ncovering the Complexity of Food/Nutrition, Physical Activity and Mental Health among Arab Immigrants/Refugees in Ontario, Canada: The Can-Heal Study

Abstract

This doctoral dissertation explores the complex food/nutrition, leisure physical activity (LPA) and mental health (MH) needs in Arab immigrants/refugees (AIR) in Ontario, Canada. The main goal is to improve the MH and well-being of AIR. The CAN-HEAL (Canadian Arab Nutrition, Health Education and Active Living) project used a collaborative community-based participatory research and integrated knowledge translation approach, and triangulated data from three different methods (qualitative interviews, Photovoice, and a questionnaire survey) to enhance study rigour. A primary finding of this research is that food/nutrition, LPA, and MH needs in AIR are multi-layered and vary considerably according to intersectional experiences, cross-cultural pressures, living conditions and racism. The research found an alarming prevalence of poor mental well-being (55%), food insecurity (65%) and low LPA levels (87%) in AIR participants (n=60). Among first-generation immigrant participants, 87% reported negative changes in MH since immigration. These negative changes are not straightforward; they are complex and dynamic, and mainly related to structural barriers, poor living conditions, and system failures to accommodate the distinct cultural needs of the AIR community. Intersections among different socio-demographic factors (e.g., gender, length of residency, income, parenthood, religion, immigration status), amplified the negative changes in MH, and played a considerable role in how nutrition, food security and LPA impacted AIR’s MH, exacerbating inequities within the AIR community. This research shows that the relationships among food/nutrition, LPA and MH among AIR are multi-faceted, and that there are various psycho-socio-cultural pathways and processes through which diet quality, cultural foods and LPA can contribute to shaping AIR’s MH. As part of this research, an upstream-downstream-based socio-political and community-level action plan was co-developed to thoroughly address the complex needs among AIR and to work towards health equity for this marginalized population. Collaboration between health and non-health sectors is required to effectively implement this action plan.