Background
The World Health Organization adopted the Global Strategy on Human Resources for Health Workforce 2030 in May 2016. It sets specific milestones for improving health workforce planning in member countries, such as developing a health workforce registry by 2020 and ensuring workforce self-sufficiency by halving dependency on foreign-trained health professionals. Canada falls short in achieving these milestones due to the absence of such a registry and a poor understanding of immigrants in the health workforce, particularly nursing and healthcare support occupations. This paper provides a multiscale (Canada, Ontario, and Ontario’s Local Health Integration Networks) overview of immigrant participation in nursing and health care support occupations, discusses associated enumeration challenges, and the implications for health workforce planning focusing on immigrants.
Methods
Descriptive data analysis was performed on Canadian Institute for Health Information dataset for 2010 to 2020, and 2016 Canadian Census and other relevant data sources.
Results
The distribution of nurses in Canada, Ontario, and Ontario’s Local Health Integration Networks reveal a growth in Nurse Practitioners and Registered/Licensed Practical Nurses, and contraction in the share of Registered Nurses. Immigrant entry into the profession was primarily through the practical nurse cadre. Mid-sized communities registered the highest growth in the share of internationally educated nurses. Data also pointed towards the underutilization of immigrants in regulated nursing and health occupations.
Conclusion
Immigrants comprise an important share of Canada’s nursing and health care support workforce. Immigrant pathways for entering nursing occupations are complex and difficult to accurately enumerate. This paper recommends the creation of an integrated health workforce dataset, including information about immigrant health workers, for both effective national workforce planning and for assessing Canada’s role in global health workforce distribution and utilization.
The method of producing food animals has changed in the United States over the past century, moving from traditional burns to enclosed structures resembling industrial buildings, where animals are raised in high stocking density (commonly known as “Concentrated Animal Feeding Operations,” CAFOs). The objective to maximize profit has resulted in poor farm management; raised issues of environmental pollution, public health, animal rights, and environmental justice, and had socio-economic impacts. Studies concerning the issues are limited to specific regions and types of CAFOs. In addition, studies on the spatial distribution and temporal changes of CAFO at a country scale are lacking. This study bridges some of the gaps by analyzing the spatial distribution of industrial farms in the United States in 2002 and 2007 and their relationship with vulnerable population and exploring the relationships among the concentrations of farms, socio-economic, health, and environmental characteristics of the counties. A range of spatial statistics tools were applied in this study. The study revealed variations in spatial distribution depending on the type of the CAFOs. The issue of environmental justice was found prevalent depending on the types of industrial farms. Each type of industrial farm was found to interact uniquely with the selected demographic, health, and environmental parameters.
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