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Break down barriers - Introduction 

From Chapter 1, "Break down barriers," in Culture Counts: A Guide to Best Practices for Developing Health Promotion Initiatives in Mental Health and Substance Use with Ethnocultural Communities (© 2007 CAMH)

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Take a look at these numbers from the 2001 census:

  • 18% of Canada’s population is foreign born, the highest proportion in 70 years
  • the number of ethnic groups in Canada has exceeded 200
  • during the period of 2001-2005, almost 80% of new immigrants arrived from Asia, Africa, the Middle East, and South and Central America.

Now more than ever, Canada is a multicultural society. Multiculturalism is the view that all cultures are equal in value. Using a “one size fits all” approach to health promotion is not only ineffective, it does not support the idea of equity.

Many are aware of the need to create health promotion initiatives in mental health and substance use specifically for particular ethnocultural communities but are not sure how to go about it. It may help to start by thinking about the barriers that often exist between ethnocultural communities and access to health services and health promotion initiatives.

Ethnocultural communities face barriers in healthcare and health promotion

Language may seem to be the most obvious barrier faced by ethnocultural communities and health promotion, but there are many more. Studies suggest that ethnocultural communities:

  • are relatively vulnerable to mental health and substance use problems due to pre-migration trauma, economic and social disadvantages, isolation, racism, discrimination and cultural pressures
  • generally lack needed knowledge of mental illness and the harmful effects of drugs
  • are less likely to take part in health promotion, prevention and treatment programs
  • are less likely to receive needed care than the general population due to barriers, which include language and cultural factors, discrimination, stigma and mistrust of mainstream service providers.

Health promotion initiatives created for the general population often do not work for ethnocultural communities

A literature review (PDF) done for the Culture Counts project found that many studies drew similar conclusions about why health promotion initiatives often do not reach ethnocultural communities:

  • Concepts that reflect the mainstream culture are often not directly transferable to communities with different cultural backgrounds.
  • The majority of health education materials and programs only reflect the cultural values of the majority group.
  • Ethnocultural communities suffer a greater loss to their overall health and productivity because health services often do not meet their needs.
  • Lack of English or French and literacy skills, different cultural norms and beliefs, differences in communication styles, stigmatizing attitudes, plus racism and discrimination often prevent members of ethnocultural communities from getting involved in health promotion activities.*

Clearly, many barriers stand between ethnocultural communities and health promotion initiatives created for the general population. By taking a closer look at the causes of some of those barriers, we can begin to work towards breaking them down.

* Source: Centre for Addiction and Mental Health: “Culture Counts: Best Practices in Community Education in Mental Health and Addiction with Ethnoracial/Ethnocultural Communities; Phase One Report”  (October 21, 2004) PDF (Canada)

To learn more about health equity and ethnocultural communities:

In Culture Counts: A Guide to Best Practices for Developing Health Promotion Initiatives in Mental Health and Substance Use with Ethnocultural Communities

About this guide

Chapter 1 – Break down barriers

Chapter 2 – Work with community partners

Chapter 3 – Gather and analyze information

Chapter 4 – Plan the initiative

Chapter 5 – Translate and adapt

Chapter 6 – Put the plan to work—and keep it working

Chapter 7 – Follow up





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