Healthcare Access Among Marginalized Communities Living in the GTA
Health equity is the practice of fair access and opportunity for everyone to attain their fullest health potential, regardless of differences among groups of people.1 According to the World Health Organization, an individual’s health can be influenced by non-medical factors called social determinants of health.2 A few examples of social determinants of health include income, education, housing, social inclusion, non-discrimination, and access to affordable health services.2
Even in multi-cultural countries with universal healthcare such as Canada, disparities in health equity are still present.3–8 Marginalized communities in Canada such as immigrant populations face barriers to accessing health services regularly.3–7 Some barriers to accessing healthcare include cultural barriers, communication barriers, socio-economic barriers, health system structure barriers, and knowledge about the Canadian healthcare system.3
Accessing physiotherapy services in particular can be challenging for marginalized communities living in Ontario. Currently in Ontario, in order to qualify for government funded physiotherapy (i.e., OHIP funded), you must either be 65 years or older, 19 years or under, have been admitted to the hospital for an overnight stay and require physiotherapy, or a recipient of the Ontario works or Ontario disability support program.9 The Ontario government funded physiotherapy requirements create a systemic barrier that may force some Canadians to resort to privately funded physiotherapy services, which can be unaffordable to low-income Canadians. Additionally, geographical availability of physiotherapy services pose another barrier that Canadians must overcome.10 Barriers to healthcare access limits the ability for marginalised communities to access services like physiotherapy and perpetuates the barriers to health equity. Although these barriers are apparent across Canada, you don’t need to look too far to see how these barriers may affect you or someone you know.
Our team conducted a study on geographical physiotherapy healthcare access among visible minorities living in the Greater Toronto Area (GTA). In the GTA, we identified 625 private physiotherapy clinics and 43 government funded physiotherapy clinics. We found that there were fewer private physiotherapy clinics available in areas with more visible minorities, more first- or second-generation Canadians, lower household income, greater number of people living under one roof, and lower levels of education. Additionally, there were fewer private clinics in areas with more Canadians with the following ethnicities: South Asian, Black, Filipino, Latin American, and Southeast Asian. Most surprisingly, publicly funded OHIP clinics were haphazardly placed across the GTA and were not prioritized in locations with greater barriers to healthcare access.
So, what can we do about this? Some community-level strategies include community health education workshops, information sessions, and support programs.5 Our team at Future Faces of Healthcare Canada are striving to overcome these barriers through educational workshops, informational sessions, and free community physiotherapy pop-up clinics for communities that need it most. In the coming months our organization, Future Faces of Healthcare Canada, will be partnering with local community healthcare organizations in areas within the GTA with the greatest barriers to accessing physiotherapy services. Stay tuned to find out more about what we have planned to address health equity in the GTA! If you’re interested in joining our efforts for this initiative, you can sign-up through our volunteer portal below!
References
1. Health Equity — Global. Accessed February 22, 2023. https://www.who.int/health-topics/health-equity#tab=tab_1
2. Social determinants of health. Accessed February 22, 2023. https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1
3. Ahmed S, Shommu NS, Rumana N, et al. Barriers to Access of Primary Healthcare by Immigrant Populations in Canada: A Literature Review. J Immigr Minor Health. 18. doi:10.1007/s10903-015-0276-z
4. Campbell RM, Klei AG, Hodges BD, et al. A Comparison of Health Access Between Permanent Residents, Undocumented Immigrants and Refugee Claimants in Toronto, Canada. J Immigrant Minority Health. 2014;16:165-176. doi:10.1007/s10903-012-9740-1
5. Turin TC, Haque S, Chowdhury N, et al. Overcoming the Challenges Faced by Immigrant Populations While Accessing Primary Care: Potential Solution-oriented Actions Advocated by the Bangladeshi-Canadian Community. J Prim Care Community Health. 2021;12. doi:10.1177/21501327211010165
6. Turin TC, Rashid R, Ferdous M, et al. Perceived barriers and primary care access experiences among immigrant Bangladeshi men in Canada. Fam Med Community Health. 2020;8(4). doi:10.1136/FMCH-2020-000453
7. Pandey M, Kamrul R, Michaels CR, McCarron M. Identifying Barriers to Healthcare Access for New Immigrants: A Qualitative Study in Regina, Saskatchewan, Canada. J Immigr Minor Health. 2022;24(1):188-198. doi:10.1007/S10903-021-01262-Z
8. Chang CD. Social Determinants of Health and Health Disparities Among Immigrants and their Children. Curr Probl Pediatr Adolesc Health Care. 2019;49(1):23-30. doi:10.1016/J.CPPEDS.2018.11.009
9. Physiotherapy clinics (government-funded) | ontario.ca. Accessed February 22, 2023. https://www.ontario.ca/page/physiotherapy-clinics-government-funded
10. Williamson DL, Stewart MJ, Hayward K, et al. Low-income Canadians’ experiences with health-related services: Implications for health care reform. Health Policy (New York). 2006;76:106-121. doi:10.1016/j.healthpol.2005.05.005