Unmet healthcare needs among migrants without medical insurance in Montreal, Canada

ABSTRACT

While access to healthcare for permanent residents in Canada is well known, this is not the case for migrants without healthcare coverage. This is the first large-scale study that examines the unmet healthcare needs of migrants without healthcare coverage in Montreal. 806 participants were recruited: 436 in the community and 370 at the NGO clinic. Proportions of individuals reporting unmet healthcare needs were similar (68.4% vs. 69.8%). The main reason invoked for these unmet needs was lacking money (80.6%). Situations of not working or studying, not having had enough food in the past 12 months, not having a medical prescription to get medication and having had a workplace injury were all significantly associated with higher odds of having unmet healthcare needs. Unmet healthcare needs were more frequent among migrants without healthcare coverage than among recent immigrants or the citizens with health healthcare coverage (69%, 26%, 16%). Canada must take measures to enable these individuals to have access to healthcare according to their needs in order to reduce the risk of worsening their health status, something that may have an impact on the healthcare system and population health. The Government of Quebec announced that all individuals without any healthcare coverage will have access to COVID-19 related health care. We hope that this right, the application of which is not yet obvious, can continue after the pandemic for all health care.

KEYWORDS:

• Universal health coverage
• unmet healthcare needs
• migrants
• undocumented
• access to care
• medical insurance
• Canada
• Quebec

Acknowledgements

We would like to thank Anne Gosselin and two anonymous reviewers for their critical reading of a preliminary version of this text, as well as Doctors of the World, its staff, students, community organisations, and all the research assistants and migrants we met so that this research can take place. This research was funded by the Canadian Institutes of Health Research (MOP 142332).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Of note, however, in the context of the COVID-19 crisis in the Spring of 2020, the Quebec government announced that COVID-related testing and treatment would be provided free of charge for any uninsured migrants. While charges will continue to apply for non-COVID health care, this was a welcome measure for the uninsured and one that, advocates hope, may open the door to broader reforms in the future.

Additional information

Funding

This work was supported by Institute of Population and Public Health: [Grant Number MOP 142332].