroad “The problem back home is the people do not exactly know what is waiting for them in Canada…they get lured by the agencies. The agency shows them the list of jobs that are available so people think that because of their qualifications and experience they will get a job.” (Male, Mechanical Engineer/Professor, 1.5 years)

19. Barrier: Unrecognized credentials • Most often cited concern for immigrants “When we say we are getting immigration from the skilled category, it’s a bit of irony because our certificates are recognized when we put in our application for our immigration, but the same thing is getting turned away when we go knocking the doors for the jobs.” (Male, Software Engineer, 8 months)

20. Barrier: Canadian Experience • Most frustrating barrier “It’s a catch 22 situation. One of the prospective employers I had an interview with asked me about my Canadian experience. These are the questions they always ask me, and so I said ‘I will get Canadian experience if you give me job.’ but then they say ‘I’m sorry, you need to get Canadian experience then come to me’. This is the biggest problem that we are facing here…” (Male, Investment Banker, 1 year)

21. Barrier: Assessment of credentials • Limited to certain professionals (teachers, engineers) “You have to get a license here before you can teach. So I have applied to the Ontario College of Teachers and they are evaluating my credentials. It’s taking a long time too…they told me it takes about 4-6 weeks to complete but now it has been 4 months since I sent them my full file. Whenever I call them, they are still evaluating me.” (Male, High School Teacher, 6 months)

22. Barrier: Lack of Canadian Network • Not cited in previous research • Canada’s hidden job market “We don’t have a network here, and they [job counselors] told us 80% of the jobs are hidden and so you have to establish a network. Network does not come overnight … Back home, I know a lot of people but here I don’t know anybody.” (Male, Computer Programmer, 2.5 years)

23. Significance of employment findings • Mismatch between expectations and experiences • Understanding of ‘survival’ jobs • A fourth barrier to employment • Insight into experiences (frustration, depression, desperation, willingness to leave)

24. Results: Health Impacts

25. Mental Health • Stress, frustration, irritation, depression, inability to sleep, anxiety, constant worry, unhappiness “Not finding work in our line after so much time, it impacts our health, it creates confusion, disappointment, delusion, disillusionment and it creates a lot stress in both the personal and professional life.” (Male, Mechanical Engineer, 4 months)

26. Lack of Income • Financial savings deplete over time • Family responsibilities “I’m concerned and worried about how to keep an income because when you have a family you have to worry about this constantly… you have to find a solution. So this career situation really affects my health… mostly it is the stress and worrying.” (Female, Business Manager, 6 months)

27. Lack of employment related skills • De-skilling • “Cream of the crop” “They brought us as professionals and we are driving taxis and working in labourjobs, and this is not fair and not healthy. It’s a waste of skills. If we start doing these things we will be away from our career, we will be away from our experience, we will lose everything we know… That is not good for Canada and it is not good for our minds.” (Male, IT Director, 4 months)

28. Loss of of Social Status • Professionals, breadwinners, contributors “It is not my field so I don’t feel like I am happy with this job… From the first day I got there, I just think to myself ‘what the heck am I doing here?’ I am an IT guy and I am professional and I have already done a couple of projects, huge projects for several millions of dollars and I am doing these garbage things here. So I give my notice to that job, I don’t care. Now I’ve reached a point, I will leave the country. I give it four more months and if I do not find something I will leave the country. I don’t care.” (Male, IT Director, 4 months)

29. Family impacts • Family members in Canada “Thinking all the time about these negative [work] things, has an affect on the kids also. They sense your stress and the adult situations get tense with the arguments in the home. So you can’t do that in front of the kids when they are small but sometimes you cannot help this…” (Male, IT Manager, 1.5 years) • Family members abroad “I think even if I don’t find job, I have to bring them [family] here somehow because I can’t take too long without them. It is very difficult to stay without them for one more year… I feel lonely, because I don’t have the family, it is very difficult you know. The emotional support… even if I do odd jobs, at least I have the kids and the wife. There is some kind of relief. “ (Male, Investment Banker, 1 year)

30. Physical Health • physical pain, weight loss, high blood pressure, physical strain • Results of: • High levels of stress • Physically strenuous work conditions

31. Level of stress • Stress results in physical pain “Before when I was sick, I would go to work and actually it made me stronger. Go to work, and I don’t feel like I am dead. Now, I cannot move, I have to sleep more, my back is hurting me, my neck is hurting me and… it kills me. One day my back has pain, everything has pain and this is the first time in my life it happened because I am not working. So work is very important for health.” (Male, Computer Programmer, 2.5 years)

32. Working conditions • Physically strenuous work conditions • Lifting, standing, moving for long periods of time “I worked once, one day in the factory. I thought maybe it is time to start getting some income but the next day I could not get up from bed, really bad back pain, for two days. I was not able to move really. So I quit that, I had to stop.” (Male, Investment Banker, 1 year)

33. Access to health care • Canada’s universal health care system • Many extended benefits through employer • Avoidance of important health care services • Dental, eye care, prescribed medication • Caused by: • Cost of receiving health care • Wait period for provincial health insurance

34. Significance of Health Findings • Similarity among general population and immigrant population • Stress associated with unemployment (general) • Limited access to health care services (immigrant) • Impact on family members (general & immigrant) • Some health concerns unique to skilled immigrant population • Loss of employment related skills and social status • Unfamiliarity with physically demanding work

35. Additional Findings • Employment and health relationship • Selection may not be relevant to immigrants • Healthy Immigrant Effect • Employment as explanatory factor for initial declines in health status • High levels of negativity about Skilled Worker Program • determinant of health for immigrants

36. Public response • Underworked, unemployed and under the weather Toronto Star (Aug 4/09) “I have also been unemployed in the past. I am also stressed, worried, despairing and feeling worthless. And guess what? I was born and raised here!!” “…And when Canadian employers refuse to recognize their hard-won credentials, what keeps them here, when their prospects seem so much better back home? Just wondering.”

37. Why is this important? • Immigrants are an increasing portion of the population • Contribute to population growth, economic growth, national identity • Equality in standards of living/quality of life within Canada’s population (Canadian or foreign-born)

38. Policy Recommendations • Local: • Offering mental health services at neighbourhood/health centres • Enhance employment programs (redundancy, locations) • Provincial: • Target regulatory bodies to change assessment practices • Reveal job market- databases of jobs; list immigrant-friendly employers • Federal: • Create awareness about employment situation to applicants • Assess credentials prior to entry • Offer incentives to businesses to hire new immigrants • Promote a culture that values international experience vs ‘the Canadian way’

39. Questions or comments? Thank you