Immigrant status and having a regular medical doctor among Canadian adults

Abstract

OBJECTIVE: New immigrants generally arrive in Canada with a health advantage over their Canadian counterparts, but lose that advantage over time. Difficulties in acquiring a physician may contribute. Past studies relied on older data, and lacked control for many confounders and assessment of gender differences. We assessed the relationship between immigrant status and having a regular doctor among Canadian adults. METHODS:Cross-sectional data from the 2011-2012 Canadian Community Health Survey were self-reported by 73,958 respondents aged 18-64, representing >20 million Canadian adults. The relationship between immigrant status and having a doctor was analyzed using χ 2 and logistic regression analyses stratified by gender. Age, body mass index, race, education, province of residence, physical activity, chronic conditions, self-perceived health, and number of children in household were controlled.RESULTS: Approximately 77% of males and 87% of females reported having a doctor. About 7% of respondents reported being new immigrants in Canada (0-9 years), while 16% were established immigrants (≥10 years). For males (M) and females (F) respectively, 78% and 88% of non-immigrants, 55% and 68% of new immigrants, and 84% and 91% of established immigrants reported having a doctor (p < 0.001). Compared to non-immigrants, new immigrants were significantly less likely to have a doctor (OR (95% CI) M: 0.43 (0.38-0.47); F: 0.36 (0.32-0.41)), while established immigrants were significantly more likely to have a doctor (M: 1.13 (1.03-1.24); F: 1.16 (1.03-1.30)).CONCLUSION: New Canadian immigrants are less likely to have a regular doctor compared to non-immigrants, and should be targeted by policies and programs facilitating finding a doctor.KEY WORDS: Canada; immigrant health; healthy immigrant effect; primary health care; health services accessibility La traduction du résumé se trouve à la fin de l'article.

Utilization of healthcare by immigrants in Canada: a cross-sectional analysis of the Canadian Community Health Survey

“…While established immigrants were more likely to have a regular health care provider than recent immigrants, there was no difference in the mean number of medical consultations in the past year of recent and established immigrants. These findings are consistent with the three previous studies that examined the effect of time since immigration on having a regular doctor and found that established immigrants were more likely to have a regular doctor than recent immigrants [ 5 , 8 , 9 ]. Previous secondary data analyses did not examine number of medical consultations in the past year as a measure of health care utilization.…”

“…The existing literature suggests that time since immigration is an important predictor for utilization of health care for Canadian immigrants [ 4 , 6 , 8 , 9 ], with established immigrants being more likely to have a regular doctor than recent immigrants. However, many studies of utilization of health care by immigrants in Canada did not include time since immigration in the analysis [ 6 , 7 , 10 – 12 ].…”

Engaging Immigrant and Racialized Communities in Community-Based Participatory Research During the COVID-19 Pandemic: Challenges and Opportunities

“…The COVID-19 pandemic has disproportionate health, social, and economic impacts on immigrants and racialized communities (Guttmann et al, 2020; Price-Haywood et al, 2020). Older adults within these communities are particularly vulnerable (Garcia et al, 2020) as they are more likely to have declining health, experience social isolation and loneliness, and report greater unmet health needs than the general population (Degelman & Herman, 2016; De Jong Gierveld et al, 2015; Koehn et al, 2013; Salma & Salami, 2020). Targeted and tailored strategies are required to support immigrant and racialized older adults impacted by the pandemic.…”

Primary Care and Access to Mental Health Consultations among Immigrants and Nonimmigrants with Mood or Anxiety Disorders: Soins de première ligne et accès aux consultations en santé mentale chez les immigrants et les non-immigrants souffrant de troubles de l’humeur ou anxieux

“…Our finding of a gap in health service use among immigrants with diagnosed mental health disorders is consistent with previous studies. 16,[18][19][20][21][23][24][25][26] Gaps in health insurance coverage may impact access to services and influence future use and interactions with the Canadian health system. 36,37 Many provinces have a 3-month waiting period before new, landed immigrants are eligible for provincial health coverage 38 causing delays in seeking or accessing health services.…”

“…4,7,21,22 Immigrants report unmet care needs and may underuse health care services due to not knowing where to access health care services, the perception that they would receive inadequate care, transportation barriers, and language barriers. 23 Immigrants are also less likely to have a regular doctor 24 and more likely to visit urgent care or walk-in clinics or emergency departments for care. 25 Furthermore, emergency departments may be viewed as a more convenient place of care, 26 and immigrant children appear more likely to receive mental health care for the first time in the emergency department.…”