New Canadian Media

By: Laura Bisaillon in Toronto

It’s World AIDS Day and this year, I am moving beyond remembering loved ones. I am shifting to a forward position and a distinct political hopefulness.

My wish on this World AIDS Day is for Canada to change how HIV is dealt with in its immigration system. Specifically, I would like to see the nation change how it makes inadmissibility decisions about people with HIV who apply to live in Canada.

This would be done through the Department of Immigration, Refugees and Citizenship. It would involve changing specific institutional practices, including the collection and circulation of HIV-related data from prospective immigrants.

The imperative for my research is to demystify social institutions like immigration so that we can explore and understand how things happen. As an interdisciplinary professor in health and social justice, and as a former social worker in a woman’s sexual health communities, I work to detect institutionally arising inequities.

For the past 15 years, I have been involved in AIDS work. I have worked in the Horn of Africa and parts of Canada in direct support. My life and lives of people I care about, some of whom cannot immigrate to Canada because of their HIV status, are deeply affected by this infection and its unfortunate pernicious social standing. I work with teams to use creativity and critique in equal measure to produce do-able ideas for remedying some of these inequities.

Using creativity and critique

This is precisely what I have done for Canada’s mandatory immigration HIV testing policy. The policy was enacted in 2002, but not ever reviewed until my work.

The policy acts as a filter. It screens for HIV and sorts people with HIV out (with some exceptions). HIV is discovered in the medical examination that all applicants for permanent residency must undergo at regular intervals. Most of these exams happen outside of Canada in contexts that Canada cannot monitor.

My motivation for assessing how this policy functions in everyday lives was because of the disconnect between immigrant people’s everyday social experiences through Canada’s imposed HIV testing, and the official representations of these experiences.

I formed alliances with racialized women with HIV from the Global South coming through the Canadian refugee ajudication system. Through them, I learned of the contrast between what actually happened in their lives with immigration medical processes and what is officially understood to have happened as documented in national government reports.

I set out to understand how this dissonance was happening. All persons aged 15 years and older who request Canadian permanent residence, such as refugees and immigrants, are required to undergo HIV testing. Tuberculosis and syphilis are the two other conditions for which people receive mandatory screening.

I produced the first social science exploration and critique of the medical, legal and administrative context governing the immigration to Canada for people with HIV. I identified both inequities and levers for change by using a feminist ethnographic policy analysis.

An immigration HIV test catalyzes the state’s collection of medical data about an applicant. These are entered into state decision-making about the person’s inadmissibility to Canada.

The good news on HIV policy

As it turns out, the HIV policy and mandatory screening ushers in a set of institutional practices that are highly problematic for prospective immigrants with HIV infection, the Canadian state and what is means to be Canadian more broadly. Avoidable inequities have been happening for 16 years, and they are ongoing.

The good news is that policies can be adjusted.

People with disease and disability, and their advocates, recently met with Immigration Minister Ahmed Hussen to discuss and plan a future course of action.

And we have recently learned that Hussen has said current medical inadmissibility rules do not align with Canadian values and need to be reformed.

Canada’s Immigration Minister Ahmed Hussen says current medical inadmissibility rules for newcomers are out of touch with Canadian values and need to be reformed. (THE CANADIAN PRESS/Adrian Wyld)

It was acknowledged that the ways in which medical inadmissibility decision-making is informed and practised are outdated. This certainly applies to HIV/AIDS, a chronic and manageable disease and an episodic disability, in the Canadian context.

We see that HIV infection is scrutinized more and differently than any other health condition through the immigration process, where we see layers of institutional directives, guidelines and practices in place governing HIV/AIDS. A core problem with the HIV testing policy is that it’s not informed by or reliant upon the most up-to-date scientific knowledge..

Democracy depends on how we talk to each other. Research on the social determinants of health shows us that we all live better lives in egalitarian societies. Part of how to achieve such societies is how we talk and listen to each other.

What sort of public spaces can we create to hear and be heard on matters related to the Canadian immigration system and medical inadmissibility decision-making? Opportunities are preciously few.

