Thesis Format
Integrated Article
Degree
Doctor of Philosophy
Program
Health and Rehabilitation Sciences
Supervisor
Donelle, Lorie
Abstract
This dissertation investigates the healthcare access and experiences of older adult Arab immigrants and family caregivers in Ontario, Canada. Guided by critical constructivist grounded theory and a critical ecological systems framework, the study addresses how factors intersect to shape health care navigation. The research highlights the unique barriers faced by Arab immigrants, including a lack of linguistic and culturally congruent services, system navigation challenges, and the pervasive influence of Orientalist stereotypes. These stereotypes, rooted in regressive and racialized perceptions of Arab populations, inform public and health care provider attitudes, further complicating access to equitable care.
This research provides a critical ecological perspective, analyzing how micro-, meso-, exo-, and macro-level systems influence health care access. Incorporating family caregivers’ perspectives broadens the understanding of the ecosystem in which older adults function and highlights the caregivers’ essential role in health system navigation. The dissertation also explores the researcher’s positionality, applying a post-colonial lens to examine insider and outsider dynamics within the research process. This reflexive approach acknowledges the colonial histories academia and the research process.
Both older adult immigrant Arabs and family caregivers negotiated their visibility and being seen in the context of accessing health care. The subcategories co-constructed and grounded in the data resulted in the grounded theory of being seen. The 4 subcategories included: 1) Being seen as family, 2) Being seen by the Arab community, 3) Being seen in their countries of origin, 4) Being seen as foreign. We also explored how Arab older adult immigrants and family caregivers describe their relationships with their family doctors. They described sharing community with Arab family physicians as facilitating care. However non-Arab family doctors were able to establish effective relational practices.
Summary for Lay Audience
This study explores how older adult Arab immigrants in Ontario, Canada, and family caregivers access health care and what challenges they face. It focuses on the unique barriers they encounter, such as difficulties with language, a lack of culturally appropriate services, and discrimination based on harmful stereotypes about Arab communities. These stereotypes, often rooted in outdated and biased ideas, can influence how health care providers and the public treat Arab patients, making it harder for them to get fair and respectful care.
The research takes a broad view, looking at how different factors—like family roles, community support, healthcare systems, and social attitudes—shape the experiences of older Arab immigrants. Family caregivers play a crucial role in helping navigate the healthcare system, often stepping in to translate, advocate, and provide care. Their perspectives are included to give a fuller understanding of how the entire support system operates.
A key theme in the findings is the idea of "being seen." This refers to how older adult Arab immigrants and caregivers feel seen or unseen in the process of getting health services. Four main experiences emerged: being seen as family, being seen by their community, being seen in their home countries (when they seek care abroad), and being seen as foreigners in Canada. Many participants shared that having an Arab family doctor made them feel more understood and supported. However, some non-Arab doctors also built strong relationships by showing cultural sensitivity and respect.
Recommended Citation
Tobah, Selma, "Navigating Visibility: Health Care Access and Experiences of Older Adult Arab Immigrants and Family Caregivers in Ontario" (2025). Electronic Thesis and Dissertation Repository. 10831.
https://ir.lib.uwo.ca/etd/10831