New immigrants to Canada face barriers to accessing primary care, may be missing benefits of family doctor relationship

Recent immigrants to Canada face barriers to accessing primary care and may be missing out on the benefits that come with having a family physician.

Research from Western University, recently published in BMC Primary Care, shows that new immigrants to Canada are almost half as likely to have a family physician as established immigrants.

"We know there are barriers to access even in a place like Canada, where we have publicly funded health care, but what hasn't been studied until now was how the length of time an immigrant has been in Canada impacts access to health care," said Dr. Nisanthini Ravichandiran, a family physician who completed the research as a master of clinical science student in the department of family medicine at Schulich Medicine & Dentistry. "This research illuminates the fact that recent immigrants are a special population who are often unfamiliar with the health-care system and may not have the social supports to help them navigate that system."

Ravichandiran now practices family medicine in Scarborough. She says the impetus for the study came from watching her parents navigate the health-care system when they immigrated to Canada when she was a child, and then seeing in her clinical practice how complex the system can be for recent immigrants with no prior knowledge of the role of family physicians in Canada.

The study is based on the Canadian Community Health Survey, which collects information related to health status, health-care utilization, and health determinants for the Canadian population. The researchers compared recent and established immigrants on whether or not they had a regular health-care provider, as well as the number of times they accessed the health-care system in a year.

And while they found that recent immigrants were significantly less likely to have a primary health-care provider, they had a similar number of health-care consultations as established immigrants. The researchers said this indicates recent immigrants may be accessing the health-care system for more episodic care through walk-in clinics, or urgent care.

"A central tenet of family medicine is having that long-term continuous relationship with your family doctor," said Maria Mathews, professor in the department of family medicine at Schulich Medicine & Dentistry and co-author on the study. "Without a primary care provider, immigrants may also be missing out on health education and health promotion which are particularly important when you are new to a system."

The researchers found that a number of factors may influence this lack of access to primary care for new immigrants, including language and transportation barriers or a lack of important social supports, or a sense of belonging to the local community.

"It may be that for some immigrants having a sense of belonging to their community means they have people in their lives who can help them navigate the Canadian health-care system and support them to find a family physician," said Bridget Ryan, professor in family medicine and epidemiology & biostatistics at Schulich Medicine & Dentistry and co-author on the study.

The researchers hope this work will help policymakers recognize what they can do to help newcomers to Canada better access primary care.