A roundtable on immigration and disease is needed

I propose a roundtable on immigration, disease and disability in which I bring to the table the most up-to-date scientific knowledge about immigration and HIV. We could invite Harvard’s Professor Michael Sandel to join, because he also asks critically important questions about immigration (and sparks debate to collectively contemplate answers), as well as my colleagues at the Canadian HIV/AIDS Legal Network. When can we meet to discuss immigration and HIV?

The World AIDS Day flag flies on Parliament Hill in Ottawa on Dec. 1 2016. (THE CANADIAN PRESS/Justin Tang)

Together in class, students and I have used the research record to examine the human rights implications of mandatory immigration HIV testing in Canada. We have done the same regarding the ethical and material consequences of medical doctors being asked to work in ethical problematic ways within Canada’s immigration system.

Just as other immigrants to Canada do, those with HIV will contribute to our society in myriad ways. Having interacted with thousands upon thousands of people with HIV over time and across space and place, they are among the most resilient and hard-working people I have met, which I attribute to the experience of personal suffering and knowledge of the larger social and political history of HIV/AIDS, not to mention their place within it.

This is precisely the sort of immigrant that Canada wants and indeed welcomes.

I am committed to a process in which we can talk with and listen to each other on matters of immigration and disease as they relate to HIV/AIDS. The moment is upon us to work with the most up-to-date scientific evidence to produce a medical inadmissibility decision-making system unfettered by inducing harm.


This article was originally published on The Conversation. Read the original article.

Published in Top Stories

Commentary by: Arvind Magesan in Calgary, AB

The Conversation

Statistics Canada has released new data from the 2016 census that shows more than any other G8 country, Canada is a nation of immigrants. One in five Canadians (21.9 per cent to be exact) were born in another country.

Immigration is a significant component of Canada’s population growth and evolving demographic composition. The census data shows more than 1.2 million new immigrants came to Canada between 2011-16. Immigrants are also typically younger and more educated than the average Canadian.

Not surprisingly then, immigration is often touted as a necessary condition for sustained economic prosperity. And yet in spite of their ostensible importance to the Canadian economy, immigrants themselves have yet to catch up to other Canadians in terms of economic outcomes.

Economists refer to this catching up as “economic assimilation” and often measure it using the “native-immigrant wage gap” — the difference between the average wages of immigrants and those whose families have been here at least three generations. The persistence of this wage gap is a feature common to economies in the Western world that rely heavily on immigration.

As an economist and a child of immigrants myself, I was curious to delve into the census data to understand how this gap has evolved over time and across major cities in Canada — and to get a hint of what may be at the root of it.

The first thing that surprised me is the gap has not changed much over the past 10 years. Census data from 2006 showed, at a national level, first-generation immigrants earned wages 12.6 per cent less than the average wage of native Canadians. In 2011, the gap dropped slightly to 10 per cent, but the new census data shows it’s climbed significantly to 16 per cent.

Importantly, the gap is a countrywide phenomenon. Looking at the three of the most popular destinations for immigrants in the past decade — Toronto, Vancouver and Calgary — the gap in 2016 sits at 25, 17 and 23 per cent respectively.

Interestingly, the gap doesn’t only exist for first-generation immigrants, but also for the children of immigrants (second generation, i.e. Canadians born to immigrant parents). The new data shows at the national level, second-generation immigrants earn 5.4 per cent less than natives.

Understanding the wage gap

The obvious question that follows then is: What is the source of these gaps?

Canada is an especially interesting case given the “points” system used to screen potential immigrants, where language, education and job skills are key determinants. And for the first time, the census has reported that about six out 10 new immigrants came here under the so-called economic admission category, meaning they have the skills “to enhance and promote economic development.”

Given the way immigrants are screened before entry, one would expect relatively quick integration into the Canadian economy and a convergence in wages. But this is clearly not the case.

The reasons put forward to explain the wage gap range from employer difficulty in assessing immigrant education credentials to outright discrimination. Economists refer to two types of “discrimination” in the labour market context, “statistical discrimination” and “taste-based discrimination.”

In the former, employers use observable traits (such as race) to make inferences about something like productivity. For example, an employer sees a job applicant with brown skin. The employer isn’t prejudiced towards brown people, but is worried (stereotypically) the employee is going to want to take trips “home” to Sri Lanka and would need a lot of vacation time. So the employer hires someone else equally qualified. Taste-based discrimination is more what we think of as prejudice — not wanting to hire someone purely because of skin colour.

