Med school prof investigates what it takes to work toward equitable access to health care for South Asian communities

Dr. Turin Chowdhury, PhD, began his career in health services research as a number cruncher.

“I was sitting in a cubicle, reading research study after research study and making sense out of data, which did the job — but I felt disconnected from the community,” says Chowdhury, a member of the O’Brien Institute for Public Health at the Cumming School of Medicine (CSM).

Chowdhury, who trained and worked as a physician in his home country of Bangladesh before coming to Canada, has since adopted a more community-based approach to his research by creating partnerships within communities where public health research is taking place.

“Meaningful community engagement is hugely important for the success of any research being done at the community level, particularly the grassroots level. Innovations that happen organically in the grassroots community fascinate me,” says Chowdhury.

Chowdhury’s latest series of projects has meant the opportunity to work alongside his own community of Bangladeshi-Canadian immigrants to identify and address barriers to primary health-care services, which include disease prevention and treatment, basic emergency services, maternity care, and mental wellness supports.

Immigrants, who make up more than one-fifth of the Canadian population, face challenges when seeking primary health care in Canada, says Chowdhury, due to factors such as language, cultural and economic barriers.  

In Canada we pride ourselves on universal access to health care, but not everyone has equitable access. 

When immigrants arrive in Canada, they report better health than the general Canadian-born population, but their health tends to decline more rapidly than their Canadian-born counterparts as their years in Canada increase. The structural and social inequities they experience is a possible factor in this decline, says Chowdhury.

Health literacy, or the ability to access, understand and use health information to support health, can play an important role in addressing health disparities in immigrant communities, says Chowdhury.  

To support community health literacy, Chowdhury is bringing together community establishments like the ethnic media, faith-based entities, and immigrant-serving organizations with health service providers to work at the grassroots to deliver culturally sensitive health information.

Community engagement must involve not only conversing with the community but doing something together that benefits community members, says Chowdhury.

“Creating capacity within the community not only increases engagement, but it also enriches our work when we are able to develop more meaningful partnerships.”

Chowdhury is using his learnings from the Bangladeshi community to expand his program of research on immigrant health and wellness issues to other South Asian communities in Calgary including the Nepalese, Pakistani and Indian communities. 

Recognition, Resilience, and Resolve

May is Asian Heritage Month, with the theme for 2021 being Recognition, Resilience, and Resolve.

This is an important opportunity to reflect on the importance of dismantling systemic barriers faced by immigrant and racialized communities, says Dr. Aliya Kassam, PhD, lead of the O’Brien Institute Equity, Diversity and Inclusion (EDI) portfolio. 

“Working towards equitable primary care access for immigrant and racialized communities through the lens of EDI helps to highlight inequities in power and privilege which ultimately leads to a respectful and flourishing community for all,” says Kassam.

Chowdhury’s work is an example of EDI in action, she says.

“By actively engaging community members in conducting research, setting priorities, co-creating knowledge, and translating that knowledge, Dr. Chowdhury’s work embodies inclusivity,” she says.

Engaging community in public health research is critical to ensuring research is culturally sensitive, equitable, responsive, and reciprocal, says Dr. Tom Stelfox, MD, PhD, O’Brien Institute scientific director.

“To address the complex public health issues that disproportionately affect immigrant and racialized communities, such as prevalence of chronic disease, and access to food, social services and health-care services, we must meaningfully engage communities and co-create solutions,” he says.

Chowdhury says he is grateful for the opportunity to do public health work within South Asian communities that will have a positive impact. 

“I have been blessed with people's contribution to this work. The community members, the students I work with — all of my colleagues.  That's why and how I can manage it all.”