'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.

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...

Full description

Saved in:
Bibliographic Details
Main Authors: Shira M Goldenberg, Shaina Schafers, Maggie Hamel-Smith Grassby, Stefanie Machado, Ruth Lavergne, Mei-Ling Wiedmeyer, IRIS Study Team
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLOS Global Public Health
Online Access:https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0001131&type=printable
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832595667023822848
author Shira M Goldenberg
Shaina Schafers
Maggie Hamel-Smith Grassby
Stefanie Machado
Ruth Lavergne
Mei-Ling Wiedmeyer
IRIS Study Team
author_facet Shira M Goldenberg
Shaina Schafers
Maggie Hamel-Smith Grassby
Stefanie Machado
Ruth Lavergne
Mei-Ling Wiedmeyer
IRIS Study Team
author_sort Shira M Goldenberg
collection DOAJ
description 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.
format Article
id doaj-art-2a736121b69d42de8c8fbfda18c38341
institution Kabale University
issn 2767-3375
language English
publishDate 2023-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLOS Global Public Health
spelling doaj-art-2a736121b69d42de8c8fbfda18c383412025-01-18T05:48:34ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752023-01-0131e000113110.1371/journal.pgph.0001131'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.Shira M GoldenbergShaina SchafersMaggie Hamel-Smith GrassbyStefanie MachadoRuth LavergneMei-Ling WiedmeyerIRIS Study TeamGlobally, 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.https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0001131&type=printable
spellingShingle Shira M Goldenberg
Shaina Schafers
Maggie Hamel-Smith Grassby
Stefanie Machado
Ruth Lavergne
Mei-Ling Wiedmeyer
IRIS Study Team
'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.
PLOS Global Public Health
title '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.
title_full '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.
title_fullStr '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.
title_full_unstemmed '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.
title_short '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.
title_sort 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
url https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0001131&type=printable
work_keys_str_mv AT shiramgoldenberg wedonthavetherighttogetsickaqualitativestudyofgapsinpublichealthinsuranceamongimmigrantwomeninbritishcolumbiacanada
AT shainaschafers wedonthavetherighttogetsickaqualitativestudyofgapsinpublichealthinsuranceamongimmigrantwomeninbritishcolumbiacanada
AT maggiehamelsmithgrassby wedonthavetherighttogetsickaqualitativestudyofgapsinpublichealthinsuranceamongimmigrantwomeninbritishcolumbiacanada
AT stefaniemachado wedonthavetherighttogetsickaqualitativestudyofgapsinpublichealthinsuranceamongimmigrantwomeninbritishcolumbiacanada
AT ruthlavergne wedonthavetherighttogetsickaqualitativestudyofgapsinpublichealthinsuranceamongimmigrantwomeninbritishcolumbiacanada
AT meilingwiedmeyer wedonthavetherighttogetsickaqualitativestudyofgapsinpublichealthinsuranceamongimmigrantwomeninbritishcolumbiacanada
AT irisstudyteam wedonthavetherighttogetsickaqualitativestudyofgapsinpublichealthinsuranceamongimmigrantwomeninbritishcolumbiacanada