What did you do for your PhD?
I looked at a range of factors affecting the health of refugee women and their babies. One was the path refugee women take to get to Canada, and the impact of that path on health.
What did you find?
Many refugees do not come straight to Canada from their country of origin. Instead, they spend time in another country first, often in a refugee camp or a similar precarious situation. I found that refugee women who spent time in another country before coming to Canada were more likely than other groups of refugees and immigrants to give birth before the baby was full term.
What did you learn from that?
Refugee women who live in another country before coming to Canada experience prolonged instability with poor living conditions, increased risk of personal violence, separation from or death of family members, and limited access to health care. The incredible stress of these conditions can cause babies to be born earlier than usual.
What can the health care system do to respond?
Health care providers can respond by understanding the migration experiences of women. Knowing whether a woman is a refugee, if she lived in another country prior to arriving In Canada and what the living conditions were like in that country, may be important indicators of stress. Health care providers should consider the stress refugee women have experienced and how this might be impacting their health and experiences of health care. Providers should also be aware of resources in the community such as counselling, cultural centres, settlement services, etc. in order to make appropriate referrals. Future research could consider developing best practices for health care providers who provide prenatal care for refugee women.
What are you doing at C-UHS?
I’m involved with two streams of research. Firstly, I am expanding my research into the health of refugee mothers and their babies. I am looking at additional factors that may cause poor health and a broader range of maternal and infant health outcomes. Some of these outcomes include high maternal blood pressure and admission to intensive care. Secondly, I am leading a community-based qualitative research project to understand reproductive decision-making in the Indian immigrant community in the Greater Toronto Area with the goal of developing an educational brochure to reduce gender-bias.
In your ideal world, what would happen as a result of your research?
Greater interest and awareness among health care providers in terms of the unique experiences of refugee women and the potential for these experiences to impact health after immigration.
Why do you think research matters?
Research into the social determinants of health matters since it can help us understand who’s vulnerable to poor health and why. This research can help effectively target health care resources and upstream prevention strategies to improve population health and wellbeing.
Urquia ML, Wanigaratne S, Ray JG, Joseph KS. Variations in severe maternal morbidity in Canada associated with maternal birth place. Journal of Obstetrics and Gynecology Canada 2017. In Press.
Brar A, Wanigaratne S, Pulver A, Ray JG, Urquia ML. Sex ratios at birth among Indian immigrant subgroups according to time spent in Canada. Journal of Obstetrics & Gynecology Canada 2017; 39(6):459-464.
Wanigaratne S, Cole D, Bassil K, Hyman I, Moineddin R, Urquia M. Severe neonatal morbidity among births to refugee women. Maternal Child Health Journal 2016; 20(10): 2189-98.
Ray J, Wanigaratne S, Park AL, Bartsch E, Dzakpasu S, Urquia M. Preterm preeclampsia in relation to country of birth. Journal of Perinatology 2016; 36(9): 718-722.
Urquia M, Ray J, Wanigaratne S, Moinnedin R, O’Campo P. Variations in male to female ratios among births to Canadian-born and Indian immigrants to Canada, 1990-2011. A population-based register study. Canadian Medical Association Journal Open 2016; 4(2): E116-E123.
Sørbye IK, Wanigaratne S, Urquia M. Variations in gestational length and preterm delivery by race, ethnicity and migration. Best Practice & Research Clinical Obstetrics Gynaecology. 2016; 32: 60-8.
Urquia M, Sørbye IK, Wanigaratne S. Birth-weight charts and immigrant populations: A critical review. Best Practice & Research Clinical Obstetrics Gynaecology 2016; 32: 69-76.
Wanigaratne S, Cole D, Bassil K, Hyman I, Moineddin R, Urquia M. The influence of refugee status and secondary migration on preterm birth. Journal of Epidemiology and Community Health 2016; 70: 622-628.
Wanigaratne S, Cole D, Bassil K, Hyman I, Moineddin R, Urquia M. Contribution of HIV to maternal morbidity among refugee women in Canada. American Journal of Public Health 2015; 105(12): 2449-2456.
Wanigaratne S, Holowaty E, Jiang H, Norwood TA, Pietrusiak MA. Letter to the Editor RE: Estimating cancer risk in relation to tritium exposure from routine operation of a nuclear-generating station in Pickering, Ontario. Chronic Diseases and Injuries in Canada 2014;34(2-3).
Wanigaratne S, Holowaty E, Jiang H, Norwood TA, Pietrusiak MA, Brown P. Estimating cancer risk in relation to tritium exposure from routine operation of a nuclear-generating station in Pickering, Ontario. Chronic Diseases and Injuries in Canada 2013; 33(4): 247-256.
Cole DC, Orozco F, Ibrahim S, Wanigaratne S. Community and household socioeconomic factors associated with pesticide-using, small farm household members’ health: a multi-level, longitudinal analysis. International Journal for Equity in Health 2011; 10:54.
Cole DC, Orozco FO, Pradel W, Suquillo J, Mera X, Chacon A, Prain G, Wanigaratne S, Leah J. An agriculture and health inter-sectoral research process to reduce hazardous pesticide health impacts among smallholder farmers in the Andes in Global Health Research Casebook: lessons from partnerships addressing health inequities. International Health and Human Rights 2011; 11 (Suppl 2): S6.
Cole DC, Vanderlinden L, Leah J, Whate R, Mee C, Bienefeld M, Wanigaratne S, Campbell M. Municipal interventions to reduce cosmetic/non-essential pesticide use on household lawns – a policy implementation and repeat cross-section analysis. BMC Environmental Health 2011; 10:74.
Orozco FA, Cole DC, Ibrahim S, Wanigaratne S. Health promotion outcomes associated with a community-based program to reduce pesticide-related risks among small farm households. Health Promotion International 2011; 26(4): 432-46.