Presenter(s):

Thanusha Kathiravel, Queen’s University, Canada

Abstract

Background and Objective: South Asian immigrants face a disproportionately high burden of Type 2 Diabetes Mellitus (T2DM) compared to non-immigrant populations in high-income countries such as Canada, the United Kingdom, Norway, and Australia. Despite this elevated risk, existing literature suggests an underutilization of diabetes-related healthcare services among South Asians. Cultural, linguistic, and structural barriers complicate access to healthcare. This systematic review aims to identify, synthesize, and evaluate qualitative literature exploring South Asian immigrants’ experiences accessing T2DM-related healthcare in host countries.

Method: A comprehensive search was conducted across MEDLINE, Embase, PsycINFO, Scopus, CINAHL, and Google Scholar in October 2022 and February 2025. Eligible studies included English-language qualitative research focused on the experiences of South Asian adults with T2DM- accessing healthcare in host countries. Study quality was appraised using the Critical Appraisal Skills Programme (CASP) tool. Data extraction and thematic synthesis were guided by Levesque et al.’s conceptual framework of healthcare access (2013), which includes five dimensions of service provision (approachability, acceptability, availability/accommodation, affordability, and appropriateness) and five corresponding dimensions of user abilities (to perceive, seek, reach, pay for, and engage with care).

Results: Thirteen qualitative research studies, conducted in the United Kingdom (n=10), Norway (n=1), Canada (n=2), identified key barriers to accessing T2DM care included language challenges, lack of culturally tailored dietary and lifestyle advice from health care providers, limited health awareness among South Asian immigrants, and mistrust or dissatisfaction with healthcare providers. Gender-specific barriers also influenced healthcare access and utilization. Across studies, participants often did not perceive the need for preventive or follow-up care due to limited symptom recognition or fatalistic attitudes towards diabetes.

Discussion: South Asian immigrants with T2DM encounter distinctive barriers that hinder equitable access to diabetes-related healthcare. Targeted interventions are needed, including the development of culturally and linguistically appropriate educational resources and community-based outreach programs. System-level changes such as the inclusion of interpreters, bilingual staff, and gender-specific care options can further improve service accessibility and acceptability. Future research should support the development and dissemination of T2DM educational programs and resources in the native languages of South Asians.

Bio(s):

Thanusha Kathiravel, PhD is a health equity researcher with a doctoral degree from Queen’s University, where her research focused on access to healthcare among South Asian older adults, with a specific emphasis on Tamil older adults living with Type 2 Diabetes Mellitus (T2DM). Her PhD work used qualitative methods to explore the lived experiences of Tamil older adults and the perspectives of healthcare providers, aiming to identify barriers and develop culturally responsive strategies to improve diabetes care access in immigrant communities.

Thanusha brings extensive experience in health promotion and chronic disease management across community, provincial, and federal levels. She has contributed to initiatives aimed at improving diabetes-related health outcomes, with a particular focus on health equity, culturally tailored care, and policy-informed interventions. Her work is grounded in community engagement, interdisciplinary collaboration, and knowledge translation. Passionate about bridging the gap between research and practice, Thanusha continues to advocate for inclusive health systems that meet the needs of aging and racialized populations.