Dr. Yvonne Bessem Ojong

Entos Pharmaceuticals, Canada

^*Corresponding author:Dr. Yvonne Bessem Ojong, Senior Clinical Trial Manager, Clinical Development, Entos Pharmaceuticals, 4550-10230 Jasper Ave Edmonton, AB T5J 4P6, Canada

Abstract

In recent years, Canada has seen a significant influx of migrants seeking better lives and opportunities. This population shift has put increasing pressure on public services, especially healthcare. With wait times rising and resources stretched thin, a debate has emerged around whether and how migrant influx may correlate with healthcare accessibility. This article reviews data and research from the last decade to assess if and how the sharp rise in new migrants to Canada has impacted the capacity and quality of healthcare services. Examining trends in migration patterns, health system funding, and changes in service delivery and wait times, provides an impartial analysis for educators and public health personnel seeking to understand this complex issue. The review synthesizes the latest evidence to determine if and how healthcare accessibility has changed across Canada amidst the major demographic changes driven by migration.

Introduction

Canada's continued economic growth and population stability rely heavily on immigration. According to Statistics Canada, over 80% of Canada's population growth in 2020 was due to immigration. The majority of new immigrants in the past decade have come from developing nations with lower GDPs. Canada’s healthcare systems have been impacted by the following:

The Influx of Migrants

The influx of immigrants from lower-income countries has significantly impacted Canada's healthcare systems. Many new immigrants arrive with healthcare needs that have not been addressed in their countries of origin. This places increased demands on healthcare resources that are already strained. A 2019 study found that recent immigrants had higher rates of chronic conditions like diabetes, heart disease, and mental health issues compared to non-immigrants. Providing care for these complex health needs requires investments in healthcare infrastructure, as well as education and training for healthcare professionals.

Economic contributions

While immigration puts pressure on healthcare systems, immigrants make significant economic contributions. Immigrants fill key roles in sectors facing labor shortages like healthcare, manufacturing, and technology. Their taxes and consumer spending also contribute substantially to economic activity. A 2021 RBC Economics report found that immigration contributed $30 billion to Canada's GDP in 2020 alone.

Integrating immigrant populations

To maximize the benefits of immigration while minimizing costs, Canada must focus on integrating immigrant populations. This includes providing language education, job skills training, and pathways to citizenship. It also requires investments in affordable housing, public transit, and community services for immigrants. Successful integration of immigrants can take a generation or more but leads to improved health, education, and economic outcomes for both immigrants and their children.

In summary, Canada's openness to global migration brings both opportunities and challenges. With strategic investments and policy changes focused on integration and supporting immigrant well-being, Canada can continue relying on immigration to drive economic growth while maintaining a sustainable healthcare system. Promoting the long-term health and prosperity of immigrant communities is key to securing the future of Canada's economy and shared prosperity. It is worthy to note that, a lot of these migrants enter Canada with underlying health problems, and from countries with non-functional healthcare systems.

Healthcare Systems in Migrants' Home Countries

The availability and quality of healthcare in migrants’ countries of origin is a major factor driving migration. According to the World Health Organization (WHO), 94% of countries allow refugees to access primary health facilities under the same conditions as nationals. However, in practice, migrants and refugees face significant barriers to accessing healthcare due to discrimination, lack of documentation, language barriers, and unaffordability. The issues of the healthcare system’s in migrants’ home countries could be summarized as follows:

Limited healthcare infrastructure

Many migrants come from developing countries with limited healthcare infrastructure and a lack of access to basic services. For example, the WHO African region has 3% of the world's health workers but bears 25% of the global disease burden. The lack of doctors, medication, and equipment in these healthcare systems pushes migrants to seek treatment elsewhere.

Poverty and healthcare affordability

The cost of healthcare is unaffordable for many migrants in their home countries. Out-of-pocket healthcare expenses in low-income countries can drive families into poverty due to a lack of health insurance and government healthcare subsidies. Migrants may migrate to access free or subsidized healthcare in destination countries.

Disease Burden and Poor Health Outcomes

Developing countries also tend to have a higher burden of infectious diseases, maternal and child mortality, and poor health outcomes, which motivates migration. The probability of dying from preventable diseases is higher in developing countries. The lack of quality healthcare and poor health outcomes are factors that propel migration.

Discrimination and Social Exclusion

Some migrants also face discrimination, stigma, and social exclusion in their home countries which deters them from accessing available healthcare services. For example, migrants from marginalized groups may face discrimination based on their gender, sexual orientation, disability status, religion, and ethnicity. All of these factors can severely limit their access to basic healthcare at home and motivate migration. Usually, these migrants do not estimate the accessibility of the healthcare systems in Canada.

