‘We don’t have the right to get sick’

A qualitative study of gaps in public health insurance among Im/migrant women in British Columbia, Canada

Bibliographic Data

ID19590747
AuthorsShira M Goldenberg (0000-0003-1633-9749, University of British Columbia, corresponding author), Shaina Schafers (0000-0003-4485-035X, Simon Fraser University, corresponding author), Maggie Hamel-Smith Grassby (Simon Fraser University, corresponding author), Stefanie Machado (0000-0002-9006-8951, Simon Fraser University, corresponding author), Ruth Lavergne (Dalhousie University, corresponding author), Mei-ling Wiedmeyer (0000-0002-9882-0415, University of British Columbia, corresponding author), on behalf of the IRIS Study Team
EditorsJulia Robinson (0000-0003-0719-3995)
Year2023
Volume3
Issue1
Pagese0001131
Publication date2023-01-26
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0001131
PMID36962991
OpenAlexW4318142113
LanguageEN
Citations received4
References cited25

Globally, the exclusion of im/migrants from public health care systems remains a significant health and human rights issue, calling into question claims of ‘universality’ of public health systems where eligibility for coverage is determined by immigration status. We aimed to describe lived experiences of health insurance coverage and the health and social impacts of gaps in health insurance amongst im/migrant women in British Columbia (BC), Canada. This analysis draws on qualitative in-depth interviews (n = 78) with im/migrant women and im/migrant-focused service providers (n = 10) conducted between July 2018-March 2021 in Metro Vancouver, BC, as part of a larger community-based, mixed-methods study of im/migrants’ health access (IRIS). In contrast to common perceptions of Canada’s health system as ‘universal’, participants faced multifaceted barriers to health insurance and necessary healthcare for themselves and their families following arrival in BC. Narratives highlighted the ways in which ineligibility for public health insurance coverage resulted in unmet needs for essential sexual and reproductive health and preventive care among im/migrant women, children, and families. Participants also described ineligibility for public health insurance as resulting in a high economic burden, and that exclusion from public health insurance perpetuated experiences of discrimination, invisibility, and exclusion from systems of care amongst im/migrant participants. Despite these structural challenges, participant narratives highlighted the crucial role of community-based supports for minimizing harm and navigating oppressive immigration and health systems. Changes to immigration and health policies are required to remove barriers to public health care for im/migrant women and ensure that Canada’s health system is accessible to all. Expanding health insurance options to cover all residents and decoupling health insurance eligibility from immigration status are recommended, alongside implementation of ‘Sanctuary’ policies at the local level

Economic growth · Health care · Immigration · Political science · Public health · Qualitative research · Sociology · Food Security and Health in Diverse Populations · Global Health Workforce Issues · Law · Medicine · Migration, Health and Trauma · Nursing · Health Policy

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