I came to Canada from the United states in 2004 on a work permit. I moved here to be with my boyfriend. Soon, we got engaged, then married, then had a baby, and another baby. After our second child, we realized that me working full time, a requirement of my work permit, was not what was best for our family. In order to work part-time I needed to immigrate. My husband sponsored me, and I became a landed immigrant, a permanent resident in 2008. Part of my immigration process for both my work permit and for my landed status was that I needed to undergo a heath exam by an approved physician. I remember thinking, as I paid (cash only!) for my exam, what are they going to do if they find that I have some sort of chronic disease? Can they deny my entry? Is this to evaluate how I might strain the health system? I must have passed the test, whatever it was.
I am not part of a vulnerable sector: I am a healthy, relatively wealthy immigrant with English as my first language and a career in healthcare that makes it easy for me to access the services tat I require. Most immigrants, particularly refugees are not so fortunate as I in this regard.
Most new immigrants are in fact, relatively healthy at their time of entry to the country, something called the ‘heathy immigrant effect’ attributed to the relative age and country of origin of most immigrants to Canada (Ng, 2015). Healthcare accessibility is a significant barrier to most new immigrants. Financial, cultural, structural and instructional barriers are all contributing factors (Quesnel-Valee, Setia, Abrahamowicz, Tsouginant, & Lynch, 2013). Barriers to access result in an increased risk of developing acute adn chronic diseases that are costly to both the patient and the healthcare system.
One study suggests that a community navigator may help to support immigrants to navigate the complexities of Canadian healthcare and to remove the barriers that many newcomers face as they enter this country (Shammu et al., 2016). Culturally competent guidance in the form of educators, translators and pathfinders may be beneficial, particularly for those that enter as refugee claimants (Shammu et al., 2016).
I have cared for patients in my emergency department who are clearly struggling to navigate the health system. We offer a social work consultation and hand out pamphlets that contain websites for how to find a primary care physician or nurse practitioner, but I wonder how effective this really is? What have you noticed in your community?
References
Ng, E. (2015). The healthy immigrant effect and mortality rates. Retrieved from https://www.statcan.gc.ca/pub/82-003-x/2011004/article/11588-eng.htm
Quesnel-Valee, A., Setia, M. S., Abrahamowicz, M., Tsouginant, P., & Lynch, J. (2013). Access to healthcare in Canadian immigrants:A longitudinal study of the national public health survey. Health and Social Care in the Community, 19(1), 70-79. http://dx.doi.org/10.1111/j.1365-2524.2010.00950.x
Shammu, N., Ahmed, S., Rumana, N., Barron, G., McBrien, K., & Turin, T. (2016). What is the scope of improving immigrant and ethnic minority healthcare using community navigators: A systematic scoping review. International Journal of Equity in Healthcare, 15(6). http://dx.doi.org/10.1186/s12939-016-0298-8