Indo-Caribbean Immigrants' Well-being: An Intersectional Exploration of the Social Determinants of Health on an Under-studied Population

There is growing research that is examining the impact of social-economic inequities on peoples health and well-being. While there is an increased focus on the pathways between inequities, and health and well-being, there is a lack of research that specifically addresses how societal power structures cause these inequities and how peoples intersecting social identities are impacted differently by power structures. Health research predominantly focuses on identity variables as being categorical rather than interconnected. However, a categorical and disconnected focus limits the understanding of how peoples lived experiences are impacted by interconnected social and economic inequities. With a social determinants of health (SDOH)-intersectional framework, this qualitative study explored the pathways between Canadian power structures that result in social-economic inequities, and how these inequities impact peoples well-being on the basis of their intersecting identities that include being a first-generation immigrant, a visible minority, and of Indo-Caribbean ethnicity. Examining Indo-Caribbean immigrants settlement experiences with an intersectional lens will both deepen and broaden the understanding of how power structures impact their settlement and well-being experiences. Individual interviews (n = 31) and 2 group interviews (n = 3; n = 2) were thematically analyzed. Themes relating to power-over, power-with and power-within in the context of SDOH were identified. Power-over themes included language challenges, deskilling and survival employment, and perceived discrimination. Gender-specific power-over themes included skilled males work-life imbalance and post-secondary educated males job promotion discrimination. Power-with and power-within themes included settlement support from family and friends. Gender specific power-with and power-within themes included male youths sense of belonging through sport and female mothers sense of independence and accomplishment from work. These findings provide new understanding regarding how nativist power structures result in the dismissal of Indo-Caribbean immigrants cultural capital. Findings also indicate how Indo-Caribbean immigrants utilize power-with and power-within to socially progress in the face of these inequities. This study contributes to a shift from focusing on singular identity factors to simultaneously including intersecting multiple identities when examining inequities and well-being. This shift will contribute to new understandings and will serve to better inform policies that aim to reduce structural barriers.