YOUR WELLBEING

A COMMUNITY-LED APPROACH TO PUBLIC HEALTH

CDC on Unsplash.

United Way Greater Toronto’s latest research surfaces learnings from COVID-19 responses to address critical issues facing communities. 

The research series, Collaboration, Cooperation, Co-Creation: Case Studies of Social Service Innovations During COVID-19, was authored by United Way Greater Toronto in partnership with the Canadian Philanthropy Partnership Research Network (PhiLab) 

Among the agencies it worked with is Apna Health, which helps advance health equity in the South Asian community in Peel region with community ambassadors. 

Peel is one of the most diverse regions in Canada, with the highest percentage of visible minorities in the GTA. In Brampton and Mississauga, which together account for more than 90 per cent of Peel’s total population, racialized peoples comprise 57.2 per cent and 73.3 per cent of their respective populations.

Excerpts from the report:

Like other public institutions, the mainstream healthcare system has not kept pace with Peel’s changing demographics. Few healthcare facilities incorporate culturally informed practice models targeted at specific communities. Community advocates feel healthcare institutions are unrepresentative of the communities they serve, and this creates systemic barriers to addressing community-specific health challenges and inequities.

Health disparities impact health outcomes of specific racialized groups across the region, with people of South Asian descent experiencing higher rates of diabetes, cardiovascular disease and lower cancer screening rates.

This same community has been disproportionately impacted by the COVID-19 pandemic: While South Asians account for 31.6 per cent of Peel’s population, they accounted for 45.1 per cent of cases in the region during the first wave of the pandemic.

Traditional public health measures were not effective for this population and, according to community advocates, resulted in misinformation spreading and low compliance with safety protocols.

Observing the dual threat of strained resources coupled with limited cultural expertise or practice models in Peel Public Health’s early COVID-19 response, social service agencies with deep roots in the South Asian community stepped up.

Apna Health was created by Indus Community Services and Punjabi Community Health Service to increase testing and vaccination uptake in the South Asian community by offering credible information, personal protective equipment (PPE) kits, transportation to clinics and wraparound supports addressing barriers related to housing and food security. The organizations hired community health ambassadors – residents who speak the dominant language of the community and understand cultural practices – to lead this work. 

Indus Community Services (Indus) is a multi-service agency providing culturally appropriate services to the South Asian community in Peel. For more than 35 years, it has provided services to newcomers, families, women and seniors, and plays a strong role in local community development efforts. Indus is a strong advocate for the South Asian community.

Punjabi Community Health Services (PCHS) provides health, settlement and social services to the South Asian community in Peel, including seniors, children, youth and families. Its mission is to improve the well-being of the individuals, families and communities it serves using an anti-racism and anti-oppression framework. PCHS has been in operation since 1990 and has also become a strong voice for the South Asian community.

Indus and PCHS have a long history of working together, having collaborated on several successful initiatives and working groups. Serving similar populations in overlapping catchment areas, Indus and PCHS offer some shared programming and otherwise coordinate services to leverage resources and avoid unnecessary duplication. The two organizations divide responsibilities on an issues basis, with Indus taking on responsibility for long-term care while PCHS leads on mental health and addictions supports

In 2018, Indus and PCHS jointly produced Our South Asian Health & Wellness Strategy for Ontario, a strategy identifying root causes of health inequities among Peel’s South Asian community and laying out recommendations across 10 priority areas for action.

Several of the recommendations in the strategy are related to the need for more culturally responsive services and include actions like creating a website or online portal with culturally specific diabetes information and resources, hiring staff who can speak South Asian languages and creating public education materials in South Asian languages to strengthen existing supports for victims of gender-based violence, among others.

In 2018/2019, PCHS developed and implemented a culturally responsive community ambassador engagement model to increase breast cancer screening rates among South Asian women. 

Co-founded by Indus and PCHS, in collaboration with the Council of Agencies Serving South Asians, Apna Health was launched in September 2020, offering supports in English, Hindi, Urdu, Tamil, Bengali and Punjabi.

They developed a hyper local community health ambassador model focused on both disseminating accurate COVID-19 information, resources and PPE kits to South Asian residents at malls, shops and door-to-door in COVID-19 hot spot neighbourhoods, and identifying unmet needs that they or others could help address. 

With provincial funding confirmed by late January 2021, Indus and PCHS hired South Asian community health ambassadors fluent in a range of languages and cultures and launched their community ambassadors programming.

Yet, funding was slow to materialize, with instalments chronically delayed, forcing both agencies to draw down their reserves to manage cash flow and sustain programming. Funding agreements were confined to three-month intervals, constraining agency contracts with the community health ambassadors themselves.

Despite the challenges, Apna Health and the community health ambassadors made a solid imprint in the community, contributing alongside other efforts, to decreased rates of COVID-19 infection in Peel’s South Asian community.

Going forward, Indus and PCHS plan to expand Apna Health to cover more health issues of relevance to the South Asian community, including heart disease, cancer screening and diabetes. Their shared vision is for a comprehensive virtual hub that provides health information and resources about and for the South Asian community across Canada. 

“The community knows itself very well,” says Baldev Mutta, CEO, Punjabi Community Health Services. “If we have a public health approach toward prevention, the community members should be involved in their prevention. So, if we are implementing within the South Asian community, the problems identified by the South Asian community need to be understood by health professionals. If we do not involve the community in the prevention aspects, then the mainstream approach will not work.”

United Way Greater Toronto is working with Indus Community Services and Punjabi Community Health Services in the following ways:

Indus Community Services

• Providing five-year Anchor grant funding.

• Providing five-year Building Strong Neighbourhoods Strategy.

• Development Grant funding.

• Supporting participation and leadership in the Peel Community Benefits Network, co-convened by United Way and the Region of Peel.

Punjabi Community Health Services

• Providing five-year Anchor Grant funding.

• Supporting participation in the South Asian Community Advisory Council, convened by United Way to help identify and address needs, strengths and service gaps facing the diverse South Asian community.