Background: We investigated the relationship between neighbourhood income quintile and mental health service use by immigration experience among youth and explored changes during the COVID-19 pandemic.
Method: We used administrative data to examine mental health service use among youth aged 10 to 24 in British Columbia, Canada, between April 1, 2019, and March 31, 2022. We compared rates of community-based mental health service use, emergency department visits, and hospitalizations and the proportion of involuntary admissions by neighbourhood income quintile and immigration.
Objectives: This study aimed to compare demographics and clinical outcomes between patients who did not undergo investigations and those who underwent investigations before receiving a prescription for medication abortion (MA) during the first 6 months of the COVID-19 pandemic. Outcomes include success rates, adverse events, pathways to completion, and loss to follow-up rates.
Methods: We conducted a retrospective medical record review of 1452 patients presenting for MA between 23 March 2020 and 30 September 2020.
Background: The onset of the COVID-19 pandemic drove a rapid and widespread shift to virtual care, followed by a gradual return to in-person visits. Virtual visits may offer more convenient access to care for some, but others may experience challenges accessing care virtually, and some medical needs must be met in-person. Experiences of the shift to virtual care and benefits of in-person care may vary by immigration experience (immigration status and duration), official language level, and age.
View Article and Find Full Text PDFThat immigration is a determinant of health and that immigration systems themselves contribute to structural disadvantage remains under-addressed within healthcare in Canada. This article offers context for how immigration shapes health, and recommendations for how health systems can be better prepared to respond to the diverse needs of immigrants and migrants (together referred to as im/migrants), based on a community-based research project in British Columbia. Findings call attention to the varied and intersecting ways in which immigration status, access to health insurance, language, experiences of trauma and discrimination, lack of support for health system limits access to healthcare, and the roles community-based organizations play in supporting access.
View Article and Find Full Text PDFIntroduction: Global migration and immigration are increasing, and migrants and immigrants (im/migrants) have specific health needs and healthcare experiences. Yet, im/migrant involvement in immigration and health research in Canada is inconsistent. Heretofore, involvement has primarily been in research planning, data collection and analysis, with little community involvement during knowledge exchange or through training and colearning opportunities.
View Article and Find Full Text PDF: Intersex, trans, and Two-Spirit people report overwhelmingly negative experiences with health care providers, including having to educate their providers, delaying, foregoing, and discontinuing care due to discrimination and being denied care. Medical education is a critical site of intervention for improving the health and health care experiences of these patients. Medical research studies, clinical guidelines, textbooks, and medical education generally, assumes that patients will be white, endosex, and cisgender; gender and sex concepts are also frequently misused.
View Article and Find Full Text PDFObjectives: Having temporary immigration status affords limited rights, workplace protections, and access to services. There is not yet research data on impacts of the COVID-19 pandemic for people with temporary immigration status in Canada.
Methods: We use linked administrative data to describe SARS-CoV-2 testing, positive tests, and COVID-19 primary care service use in British Columbia from January 1, 2020 to July 31, 2021, stratified by immigration status (citizen, permanent resident, temporary resident).
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).
View Article and Find Full Text PDFThis qualitative study aimed to understand how migration experiences shape im/migrant women's needs, desire for, and expectations of healthcare in the British Columbia (BC), Canada context. Interviews with 33 im/migrant women (December 2018-January 2020) highlighted that traumatic experiences across migration increased healthcare needs; insufficient prior health system information contributed to poor experiences; and comparative healthcare experiences across places shaped future healthcare expectations. We use the BC setting to demonstrate the need to abide by global commitments to protect people during migration, train providers in trauma-informed care, develop health assessments that center migration journeys, and appropriately fund im/migrant-serving community organizations.
View Article and Find Full Text PDFBackground: Strong primary care systems have been associated with improved health equity. Primary care system reforms in Canada may have had equity implications, but these have not been evaluated. We sought to determine if changes in primary care service use between 1999/2000 and 2017/2018 differ by neighbourhood income in British Columbia.
View Article and Find Full Text PDFNewly arrived refugees and refugee claimants experience low cervical cancer screening (CCS) rates in Canada. We investigated CCS at a dedicated refugee clinic. We completed a retrospective cohort study among patients at the Mosaic Refugee Health Clinic in Calgary, Canada, between 2011 and 2016.
View Article and Find Full Text PDFObjectives: To evaluate impacts of a residency-based waiting period for health insurance coverage on lived experiences of health and settlement for im/migrant women in British Columbia, Canada.
Design: The IRIS study is a mixed-methods, community-based, qualitative evaluation of recently arrived im/migrant women's access to sexual and reproductive care. In-depth, semistructured interviews were conducted by trained multilingual and multicultural interviewers with lived migration experience in the participant's preferred language.
This study examines correlates of being unable to access primary care in the past 6 months among cisgender (cis) and trans women living with HIV (WLWH). Data were drawn from a longitudinal community-based cohort study of WLWH (ages 14+) in Metro Vancouver, Canada (2014-2017). Of 291 participants contributing 914 observations, 15.
View Article and Find Full Text PDFGiven growing concerns of im/migrant women's access to sexual and reproductive health (SRH) services, we aimed to (1) describe inequities and determinants of their engagement with SRH services in Canada; and (2) understand their lived experiences of barriers and facilitators to healthcare. Using a comprehensive review methodology, we searched the quantitative and qualitative peer-reviewed literature of im/migrant women's access to SRH care in Canada from 2008 to 2018. Of 782 studies, 38 met inclusion criteria.
View Article and Find Full Text PDFBackground: Most abortions occur due to unintended pregnancy. Unintended pregnancies are linked to poor health outcomes. Canada receives immigrants from countries with disparate sexual and reproductive health contexts which may influence abortion rates post-migration.
View Article and Find Full Text PDFObjective: To examine the association between usual place of primary care and mental health consultation among those with self-reported mood or anxiety disorders. We also describe access to mental health services among people who are recent immigrants, longer-term immigrants, and nonimmigrants and determine whether the association with place of primary care differs by immigration group.
Methods: We used data from the Canadian Community Health Survey (2015 to 2016) to identify a representative sample of individuals with self-reported mood or anxiety disorders.
Objective: To see if refugee women at a community health centre (CHC) in Toronto, Ont, are appropriately screened for cervical cancer and if there are any demographic characteristics that affect whether they are screened.
Design: Chart review.
Setting: A CHC in downtown Toronto.
Background and Purpose. Inpatient rehabilitation in countries other than the United States (US) has been described as a time where patients are often not engaged in intensive physical activity. The purpose of this case report is to explore the amount and intensity of physical activity provided in inpatient rehabilitation after stroke in the US.
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