Healthcare Accessibility for Migrants in Canada

Canada offers universal healthcare coverage to residents through its public healthcare insurance plans. However, migrant populations still face barriers to accessing healthcare. Some of the challenges include:

1. Language barriers: Many migrants have limited English proficiency, making it difficult to communicate with doctors and understand health information. This can lead to misdiagnoses, medication errors, and unnecessary emergency room visits.

2. Lack of awareness: Migrants may not be aware of available healthcare services, eligibility requirements, and how to navigate the complex Canadian healthcare system. This lack of health literacy can discourage them from seeking needed care.

3. Work conditions: Migrant workers in low-paying jobs may not have employer-provided health benefits and face difficulties taking time off work to access care. Their working and living conditions can also negatively impact their health.

4. Cost barriers: Some migrants, like those on temporary work or student visas, may have to pay out-of-pocket for healthcare services rather than being covered by a public plan. This makes care unaffordable for many.

5. Discrimination and stigma: As with their home countries, migrants in Canada can face discrimination and unequal treatment from healthcare providers due to a lack of cultural sensitivity. This acts as a deterrent to accessing care.

Overall, while Canada has a relatively accessible healthcare system for migrants compared to their countries of origin, there are still opportunities to improve access and health equity for these populations.

Ethnicity or other attributes when seeking healthcare. Fear of discrimination and lack of culturally appropriate care are additional motivators for migration.

In summary, limited healthcare infrastructure, poverty, high disease burden, and discrimination in migrants’ origin countries are significant drivers of global migration as migrants seek safe and affordable access to healthcare elsewhere. Improving healthcare systems and reducing barriers to access in developing countries may help curb health-related migration.

Barriers to Healthcare Access for New Immigrants

New immigrants to Canada often face substantial barriers to accessing healthcare services. Upon arrival, immigrants may have limited language proficiency and health literacy which can hinder their ability to navigate Canada's healthcare system and understand health information. For some, systemic barriers within the healthcare system itself, such as lack of culturally appropriate care, insufficient appointment availability, and long wait times pose additional challenges.

Language and literacy barriers are a primary obstacle for many new immigrants seeking healthcare. Not being fluent in English or French can make it difficult to communicate with healthcare providers, understand medical forms, and access health education resources. Low health literacy, or the ability to obtain and understand basic health information, further exacerbates these issues. The complexity of Canada's healthcare system with various private and public components may also be hard to grasp for those with little experience with such systems.

Institutional barriers built into the healthcare system also disproportionately impact immigrant populations. Lack of culturally sensitive care, including access to translators and staff from similar cultural backgrounds, deters some from seeking care. Difficulty getting appointments and long wait times for both primary and specialist care lead to delays in receiving treatment and preventative care. Strict requirements for coverage under provincial health insurance plans can mean a temporary lack of coverage and out-of-pocket costs for some new immigrants.

Overall, new immigrants in Canada face a multitude of obstacles to accessing healthcare services relative to native-born Canadians. Targeted interventions to address language and literacy barriers, increase cultural sensitivity, and improve access and wait times are needed to promote health equity within immigrant communities. Improving healthcare accessibility for new immigrants should be a priority to enable their successful integration into Canadian society.

A majority of these migrants although having performed the IRCC standard tests, still have chronic diseases which have not been treated for a long time before they migrate.

Untreated chronic diseases before migration

According to research, chronic diseases frequently remain undiagnosed or poorly controlled in migrant populations before immigration. These illnesses generally do not resolve on their own and are rarely completely cured. Chronic conditions diagnosed before migration warrant particular attention because of their enduring impact.

The healthcare systems in many developing nations lack the resources to properly screen, diagnose, and treat chronic diseases. As a result, conditions like diabetes, hypertension, and heart disease often remain undiagnosed or are not optimally managed in these populations before immigration. Upon arrival in host countries like Canada, these chronic diseases may have already caused significant damage or complications, and they would be under pressure to get healthcare once they arrive in Canada. This is usually faced with the following challenges:

Healthcare accessibility challenges

Migrants frequently encounter difficulties accessing healthcare services after immigration due to language barriers, lack of health insurance, unfamiliarity with the healthcare system, and cultural differences. These challenges can further exacerbate poor management of chronic health conditions. Research shows migrants tend to access healthcare services less frequently, receive fewer preventative health measures, and have poorer health outcomes overall compared to native-born populations.

