Author: Ace Sang-Yong Ko
Dr. Bruce Newbold is the Associate Dean of the Faculty of Science at McMaster University, as well as a Professor at the School of Environment and Society. He is a member of the McMaster Institute on Aging, and his research involves the various intersections of health: Primarily around aging and the health of immigrants to Canada. He is also a Visiting Scholar at the University of Glasgow, and the University of California San Diego.
Today, we had the pleasure of interviewing Dr. Newbold on his recent work, common misconceptions around immigrant health, and his advice for students hoping to pursue similar research.
How did you come into this work, from an academic perspective? Specifically: The intersection of health, immigration, and aging.
As a PhD student, I was interested in migration, the movement of people across space, as well as the determinants. Why they did it, when they did it, and what were the reasons for it? It gets into economics.You know, are they moving for money, a job, a family? And it changes as people move through their lifespan. Post-PhD, I thought Okay, well, immigration is movement as well. So I started looking at immigration into Canada and settlement. And then, you know, the benefits to communities, and that sort of led into the health. The health aspect of immigration, and understanding that. So it's sort of snowballed over time. Migration, international migration, health of migrants. That sort of thing. So and along the way, adding the nuance of, you know, maybe it's, it's refugee populations–Or the older adult piece. It's understanding these sort of segments within the population.
Right. So I suppose the interest sort of grew organically, I suppose.
Yeah. And, I find that you do some research, right? And you have some answers, but then you say, well: “I don't understand this part,” or perhaps, “What's the nuance here that we can find?”
And that has, has long driven my own research agenda: That next question. You know, what are the questions that come out of the questions that you've answered.
The research never ends I suppose..
Exactly, exactly.
And filling as many of the gaps as possible?
Yeah, that's certainly part of it and where you can fit in. It's changing or just evolving interest. Part of my research agenda has been driven by that increased awareness and focus on immigration into the country. Part of it now is because of the aging population, and we see that as dominating headlines. So there's my own interests as well as what's happening in the broader society around me.
Would you say that aging is a current gap in the literature?
Well, there is a fair amount of work that's happening in the space: What does it mean from a cultural perspective? What does it mean from an economics perspective? These aren't questions that I'm looking at, precisely. But there's lots of people that are quite engaged in the aging population. There's actually a fairly long record or history of aging work here at McMaster.
Right.
The M-I-R-A, I believe. Yeah. Then before that, there's a large program that came out of economics that focused on the aging population. It was called SEDAP, I think: Program for Research on Social and Economic Dimensions of an Aging Population.
Incredible! On that note: What are some recent projects you’re focusing on?
So one of my most recent projects. I just had funding this past spring: So, spring 2024. This is looking at older adults and their residential choices as they age, and what both drives or allows them to stay in the place where they are currently living: or what drives them to move. And I think, you know, there's there's a general sense that, okay, as we age and we lose functional ability, then we're more likely to focus on, say, a retirement home or consider moving into that. But I think it's more nuanced than that. So trying to get an understanding of, of this older, older adult mobility and the changes that they, they go through and the thought process that they're going through for sure.
I see. What are some common misconceptions people have about your research?
Well, I think one of them is, you know, when we were taking a look at the use of healthcare facilities by immigrants, you would think there is a potential for abuse. And actually we saw that there wasn't. It's interesting, because we see that people would say “I have a need for health care,” but they're not necessarily accessing that health care. So they're not using the healthcare system. And so there's this disconnect. And you know, I think that in part that reflects a lack of awareness, right? A lack of knowledge about how to access this system for sure. And, and it could also, you know, lack of insurance or lack of funding, like money to support it.
Do you have a specific method for approaching these complex topics?
Where possible: We've sort of asked smaller scale, detailed questions. So, for example, we've done some work on refugee women and their resiliency. We've taken a look at the use of maternal childcare services, or preferences in terms of child delivery amongst newcomers to the country, for example. That work has been done at the national scale, using large scale data sets. We've also done a lot of work at the community level in Hamilton, and qualitative research. And you know, the two give different results: Not different answers, but different details.
So you can get a general overview, general insights from a national survey, say a census or other related surveys. And then when you do qualitative work within the city, you get the lived experience. These are details associated with how individuals say, navigate the healthcare system once they arrive, how they understand it: What are the barriers to that? So it's deeper, more nuanced. I've been involved, as you noted in the McMaster EMBOLDEN study. And so that's an ongoing piece in the city that's not necessarily directed just to newcomers, but to vulnerable populations in part, in general, older adults. And, you know, trying to engage them around their physical fitness and health. And I guess that, in part, both of those reflect a broader interest in health and aging that I have, and I've done that for some time now.
What are other barriers that immigrants face to accessing healthcare?
Another piece we saw, and this is more problematic, I think: Is that the barriers are not only amongst older adults, but amongst adults in general. We found new arrivals didn't pursue screening: Regular cancer screening procedures. So, you know, for women, breast cancer or pap tests, and for men, prostate cancer tests. So they weren't taking advantage of that. And we know you know: If you catch it [cancer] early, you're much more successful in terms of treating it. So then, you know, if it's not caught then there's greater health and personal implications further down the road. So there you know, what we were seeing in part is a cultural piece. And then here again, a lack of awareness that “Yes, I'm this age, I should be having this screening done as a preventative check.”
The other piece that was really interesting too, is around mental health. So, you know, we talk a lot about mental health support and the need for mental health care within our population. It's a topic that's much more openly discussed than even, you know, ten, twenty years ago when it was still “We don't we don't talk about that.” But for some immigrant groups, due to their not talking about it, it becomes a stigma , or it's just not recognized. For that and again, you know, that brings personal costs, personal burdens or family burdens, as newcomers try to sort of for sure deal with that, but without professional assistance.
Right. Would you say that there’s also a lack of trust? I remember that my grand-aunt ended up waiting for… Two weeks? After falling down the stairs, because she wanted my dad’s advice at a family reunion.
Well, that's a good point: There is also a lack of trust. And especially for people that are here potentially in more precarious situations, such as refugee claimants, asylees. Or people that don't have a legal status within the country yet. They're not going to seek care because it could compromise their ability to be here. So it's just not sought out: You know, care isn't isn't looked for.
The other thing that you mentioned is something that, you know, we see again and again. You mentioned your father providing that sort of guidance to your grandmother. But that's a very common thing where, you know, the children of new immigrant arrivals, are the ones in a doctor's office and doing translation services between their parents and the doctor.
And that can be a really uncomfortable situation, as you can imagine, if you’re talking about personal health issues. All of a sudden, it's now being filtered through somebody that maybe is twelve, thirteen. You know, there's a need to talk. But at the same time you don't necessarily want to talk about intimate details.
I suppose this is more nuanced than people expect, especially in this political climate (with recent restrictions against immigration).
It's very detailed and you know, too often we just sort of gloss over or try to provide something that isn't correct, isn't true. I think, in today's political climate, work like this is increasingly, or even or just as relevant, as it was before.
That's amazing. On that topic, I wanted to ask: What advice would you give to prospective students hoping to follow a similar career route as yours?
Part of it in being a researcher is just being curious, asking questions. Then there's a chance that somebody will have taken a look at it, but not necessarily in the same way, or find your passion in it. What are the things in society that interest you, that drive your own curiosity? Pursue that: because I think if you've got a feeling that you've got a personal stake in it, it makes it that much more relevant. So it could be your own experiences that drive a question, or the experiences of family members or of a particular group. That's one way that drives research curiosity.
Thank you. That was very informative. I really appreciate your time, and I hope you have a wonderful day.
Thanks, you too.
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