A Comparison of Health Access Between Permanent Residents, Undocumented Immigrants and Refugee Claimants in Toronto, Canada

• Published in: Journal of immigrant and minority health 2014-02, Vol.16 (1), p.165-176
• Main Authors: Campbell, Ruth M., Klei, A. G., Hodges, Brian D., Fisman, David, Kitto, Simon
• Format: Article
• Language: English
• Subjects: Adult; Claimants; Community involvement; Community organizations; Community Relations; Comparative Law; Deportation; Emergency medical care; Emergency medical services; Emigrants and Immigrants; Estimates; Fear; Female; Health; Health care; Health care access; Health services; Health Services Accessibility; Health Services Needs and Demand; Health services utilization; Humans; Illegal immigrants; Immigrants; Immigration; Immigration policy; International & Foreign Law; Interviews as Topic; Language; Literature reviews; Male; Medical research; Medicine; Medicine & Public Health; Middle Aged; Migration; Noncitizens; Ontario; ORIGINAL PAPER; Participatory research; Physicians; Private International Law; Public Health; Qualitative Research; Refugees; Research Methodology; Sociology; Studies; Urban Areas; Urban Population
• ISSN: 1557-1912; 1557-1920
• DOI: 10.1007/s10903-012-9740-1

Understanding the immigrant experience accessing healthcare is essential to improving their health. This qualitative study reports on experiences seeking healthcare for three groups of immigrants in Toronto, Canada: permanent residents, refugee claimants and undocumented immigrants. Undocumented immigrants who are on the Canadian Border Services Agency deportation list are understudied in Canada due to their precarious status. This study will examine the vulnerabilities of this particular subcategory of immigrant and contrast their experiences seeking healthcare with refugee claimants and permanent residents. Twenty-one semi-structured, one-on-one qualitative interviews were conducted with immigrants to identify barriers and facilitators to accessing healthcare. The open structure of the interviews enabled the participants to share their experiences seeking healthcare and other factors that were an integral part of their health. This study utilized a community-based participatory research framework. The study identifies seven sections of results. Among them, immigration status was the single most important factor affecting both an individual’s ability to seek out healthcare and her experiences when trying to access healthcare. The healthcare seeking behaviour of undocumented immigrants was radically distinct from refugee claimants or immigrants with permanent resident status, with undocumented immigrants being at a greater disadvantage than permanent residents and refugee claimants. Language barriers are also noted as an impediment to healthcare access. An individual’s immigration status further complicates their ability to establish relationships with family doctors, access prescriptions and medications and seek out emergency room care. Fear of authorities and the complications caused by the above factors can lead to the most disadvantaged to seek out informal or black market sources of healthcare. This study reaffirmed previous findings that fear of deportation forestalls undocumented immigrants from seeking out healthcare through standard means. The findings bring to light issues not discussed in great depth in the current literature on immigrant health access, the foremost being the immigration status of an individual is a major factor affecting that person’s ability to seek, and experience of, healthcare services. Further, that undocumented immigrants have difficulty gaining access to pharmaceuticals and so may employ unregulated means to obtain medic