Slow Improvements in Access to Care

In recent years, Canada has made efforts to improve healthcare accessibility for new immigrants and refugees through targeted programs, but this has been described as slow and underreaching. These improvements include coverage for essential services like primary care, public health, and catastrophic care for all newcomers. Interpretation services have also expanded to overcome language barriers. However, disparities in health outcomes persist, especially for poorly controlled chronic diseases diagnosed before migration.

Additional research is needed to better understand and address the health challenges of migrant populations in Canada. By improving access to high-quality care, providing culturally competent services, and tailoring health education to this group, Canada can work to minimize health inequities and enable better management of chronic diseases in migrant communities. With time and increased familiarity with the healthcare system, migrants can gain better control over previously undiagnosed or poorly managed chronic health conditions, leading to an overwhelmed health systems infrastructure in Canada.

Canada's Public Health Infrastructure Overwhelmed

Limited Healthcare Funding

Over the last decade, Canada's healthcare funding has failed to keep up with inflation and population growth. According to the Canadian Institute for Health Information, healthcare spending per capita has increased by only 1.6% annually, while the population has grown by 1.2% each year. This limited funding has strained resources in Canada's universal healthcare system, impacting healthcare access across the country.

Inadequate Personnel and Facilities

Canada has fewer physicians and hospital beds per capita than comparable OECD countries. A 2019 survey found 42% of Canadians believe their local hospitals are overwhelmed. Emergency room overcrowding has become common, with some patients waiting up to 10 hours to see a physician. This overcrowding and lack of resources have been linked to poorer health outcomes and a higher risk of mortality. The COVID-19 pandemic has further highlighted the fragile state of Canada's healthcare infrastructure.

Disproportionate Impact on Vulnerable Groups

Marginalized groups like immigrants, refugees, and Indigenous peoples face additional barriers to accessing healthcare. Language difficulties, lack of health insurance, and systemic discrimination create obstacles to navigating an already overburdened system. Migrants in particular rely heavily on emergency services for primary care, as they face challenges accessing family doctors. With migrant populations growing in major cities, this further strains emergency resources.

Overall, limited funding, inadequate resources, and unequal access have seriously compromised Canada's healthcare infrastructure over the past decade. Urgent investments in healthcare funding, personnel, and facilities are critical to improving health equity and outcomes across Canada's diverse population. With the added pressure of COVID-19, ensuring a robust public health system is more important now than ever before. However, to obtain a license in Canada, as a migrant who was licensed in their home country is close to impossible. And this has led to the shrinkage of workforce in the licensed healthcare professions.

Lack of Licensed Health Personnel in Canada

Shortage of Nurses

There is a predicted shortage of 60,000 nurses by 2022 and 117,000 nurses by 2030 in Canada according to recent health workforce analyses. The aging population and lack of new nursing graduates have contributed to this projected deficit. With the increase in demand for healthcare and social services for the elderly, the shortage of nurses will have significant implications on the accessibility and quality of care. The nursing vacancy rate has also steadily climbed to reach a high of 6.3% in 2022, suggesting a lack of supply to meet the growing demand.

Job Vacancies in Healthcare

The healthcare sector had 96,200 unfilled positions for various health occupations in 2022. The job vacancy rate for the healthcare and social assistance sector reached 5.8%, the highest since the 2008 economic recession. The lack of health personnel is a major constraint on the healthcare system's capacity to meet the needs of the population. With the rising healthcare demands due to aging demographics, the shortfall in health human resources, especially for regulated professions like nursing, will put additional strains on the healthcare system.

Impact on Healthcare Accessibility

The lack of licensed health personnel in Canada has serious implications for healthcare accessibility. Longer wait times, lack of available services in communities, and system overload are some of the consequences. The shortages also lead to heavier workloads, job burnout, and poorer working conditions for existing health workers. With the increasing healthcare demands, the deficit in the health workforce threatens the viability and sustainability of Canada's public health system. Urgent policy interventions and strategic investments in health human resources are required to address this critical issue.

In summary, the shortage of nurses and high job vacancy rates in the healthcare sector, combined with the aging population, have significantly impacted healthcare accessibility in Canada. Solving the lack of licensed health personnel should be a top priority to uphold and improve the country's public health system.

Impact of Migration on Healthcare Costs and Wait Times

Research indicates that increased immigration may negatively impact the Canadian healthcare system. Studies show that migrants tend to have lower healthcare expenditures but higher out-of-pocket costs compared to native-born Canadians, due to obstacles in accessing healthcare services.

