Strengthening Health Resources for Immigrants, Refugees, and Newcomers in Greater Vancouver through Cross Cultural Health Brokers

Umbrella Multicultural Health Co-op et al

Umbrella Multicultural Health Co-op is a cooperative community health centre, we are delivering culturally-appropriate health care to immigrants and newcomers in the Lower Mainland.

To target some of the challenges that newcomers face with accessing healthcare, Umbrella Multicultural Health Co-op (UMHC) conducted a research project to test a model of employing foreign-trained healthcare providers as Cultural Community Health Brokers (CCHBs). CCHBs are bilingual/bicultural health workers who bridge language and cultural barriers to support the care of immigrants, refugees, and newcomers to Canada. They support healthcare providers and patients not only by translating conversations, but by using their own medical and cultural knowledge to advocate for patients, ask follow-up questions and ensure that information is being conveyed in a culturally sensitive manner

Summary of Key Findings

  • Findings from UMHC patients:
    • Arriving and settling in Canada can be an overwhelming process. In particular, newcomers tend to face challenges adjusting to things like climate, knowledge about public transit, social system, new arrangements/familial support, income, healthcare
    • Patients often feel rushed and unheard in healthcare. Long wait times to receive medical help further reduce their likelihood of seeking help
    • Patients feel supported by UMHC’s CCHBs
      • Some indicated that they were able to get support beyond just healthcare (e.g., translating documents, applying for WorkSafe BC, finding housing, receiving introductions to social workers/counsellors). This holistic and encompassing approach applied not only basic health needs but helped increase newcomers’ access to social determinants of health.
    • Clients value the longitudinal relationships built with their CCHBs over time. Many reported having strong relationships with their CCHBs (e.g., seeing them as extended family members) and were appreciative of their flexible availability and the way CCHBs created a sense of cultural safety and respect.
    • Some challenges noted about the current system include:
      • Regardless of the support of CCHBs, some newcomers (especially seasonal workers) expressed challenges with being able to find time to seek medical support.
      • Patients mentioned being aware of the waitlist at UMHC to receive help from CCHBs.
  • Findings from Cultural Community Health Brokers:
    • CCHBs recognize the importance of their role as advocates for medical patients, who can ask follow-up questions, clarify important values with the physician, and add context if client lacks understanding.
    • Many CCHBs spoke about the importance of building trust with both healthcare providers and patients, and how this three-way connection helped all parties get through challenging medical situations.
    • CCHBs also spoke about the value of having their own healthcare training and background to help with their work. For example, one CCHB noted that by understanding what a healthcare provider is trying to understand through questioning, they can take some burden off the providers and ask about the topic in a way that is understandable to patients.
    • Overall, many CCHBs felt that their work was rewarding, and enjoyed being able to support their cultural community. They also expressed that the work is professionally rewarding, since it gives them the opportunity to use their internationally acquired medical background within the Canadian healthcare system.
    • As a highlight of their work, several CCHBs expressed satisfaction with the positive work culture at UMHC and the meaningful and productive relationships between all members of the team.
    • Challenges:
      • Many CCHBs can find it difficult to protect their time and boundaries, as they feel a sense of responsibility to support patience.
      • Some CCHBs reported that the work can be emotionally draining.
      • CCHBs experienced challenges at times when patients did not have a clear understanding of the role of CCHBs and what they could or could not control.


To learn more about this research project and its findings, view the entire body of work here:

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