Grant: Project Grant

An estimated 500,000 people in Canada lack provincial health coverage because their legal status makes them ineligible. Fearing deportation, out-of-pocket costs, and a mistrustful system, many uninsured immigrants delay preventive care, which worsens health and increases long-term costs. The health and social service use of these immigrants is not known in Canada, limiting the ability to direct finite healthcare resources. Our overall aim is to improve access to care for these immigrants. We compiled data from all community health centres (CHCs) across Ontario to build the first-ever population-based cohort of ~300,000 uninsured immigrants. Developed in collaboration with knowledge users, our projects will focus on: 1) Why and how often do uninsured immigrants visit CHCs to use health and social services compared to immigrant and non-immigrant Ontarians with provincial coverage. 2) If and how the services used change when they get coverage: In a subset of 30,000 uninsured immigrants who later get provincial health coverage, we will track use of services before and after getting provincial coverage. 3) Hearing directly from them: We will interview ~30 uninsured immigrants, preferably in person, to hear in their own words how the lack of provincial insurance affects their decisions about seeking care. We will use a trauma-informed, non-coercive approach that takes into account their individual backgrounds and identities, and vulnerability when interacting with healthcare. The interviews will be voluntary, and data will be de-identified. We have the data and skills to conduct this project and the experience studying immigrant populations. We will close a critical knowledge gap to assist in resource planning at CHCs and other organizations serving uninsured immigrants. By combining population-level data and lived experiences, we will produce data-driven policy briefs to inform our immigration and health policies and improve the lives of all Canadian immigrants.