Immigrants are twice as likely to fear being targets of stigma during the COVID-19 pandemic in Canada

A new study from the University of Toronto has found that that COVID-19-related health concerns are more prevalent among marginalized people who are migrants to Canada.

Published online in the Journal of Immigrant and Minority Health, the research revealed that during the early phase of the pandemic, migrants were almost twice as likely as Canadian-born residents to fear being the target of stigma. They were also more likely to express vaccine hesitancy (21.5% vs. 15.5%) and perceive health risks when accessing care (89% vs. 76.3%).

"Fear and anxiety about COVID-19 have sparked big rise in social stigma," says lead author Shen (Lamson) Lin, a doctoral candidate and researcher at the University of Toronto's Factor-Inwentash Faculty of Social Work. "The pandemic and consequential public health restrictions seem to have contributed to 'othering' and labeling that disproportionately affects marginalized minority groups—especially immigrants, refugees, and migrant populations."

Among those who anticipated being the target of stigma, Canadian-born residents were more likely than immigrants to attribute their fear of stigmatization to non-compliance with mask wearing. Migrants to Canada, however, were three times more likely to link their fear to non-health-behavioral reasons, such as racial identity.

"Excess fear of stigmatization among immigrant populations may be partly ignited by a tendency to frame COVID-19 as foreign virus," says Lin. "This framing blames the pandemic on foreign 'others' and exacerbates physical and mental health disparities already present in the immigrant and refugee communities."

The study's finding that immigrants were more likely to view going to a doctor or hospital as a health risk, regardless of the free services offered by Canada's publicly funded health care system, may not be unrelated, says Lin.

"Those who fear stigmatization often hide symptoms or illnesses and may avoid obtaining early medical attention, which can make it more difficult to limit the spread of the virus," he says. "Perceiving medical care as a health risk is worrying, as it could lead to immigrants' underutilizing needed services, such as diagnostic tests and care for COVID-19 infection, during the crisis."

While 16.9% of all study participants expressed vaccine hesitancy before the first COVID-19 vaccine was authorized for use in Canada, the prevalence of vaccine hesitancy during this time was greater among migrants to Canada compared to Canadian-born residents (21.5% vs. 15.5%, respectively). Among vaccine-hesitant individuals, immigrants reported higher concerns than non-immigrants on vaccine safety (71.3% vs. 49.5%) and side effects (66.4% vs 47.3%). Immigrants who were vaccine hesitant were almost twice as likely to mistrust vaccines.

The study analyzed the publicly available data from the Statistics Canada's Canadian Perspective Survey Series 3 (CPSS-3, June 15 to 21, 2020) which included 2,924 non-immigrants and 598 immigrants aged 25 years and above. The CPSS-3 survey is a probability sample of the nationwide population in Canada with a response rate of 58.1%.

"Our response to the COVID-19 pandemic must include confronting xenophobia and stigmatization in order to mitigate heightened fear and mistrust of new vaccines among immigrants amidst turbulent times. Health authorities need to ensure equitable access to COVID-19 vaccines and other health-enhancing resources for immigrant communities," says Lin.

"It is vital for any COVID-19 recovery plans to proactively include migrant and displaced populations—regardless of their legal status. Health equity should be placed at the center of the pandemic responses."