title: Accessibility and use of primary healthcare for immigrants living in the Niagara Region.
abstract: Although the challenges of accessing and using primary healthcare for new immigrants to Canada have been fairly well documented, the focus has primarily been on large cities with significant immigrant populations. The experiences of immigrants living in smaller, less diverse urban centres remain largely unknown. The purpose of this study was to examine the lived experiences of immigrants living in a small urban centre with regards to the primary healthcare system. A total of 13 immigrants living in the Greater Niagara Region participated in semi-structured interviews. All interviews were recorded, transcribed, and then coded and analyzed for emergent themes using NVivo. Five factors were found to impact primary care access and use: lack of social contacts, lack of universal healthcare coverage during their initial arrival, language as a barrier, treatment preferences, and geographic distance to primary care. Overall findings suggest that immigrants moving to smaller areas such as the Niagara Region face similar barriers to primary care as those moving into large cities. Some barriers, however, appear to be specific to the context of smaller urban centres, further exacerbated by living in a small city due to a smaller immigrant population, fewer services for immigrants, and less diversity in practicing physicians. More research is required to understand the contextual factors inhibiting primary care access and use among immigrants moving to smaller urban centres, and determine effective strategies to overcome these barriers.
authors.affiliation: McMaster University, Michael G. DeGroote School of Medicine, Niagara Regional Campus, 500 Glenridge Avenue, St. Catharines, Ontario L2S 3A1, Canada. Electronic address: irene.lum@medportal.ca.
authors.forename: Irene D
authors.initials: ID
authors.lastname: Lum
authors.affiliation: McMaster University, Michael G. DeGroote School of Medicine, Niagara Regional Campus, 500 Glenridge Avenue, St. Catharines, Ontario L2S 3A1, Canada. Electronic address: rebecca.swartz@medportal.ca.
authors.forename: Rebecca H
authors.initials: RH
authors.lastname: Swartz
authors.affiliation: McMaster University, Michael G. DeGroote School of Medicine, Niagara Regional Campus, 500 Glenridge Avenue, St. Catharines, Ontario L2S 3A1, Canada; McMaster University, Department of Family Medicine, 5th Floor - 100 Main Street West, Hamilton, Ontario L8P 1H6, Canada. Electronic address: kwanmy@mcmaster.ca.
authors.forename: Matthew Y W
authors.initials: MY
authors.lastname: Kwan
mesh_terms: D000328:Adult; D002170:Canada; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*; D036301:Qualitative Research
keywords: Access to healthcare; Canada; Immigrant health; Primary care; Qualitative research