Canadian Public Health Association Halifax, 2008 Caregiving in the Context of Intersecting Inequities: African Nova Scotian Women Canadian Public Health Association Halifax, 2008 Barbara Clow, PhD Wanda Thomas Bernard, PhD Josephine Etowa, PhD

Overview Population (s) Project (s) Race, class, gender and unpaid caregiving Conclusion

Population(s) Description Indigenous/immigrant Rural and urban Diverse Determinants of health Nova Scotia has a relatively small population of newcomers from African or Caribbean countries, but it is home to the largest population of indigenous African Canadians in the country ** NOTE re Indigenous – 2-3% of NS population and 57% of visible minority population -- 66% of African Nova Scotians live in Halifax while most of the remainder live in communities along the south and west shores -- 91% of African Canadians living in Halifax are Cdn-born Diverse population – some have roots in the province dating back to the American revolution – or subsequent waves of immigration in the 18th/19th centuries – some identify as Loyalists and some do not – many have a shared history of slavery and segregation Lots of intermarriage with Mi’kmaq and Caucasian populations, different religious and cultural beliefs History of racism and discrimination that continues to this day With implications for health and well-being – more likely to live in poverty, be unemployed or underemployed, have lower income, levels of education And we have little data on health status, health care delivery and health care utilization

Project(s) Description Focus groups Caregiver portraits Equity reference groups Two caregiver portraits – both for women of African descent based in Halifax

On the Margins Community consultations Questionnaires Other project I am drawing data from is OTM 3-year CIHR funded project – focused on African NS women and families in communities along south and west shores -- with 3 main objectives -- method was PAR -- community facilitators quantitative and qualitative data collection 237 in-depth interviews Community consultations Questionnaires In-depth interviews

Black Women Caregivers Unpaid caregivers tend to share certain experiences See added sheets Women of African descent in Nova Scotia also share specific experiences and perspectives

Intersecting inequities and unpaid caregiving

Interesting that many participants recognized this situation as untenable – African NS communities experiencing the same outmigration of youth as other communities in the Atlantic region and same aging as most other populations in Canada, same shift in labour with more women employed outside of the home So next generation may not be available to look after aging population-- As one participant said, “I keep thinking to myself, I’ve gone through this with all these people but who is there for me?” Also recognition that the ideal of the strong black woman is a myth –cannot do it all for everyone for always – as women unable to keep up – need to find alternative solutions A HBRP particpant said she just assumed that her own children will not be able to look after her and she says she thinks that older people in the Black community are increasingly likely to feel comfortable with the idea of a nursing home – but important to note that she has always lived in Halifax, where both family and friends would be nearby to a nursing home But same sentiments may not be reflected among African NS living in rural and remote communities – where activities and values reflect identity “It has to do with who you are as a people” said one participant – and where lack of and distrust of existing services is deeply entrenched

Thank you Gail Jarvis and Fay Cromwell -- health promotion for African NS women, their families and communities