Data, including a new study, suggest the answer may be yes
Are provincial health systems stacked against new immigrants? Several studies suggest the answer may be yes.
In a new study, my colleagues and I measured wait times for elective surgeries in British Columbia. The study found that immigrants face longer waits than Canadians born here.
While our research focused on only one aspect of healthcare services in one province, the results are consistent with other findings that reveal immigrants in many provinces encounter problems when trying to access healthcare. Previous research has highlighted challenges immigrants face accessing primary healthcare, physician-based healthcare servicesand cervical cancer screening in Canada, for example.
This not only raises questions about fairness but also whether all of us will pay more for delaying care, delayed access results in more emergency department visits and avoidable hospitalizations.
As provinces across the country – including Alberta, Manitoba, Ontario, Quebec and Nova Scotia – pledge millions in new investments in this year’s budgets to cut healthcare wait times, they must not overlook whether their health systems’ practices are fair to new arrivals.
New funding to shorten wait times must be accompanied by new policies and practices that reduce barriers preventing immigrants from accessing healthcare services in the same way the rest of us do.
Our new study compared wait times between immigrants and non-immigrants for thousands of elective surgeries. Immigrants waited significantly longer than non-immigrants for their surgery – an average of 83.7 days compared to 76.3 days. For gallbladder removal, the wait for immigrants was two weeks longer than for non-immigrants on average.
Immigrants that were visible minorities waited even longer than those for immigrants from European or English-speaking countries.
Ensuring immigrants have equal access to healthcare should matter to everyone, not just immigrants.
Long wait times for elective surgery can negatively impact patients, reduce their quality of life, increase psychological distress and lengthen the time their symptoms persist. Quick recovery helps reduce health system costs in the long run and gets people back to work.
For those with lower socioeconomic status – including many immigrants – the effects can be even more pronounced as surgical delays can exhaust immigrants’ limited financial resources or social capital.
The Canada Health Act applies to all Canadians equally. The Act requires provinces and territories to provide publicly funded healthcare to all eligible residents regardless of where they were born.
The reasons for longer elective surgery wait times for immigrants are multi-pronged.
Immigrants from non-English-speaking countries might encounter language difficulties, racism or have cultural backgrounds that make it harder for them than non-immigrants to communicate with healthcare providers about the severity of their symptoms, understand directions for managing symptoms or travel to appointments.
Communication breakdowns can also lead surgeons to believe that their surgery is less urgent than for someone better able to explain themselves.
Immigrants’ working hours or caregiving responsibilities might also make it difficult for them to schedule appointments during the day.
Social preferences might also play a role – with immigrants possibly relying more on family or social networks to recommend surgeons who share their cultural background but have longer wait times.
Immigrants make up almost one-quarter of Canada’s population – over eight million people – and their numbers are expected to grow even higher in the coming decades. Governments need to work with communities to identify barriers and adapt practices to reduce or eliminate them, beginning with addressing language and cultural barriers within hospitals.
So, what measures can be put in place?
Hospital staff who interact with patients, including healthcare providers and those responsible for booking appointments, should practice cultural sensitivity. Hospitals should have access to readily available translation services like medical interpreters or translation software.
Physicians’ practices should hire office staff with cultural backgrounds reflective of their patients, including diverse language skills.
New immigrants should be provided support to linguistically and culturally navigate their new health system. Immigrants should have support to more readily find a family doctor or nurse practitioner – a crucial step for ensuring timely referrals for surgeries and other services.
It is time to make fair access to healthcare for immigrants a central part of provincial strategies to reduce healthcare wait times.
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