A 2019 survey found that 22% of immigrant adults reported skipping or postponing necessary medical care in the past year due to costs, compared to only 14% of Canadian-born adults. Lack of health insurance was a major barrier for many migrants, especially recent immigrants, to access healthcare. The financially vulnerable migrant population often has to pay sizable amounts out-of-pocket for health services or delay seeking medical care until their condition worsens. Their limited access to primary care and preventive services may lead to overuse of emergency departments, increased rates of preventable health issues, and higher long-term healthcare costs.

The influx of migrants, especially from areas with lower income levels and different healthcare systems, has also been associated with longer wait times for medical procedures in Canada. A study examining data between 1993 to 2010 found that immigration growth increased wait times for several major surgeries, including hip replacement, knee replacement, and cataract removal. Each 1% increase in the immigration rate was associated with up to a 3.5% longer wait for these elective surgeries. The additional demand for healthcare resources from immigrants and refugees strained the capacity of providers, resulting in extended delays.

In summary, research shows a correlation between increased immigration rates in Canada and negative impacts on the healthcare system, including higher out-of-pocket costs and longer wait times, especially for migrant populations with limited health insurance and access to primary care. Targeted policy interventions may be needed to improve healthcare accessibility and equity for migrants to achieve an inclusive public health system in Canada.

Improving Healthcare Access for New Immigrants

New immigrants face unique barriers to accessing healthcare services in Canada. According to studies, immigrant populations tend to underutilize healthcare resources compared to native-born citizens. This discrepancy points to inequities in the healthcare system that disadvantage newcomers.

To address these inequities, improving health literacy and digital access among immigrant groups should be a priority. Health literacy refers to an individual's ability to obtain, comprehend, and act on health information. For new immigrants, limited English language proficiency and unfamiliarity with the Canadian healthcare system pose significant barriers to health literacy. Targeted education on how to navigate resources like finding a family doctor, accessing mental healthcare, and understanding coverage under provincial healthcare plans would help bridge this gap.

Furthermore, digital tools have become increasingly important for accessing and managing healthcare. However, data shows that recent immigrant populations tend to have lower rates of digital access and literacy. Lack of digital literacy prevents new immigrants from using online resources to book appointments, fill prescriptions, access health records, and connect with healthcare providers. Increased digital inclusion through multilingual online resources and education on digital health tools may help address this barrier.

Overall, culturally sensitive healthcare, health education, and improved digital access are key to ensuring new immigrants can fully utilize healthcare services. Healthcare policymakers and administrators should consider the unique challenges facing immigrant groups and implement targeted interventions to promote health equity. By improving health literacy and digital access, new immigrants can gain the knowledge and means to optimize their health and well-being. A healthcare system that serves all members of the population equally leads to a healthier, more just society.

FAQ on Migration and Healthcare Accessibility in Canada

Canada's universal healthcare system provides necessary medical services to all permanent residents and citizens. However, research indicates disparities in healthcare utilization between immigrants and native-born Canadians. Studies show lower rates of healthcare access and higher unmet healthcare needs within immigrant populations.

Healthcare policy experts posit several factors that potentially contribute to these disparities. Language barriers, lack of health insurance coverage, and cultural differences can make Canada's complex healthcare system difficult to navigate for new immigrants. Additionally, immigrants may face systemic barriers like discrimination that negatively impact their health outcomes and access to care.

To address these issues, the Canadian government has implemented policies and programs targeting immigrant health. Provinces offer interpretation services to facilitate communication between patients and healthcare providers. Settlement programs help immigrants understand and access available health benefits and resources. Community health centers cater to the needs of diverse populations. However, studies demonstrate a need for further policy changes and more comprehensive, long-term strategies.

Overall, while Canada provides universal healthcare, disparities remain in access and outcomes for immigrant populations. Ongoing research and responsive policy changes are required to fulfill the promise of equitable, high-quality care for all. Improving healthcare accessibility for immigrants should remain a priority to uphold principles of fairness and inclusiveness central to Canadian identity. With a steady flow of newcomers, Canada's public health system must continually adapt to serve both long-standing residents and new arrivals alike.

What to do moving forward

Several key approaches can be taken to improve healthcare accessibility for both citizens and new migrants in Canada. First, increased funding for proven medical treatments and preventative care measures should be allocated. By investing in primary care, the overall health of the population can be improved while reducing costs from emergency room visits and chronic disease management. Universal prescription drug coverage is another initiative that would benefit all residents and reduce inequities in the system.

Provincial and federal governments must work together to establish shared priorities for healthcare, with a focus on increasing access to primary care physicians and community health centers. Wait times to see specialists and for certain procedures can be reduced by improving coordination across regions and ensuring healthcare resources are distributed based on population needs. Electronic health records and telemedicine are additional tools that can be leveraged to provide high-quality care regardless of location.

