Religious Identity and Health Inequalities in Canada

The Effects of Sociocultural Transitioning on Accessibility to Healthcare: The Case of Haredi Jews Who Leave Their Communities

Minority groups and immigrants encounter complex issues when attempting to access healthcare. This study examines factors affecting access to healthcare by a group of individuals in Israel who decided to leave their Haredi Jewish communities. We conducted 23 semi-structured interviews with individuals disaffiliating from Haredi communities in Israel in order to identify hurdles encountered during the process of seeking healthcare. We focused on specific steps in this process, including recognizing the need for help, deciding to actually turn to the health system, interaction with the system, and behavior after referring to the health system. We identified approximately 20 factors which can be either barriers or catalysts affecting healthcare access at the various stages. These were then traced to religious upbringing, hurdles of sociocultural transition, and unique characteristics of individuals reshaping their lives. The findings can be instrumental in designing culturally adapted health programs for individuals leaving the Haredi community. Moreover, the methodology that we are proposing can serve other investigations studying access to healthcare among various groups undergoing sociocultural transitions.

The Influence of Religiosity and Spirituality on Health in Canada: A Systematic Literature Review

The association between religion and health has been the subject of growing interest in academia. However, limited reviews of such studies in Canada exist. The paper systematically reviews and synthesizes existing literature on the relationship between spirituality and health in Canada. Available general databases such as: Medline; Web of Science, PubMed, Sociological abstract, Social Service Abstracts, Google scholar, Humanities International Index, JSTOR, CPI.Q Canadian Periodicals, and American Theological Library Association were searched for the period between 2000 and April 2019 inclusive. Collected data were then systematically analysed for common themes about spirituality and health in Canada. In total, 151 articles were found, but only 128 had relevance with the study objectives. Overall, the analysis showed that religion and spirituality do influence health behaviours, and well-being. However, more gender-based studies need to be conducted to tease out the differences in religion/spirituality and health across different genders, and ethnic groups in Canada.

Which Non-Pharmaceutical Primary Care Interventions Reduce Inequalities in Common Mental Health Disorders? A Protocol for a Systematic Review of Quantitative and Qualitative Studies

Common mental health disorders (CMDs) represent a major public health concern and are particularly prevalent in people experiencing disadvantage or marginalisation. Primary care is the first point of contact for people with CMDs. Pharmaceutical interventions, such as antidepressants, are commonly used in the treatment of CMDs; however, there is concern that these treatments are over-prescribed and ineffective for treating mental distress related to social conditions. Non-pharmaceutical primary care interventions, such as psychological therapies and "social prescribing", provide alternatives for CMDs. Little is known, however, about which such interventions reduce social inequalities in CMD-related outcomes, and which may, unintentionally, increase them. The aim of this protocol (PROSPERO registration number CRD42021281166) is to describe how we will undertake a systematic review to assess the effects of non-pharmaceutical primary care interventions on CMD-related outcomes and social inequalities. A systematic review of quantitative, qualitative and mixed-methods primary studies will be undertaken and reported according to the PRISMA-Equity guidance. The following databases will be searched: Assia, CINAHL, Embase, Medline, PsycInfo and Scopus. Retrieved records will be screened according to pre-defined eligibility criteria and synthesised using a narrative approach, with meta-analysis if feasible. The findings of this review will guide efforts to commission more equitable mental health services.

With a little help from my (Canadian) friends: Health differences between minimal and maximal religiosity/spirituality are partially mediated by social support

RATIONALE

Higher levels of religion and spirituality (R/S) are associated with better health in both Canadian and American samples. One mechanism that can account forthis relationship is social support, which is positively associated with higher R/S and is positively associated with overall wellness. Although social support has been found to mediate the relationship between R/S and health in American samples, parallel research on Canadian samples is lacking.

OBJECTIVE

While having cultural similarities, Canada and the United States have noteworthy differences with respect to religion, politics, and demographics. Consequently, it is problematic to assume that social support accounts for the R/Shealth relationship for Canadians. The goal of the current study was to explore whether social support mediated the relationship between R/S and health outcomes.

METHOD

Using individuals ≥20 years of age from the 2012 Canadian Community Health Survey - Mental Health component (N ≥ 9043), we isolated people who had either the lowest or highest possible score on a composite measure of R/S. We then compared 'minimal R/S' respondents to 'maximal R/S' respondents on 11 health outcomes and investigated if these health disparities attenuated when accounting for differences in social support.

RESULTS

Maximal R/S was associated with better health for nine of the tested outcomes, but seven of these relationships were attenuated when social support was added to the model. The two remaining outcomes, drug abuse/dependence and alcohol abuse/dependence, were not significantly impacted by the inclusion of social support.

CONCLUSION

Social support plays a mediating role in many R/S-health relationships for Canadians. Although R/S appears to have a statistical relationship with many health outcomes, several of these lack practical significance.