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Access to health-care in Canadian immigrants: a longitudinal study of the National Population Health Survey

Authors

  • Maninder Singh Setia MD MPH,

    1. Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
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  • Amelie Quesnel-Vallee PhD MSc,

    1. Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
    2. Department of Sociology, McGill University, Montreal, QC, Canada
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  • Michal Abrahamowicz PhD,

    1. Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
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  • Pierre Tousignant MD MSc FRCP(c),

    1. Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
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  • John Lynch PhD

    1. School of Health Sciences, University of South Australia, Adelaide, SA, Australia
    2. Department of Social Medicine, University of Bristol, Bristol, UK
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Dr Maninder Singh Setia
Department of Epidemiology, Biostatistics, and Occupational Health
McGill University
1020 Pine Avenue West, Montreal, QC
Canada H3A 1A2
E-mail: maninder.setia@mail.mcgill.ca

Abstract

Immigrants often lose their health advantage as they start adapting to the ways of the new society. Having access to care when it is needed is one way that individuals can maintain their health. We assessed the healthcare access in Canadian immigrants and the socioeconomic factors associated with access over a 12-year period. We compared two measures of healthcare access (having a regular doctor and reporting an unmet healthcare need in the past 12 months) among immigrants and Canadian-born men and women, aged more than 18 years. We applied a logistic random effects model to evaluate these outcomes separately, in 3081 males and 4187 females from the National Population Health Survey (1994–2006). Adjusting for all covariates, immigrant men and women (white and non-white) had similar odds of having a regular doctor than the Canadian-born individuals (white immigrants: males OR: 1.32, 95% C.I.: 0.89–1.94, females OR: 1.14, 95% C.I.: 0.78–1.66; non-white immigrants: males OR: 1.28, 95% C.I.: 0.73–2.23, females OR: 1.23, 95% C.I.: 0.64–2.36). Interestingly, non-white immigrant women had significantly fewer unmet health needs (OR: 0.32, 95% C.I.: 0.17–0.59). Among immigrants, time since immigration was associated with having access to a regular doctor (OR per year: 1.02, 95% C.I.: 1.00–1.04). Visible minority female immigrants were least likely to report an unmet healthcare need. In general, there is little evidence that immigrants have worse access to health-care than the Canadian-born population.

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