Disparities/Minority Health

Immigrants to the United States and Canada have worse access to care than native-born counterparts

Every year, the United States and Canada receive new immigrants who will require access to primary and preventive health care services. A new study reveals that foreign-born immigrants have worse access to care in both countries compared with native-born persons, for certain access indicators. Immigrants in the United States fared worse than nonimmigrants when it came to having a regular doctor and an annual visit with a health care provider. Overall, immigrants in Canada had better health care access compared with their counterparts in the United States. However, immigrants living in Canada had lower rates of timely Pap tests compared with U.S. immigrants.

Significant differences exist between these two countries when it comes to health insurance coverage, and these differences help to explain some of the differences in access to care across countries. Canadians rely on universal access to publicly funded health care services. In contrast, the majority of Americans have private health insurance, and a significant portion lack any insurance. Other differences in the sociodemographic composition of each country's immigrant population may also help to explain access-to-care differences.

Findings were based on a telephone survey, conducted between 2002 and 2003, of residents living in both countries. The sample included 6,620 adults aged 18-64 years with known information on nativity status. Participants were asked about their access to health care in the past 12 months, Pap test screening in the past 3 years, and mammograms in the past 2 years. Out of 2,729 participants living in Canada, 473 were born outside the country. The sample also included 3,267 native-born U.S. residents and 624 foreign-born individuals. The study was supported in part by the Agency for Healthcare Research and Quality (T32 HS00029).

See "Access to primary and preventive care among foreign-born adults in Canada and the United States," by Lydie A. Lebrun, M.P.H., and Lisa C. Dubay, Ph.D., in the December 2010 HSR: Health Services Research 45(6) Part I, pp. 1693-1719.

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