ARCHIVED – Portrait of an Integration Process
Accessing health care services
Accessing health care services was an ongoing settlement and integration activity reported by the most immigrants throughout the 4 years. Among the four integration activities examined (i.e. finding employment, accessing education, accessing health care services and finding housing), accessing health care services was the activity in which the second largest number (31,300 or 20%) of immigrants reported barriers at the end of 4 years in Canada, while the least number of immigrants reported difficulties in this area in the first 6 months (18%) compared with other integration tasks.
Different immigration categories exhibited variations in the proportion reporting problems or difficulties accessing health care services. Economic immigrants were more likely to report problems accessing health care, as shown in Figure 9 by higher than average proportions reporting problems in all 3 waves1. Possibly through families’ help and support, family class immigrants were able to better deal with obstacles related to health services, and as a result, they were least likely to report difficulties among all immigration classes. Over the duration of the LSIC, increasing proportions of immigrants who reported difficulties accessing health care services were found in almost all the immigration categories, with the exception of refugees. By the end of the 4th year in Canada, 12% of refugees claimed barriers accessing health care services, which was the smallest proportion among all the immigration classes at the same point in time, and also the only decrease in the proportion reporting barriers accessing health care services compared to the first 6 months in Canada.
Figure 9: Proportion of immigrants who encountered difficulties accessing health care services, by immigration category — Wave 1, 2, and 3.
Long wait times was ranked as the most reported problem related to accessing health care services throughout the first 4 years for the LSIC immigrants (Figure 10). This problem worsened over time with increasing proportions citing wait times as the most serious problem. Of note, this problem is not specific to the immigrant community, as Canadians also mention long wait times as a critical problem for health care access — “waiting too long for care was cited as the number one barrier among those who experienced difficulties.”2 Poor quality of services or care was another emerging problem reported by these newcomers.
It is also worth noting that as time went on, the proportion citing language problems as the most serious difficulty in accessing health care dropped significantly, from 14% at 6 months to 4% at 4 years after arrival.
Figure 10: Most serious problem in accessing health care during the first 4 years in Canada
While the proportion of immigrants who reported receiving help for barriers accessing health care services decreased over time (28%, 14% and 11% at the time of Wave 1, 2 and 3, respectively), the proportion reporting not receiving assistance needed also displayed a similar decreasing trend (28%, 18% and 17% in 3 waves, respectively) (Table 6). Although the percentage of newcomers getting assistance declined with time spent in Canada, the decline may partly reflect a reduced need for such help.
Family class immigrants were most likely to obtain assistance with problems accessing health care services compared with their counterparts who landed in the other immigration categories. Presence of some kind of network upon landing probably played a role in assisting immigrants in this category accessing health care services. In contrast, refugees had the highest proportion for reporting unmet needs.
Table 6: Received help and needed but not received help for the most serious problem reported for accessing health care services.
| Selected types of unmet needs | Immigration Category | |||||
|---|---|---|---|---|---|---|
| Family Class | Skilled Workers (PA) | Skilled Workers (S&D) | Other Economic | Refugees | All Immigrants2 | |
| Immigrants who had problems accessing health care - Wave 1 | 5,092 | 11,399 | 8,432 | 1,644 | 1,583 | 28,203 |
| Immigrants who had received help for the most serious problem in getting health care - Wave 1 | 42% | 23% | 27% | 19% | 33% | 28% |
| Immigrants who had not received help needed for the most serious problem accessing health care services - Wave 1 | 29% | 31% | 25% | 13% | 39% | 28% |
| Immigrants who had problems accessing health care - Wave 2 | 4,627 | 9,139 | 7,423 | 1,850 | 1,041 | 24,114 |
| Immigrants who had received help for the most serious problem in getting health care - Wave 2 | 21% | 15% | 9% | 10% | 8% | 14% |
| Immigrants who had not received help needed for health problem in general1 - Wave 2 | 12% | 18% | 22% | 11% | 24% | 18% |
| Immigrants who had problems accessing health care - Wave 3 | 6,095 | 12,233 | 9,400 | 2,290 | 1,191 | 31,295 |
| Immigrants who had received help for the most serious problem in getting health care - Wave 3 | 14% | 8% | 11% | 12%E | F | 11% |
| Immigrants who had not received help needed for health problem in general1 - Wave 3 | 15% | 17% | 18% | 18%E | 20%E | 17% |
1Source question was changed substantially. Instead of being asked about whether the LR had needed but did not receive help for the most serious problem in accessing health care, the question was asked about whether the LR had any help needed but did not
2All immigrants include a small number of immigrants who landed in the classes not mentioned in the table.
EUse with caution.
F Too unreliable to be released.
Source: Longitudinal Survey of Immigrants to Canada - Wave 3, 2005.
Not surprisingly, older immigrants received more attention accessing health care services. Four years after landing, of immigrants 45 years of age and over who reported problems accessing health care, 14% received help for the most serious problem, considerably higher than the proportion for immigrants aged 25 to 44 years (9%).
Looking at the sources of assistance, social networks were prevalent for all immigrants (Figure 11). Help from a friend was one of the most cited resources of help for obstacles accessing health care services (36% at 6 months after landing and 44% since 2 years after arrival). The prevalence of the reliance on relatives declined from 38% at 6 months after landing to 20% at 4 years in Canada, but the use of the kinship network was still prominent. In addition, there was a modest increase in the proportion of immigrants reporting receiving help from health care workers over time.
Figure 11: Main sources of help received for the most serious problem accessing health care services — Wave 1, 2, and 3.
Financial assistance and information were the types of help most needed but not received for problems accessing health care services for the LSIC newcomers. Four years after landing, nearly one in three (31%) immigrants who reported not receiving help needed claimed financial assistance was most needed, closely followed by information (30%) and advice (22%). Across immigration category, it is worth noting that financial assistance was most pronounced for refugees (57%) while skilled worker principal applicants were more likely to report needing information (32%).
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