Identifying causal factors that explain the wage gap is a difficult task - individuals who immigrate to Canada do so by choice. These choices are a function of a host of factors that could potentially jointly explain the decision to immigrate and labour market outcomes, including personal characteristics, job experience and education, to name just a few. Identifying discrimination in the labour market, and separating between taste-based and statistical discrimination, is even harder.

However, a 2011 study by University of Toronto economist Phil Oreopolous takes an important step in this direction.

In the study, thousands of computer-generated resumes were mailed out to companies that had posted ads searching for employees. The resumes were randomly assigned either a foreign or a “white” sounding last name, and were otherwise identical. The result: The resumes where the applicant had a foreign-sounding last name were less likely to receive a call back than identical looking resumes with a “white” last name.

When the author followed up with some of the recruiters, the overwhelming reason given for overlooking resumes with a foreign-sounding name was that they anticipated difficulty with language. Specifically, recruiters expected a lack of fluency in English, problems with communicating at work and difficulty for customers and co-workers in understanding a foreign accent. In other words, recruiters were statistically discriminating between job candidates based on their names.

Can language proficiency close the gap?

The census presents an opportunity to study the importance of English proficiency for the gap in labour market earnings between immigrants and native Canadians in 2016. The census provides information on wages, immigrant (and generation) status, as well as the language most commonly spoken at home.

Specifically, guided by the findings in Oreopolous’s study, I looked at how the gap in average wages changes when English is spoken at home. (For the purpose of this study, I looked at communities outside of Quebec, where French is the dominant language.) In 2016, 63 per cent of new immigrants living outside of Quebec most often spoke a language other than English or French while at home.

The latest census data says the native-first generation immigrant wage gap is 16 per cent at the national level. Once we examine whether immigrants speak English at home, things change — the wage difference is just 5.8 per cent. But for first-generation immigrants who don’t speak English at home, the gap jumps to 27.3 per cent.

For second-generation immigrants, there is barely any gap for those who speak English at home (0.7 per cent) but it’s still a significant gap for those who don’t speak English at home (a whopping 45.7 per cent).

This pattern also holds in the major metropolitan centres in the English-speaking parts of the country, which attract the most immigrants.

Interestingly, at almost 25 per cent, Toronto has one of the largest city level wage gaps in the country, explained at least in part by the fact that new immigrants tend to land in Toronto first and are more likely to be unemployed for a period of time. The three largest cities in English-speaking Canada, which also attract the most immigrants, also have gaps larger than the national average.

In Ottawa, immigrants of either generation who speak English at home actually earn more than natives on average. While it may be tempting to attribute the major differences across the cities to differences in culture, they are more likely due to regional differences in industrial composition and attendant labour demand.

The wage gap for immigrants who don’t speak English at home is very large. In Toronto and Calgary, first-generation immigrants who don’t speak English at home can expect to earn 37 per cent less than natives. Perhaps even more interesting is the fact that the gap across all cities for is larger for second generation immigrants who don’t speak English at home.

Though these patterns are striking, they should not be interpreted as causal – immigrants can’t necessarily start speaking English at home and expect to see their future earnings increase. There are unobserved qualities of individuals that may correlate both with the tendency to speak English at home as well as with labour market earnings potential. Without holding these fixed in some way, we can’t say whether there is a causal relationship between English skills and the gap in labour market outcomes.

But supposing that the findings here are suggestive of a causal relationship, why does speaking English at home matter so much?

One obvious answer is that individuals who speak English at home speak better English in general — and this would mean better communication at work. This would be consistent with the worries that the recruiters in Oreopolous’s study had when deciding who to call back. Or perhaps individuals of foreign descent that speak English at home tend to have other important skills on average.

But another possibility is the labour market discriminates against individuals with weaker English skills even when English is not important for productivity. Sorting between these different explanations (and others) will require more data and a deeper look.


Arvind Magesan is an Associate Professor of Economics at the University of Calgary.

This article was originally published on The Conversation. Read the original article.

Published in Commentary

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