Community health programs aimed at health promotion and disease prevention have also been shown to positively impact population health over the long term. Investing in affordable housing, education, job opportunities, and social services will help address the social determinants of health and create an environment where people can thrive. Healthcare policies and the system itself must be equitable, inclusive, and accessible to people of all backgrounds. This includes providing care and information in a culturally sensitive manner, as well as interpretation services for those with limited English or French proficiency.

Moving forward, a collaborative, evidence-based approach focused on shared priorities will be needed to build a healthcare system that serves the needs of both long-term citizens and new migrants alike in Canada. By emphasizing health promotion, disease prevention, primary care, and social services, the overall health of the population can be improved. Healthcare resources, electronic records, and policies must also be equitable and inclusive to provide high-quality care for people of diverse cultural backgrounds. With strategic investments and cooperation across sectors, Canada's public healthcare system can become a model for other countries with increasingly multi-cultural populations.

The evidence of correlation between the recent influx of migrants and healthcare accessibility in Canada is mixed. While data shows some strain on services in major urban centers receiving significant numbers of new immigrants and refugees, national healthcare budgets have expanded over the same period. Overall, Canada's public health system appears to be managing increased demand, although localized shortages and longer wait times are concerning. Further research should continue monitoring this important issue to safeguard healthcare equity. Policy discussions must balance rapidly evolving demographics with Canadian humanitarian traditions. With thoughtful planning and targeted investments, Canada can uphold its commitment to universal access for all residents regardless of migrant status.

Recent years have seen Canada experience a substantial influx of migrants, prompting questions about the impacts on public services and infrastructure. Healthcare is a key area of focus, as increased demand could strain limited resources. This article examines the correlation between migrant influx and healthcare accessibility in Canada over the past decade. Analyzing healthcare spending, service availability, and utilization rates, it assesses whether influxes have significantly affected the healthcare system. With migrant numbers projected to continue rising, these findings offer valuable insights for policymakers and public health personnel planning for the future. Approaching this complex issue through an evidence-based lens, the article explores the nuances of balancing inclusive policies with pragmatic resource allocation.

Conclusion

According to recent studies, there appears to be a correlation between increased immigration rates in Canada and difficulties accessing healthcare services. Research shows new immigrants face unique barriers to healthcare, leading to inequities in utilization. Studies found new immigrants were twice as likely to report difficulties accessing immediate care compared to those born in Canada.

To improve healthcare access for new immigrants, culturally competent care may be beneficial. Culturally competent healthcare involves understanding and respecting cultural differences to provide effective services. For new immigrants, especially older adults, language barriers, unfamiliarity with the healthcare system, and differing health beliefs can hinder the use of services. By acknowledging and addressing these challenges, culturally competent care may encourage underserved groups to utilize healthcare.

Although new immigrants face initial barriers, their health status generally improves over time. Research found that immigrants in Canada, especially children and infants, often have equal or better health outcomes compared to non-immigrants. As immigrants spend more time in Canada, their health status tends to converge with health norms. However, disparities may persist for some groups, demonstrating the need for targeted interventions.

In summary, while increased immigration in Canada may correlate with difficulties accessing healthcare services, especially for new immigrants, culturally competent care and time spent in Canada appear to help address these challenges. Most research shows health outcomes for immigrants are often as good as or better than for non-immigrants. Continued efforts to understand and reduce access barriers will help promote health equity for immigrant groups. Overall, immigration has not negatively impacted Canada's healthcare system capacity within the past decade. Canada's universal healthcare model, along with targeted programs, helps provide comprehensive services for both immigrant and non-immigrant populations.

Overall, the influx of migrants to Canada in the past decade has significantly impacted the healthcare system, creating both opportunities and challenges. While migrants often place additional demands on healthcare services, especially in major urban centers, they also fill critical healthcare labor shortages and contribute to population growth that can strengthen public health infrastructure over time. As Canada continues to see high levels of immigration, policymakers must find ways to expand healthcare capacity and accessibility for both existing and new residents. Targeted investments, cultural training for providers, and partnerships between government and community organizations can help achieve an inclusive, equitable system. By taking a nuanced, evidence-based approach, Canada can uphold its values of diversity and universal healthcare in the face of demographic shifts.

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Received: May 16, 2024;
Accepted: June 17, 2024;
Published: June 19, 2024.

To cite this article : Yvonne Bessem Ojong. Assessing the Correlation Between Migrant Influx and Healthcare Accessibility in Canada. Health Education and Public Health. 2024; 7(1): 552-557. doi: 10.31488/HEPH.185.

© The Author(s) 2024.