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Thesis Format

Integrated Article

Degree

Master of Clinical Science

Program

Family Medicine

Supervisor

Ryan, Bridget

2nd Supervisor

Mathews, Maria

Co-Supervisor

Abstract

Immigrants to Canada face unique barriers to health care, which leads to inequities in the utilization of health care. Lower utilization of health care by immigrants to Canada is associated with the deteriorating health of individual immigrants as well as costs to the health care system. The existing literature suggests that time since immigration is an important predictor for utilization of healthcare for Canadian immigrants. This thesis uses Andersen and Newman’s Framework of Health Service Utilization and data from the 2015-2016 Canadian Community Health Survey to examine health care utilization among immigrants in Canada. The objectives were: (1) To examine the relationship between having a regular health care provider and time since immigration, and (2) To examine the relationship between number of medical consultations in the past year and time since immigration. A secondary cross-sectional data analysis was conducted using the 2015-2016 dataset for the Canadian Community Health Survey (CCHS). Eighty four percent of immigrant respondents to CCHS 2015-2016 had a regular health care provider. After controlling for other independent variables, established immigrants (10 or more years since immigration) were 1.75 times more likely to have a regular health care provider compared to recent immigrants (less than 10 years since immigration), confirming the hypothesis. The mean number of medical consultations in the past year for adult immigrant respondents to CCHS 2015-2016 was 3.37±4.53. After controlling for other independent variables, this study found that, contrary to the hypothesis, time since immigration did not have a significant effect on the number of consultations. The patterns of health care utilization for recent and for established immigrants observed in this study may be partially explained by shifting immigration policy, and the economic and social integration of immigrants over time.

Summary for Lay Audience

Although health care in Canada is universal, immigrants to Canada sometimes have difficulty getting the health care they need. Some previous studies have looked at the differences between use of health care by immigrants compared to the Canadian-born. However, there are few studies about the effect of time since immigration on use of health care by immigrants to Canada. The goals of this study were to investigate the effect of time since immigration on: (1) having a regular health care provider, and (2) the number of visits with a doctor in the past year.

In this study, the results of a national survey, the Canadian Community Health Survey (2015-2016), were used to answer these questions. We compared recent immigrants, who immigrated within the last 10 years, to established immigrants, who immigrated 10 or more years ago. Eighty four percent of immigrants had a regular health care provider. Established immigrants were more likely to have a regular health care provider than recent immigrants. On average, immigrants had 3.37 consultations with a doctor in the past year. However, time since immigration did not have an effect on the number of consultations with a doctor in the past year.

There may be many reasons for these findings. Over time, changes have been made to the way Canada accepts immigrants into the country. This may have resulted in differences in the types of immigrants accepted, which may affect the use of health care by recent immigrants compared to established immigrants. Over time, immigrants also become socially and economically integrated into Canada, which may explain some of the differences in use of health care by recent and established immigrants.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

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