Canada’s health and settlement systems are failing newcomers. It’s time for a new system of care

More theoretical than practical given the fragmentation within and between sectors an the jurisdictional issues:

Last year, the federal government announced its intention to welcome over 1.2 million immigrants to Canada by the end of 2023. The truth is, however, that our care systems are not ready to adequately support those newcomers upon arrival — and here’s why.

Right now, Canada’s health care system and settlement services have operated in silos and are funded by different levels of government. This is creating large gaps in services, with newcomers falling right through them. The fact is many newcomers come to Canada in better health than the rest of the population. Yet, their health and wellness tend to rapidly decline during and after settlement. Some reasons for this could be due to not having secure housing, access to health care, and/or enough to eat. 

So, what is a solution to these problems? Two words: Integrated care.

Integrated care connects newcomers with a seamless suite of co-ordinated and holistic health and settlement services, including mental health care, employment services and access to food security. Existing integrated care programs offered by health agencies and community organizations, like WoodGreen Community Services’ Inter-Professional Care Program, offer solid proof that integrated care can improve systems of care for newcomers, predominantly in two ways. 

Firstly, integrated care can improve the efficiency, cost-effectiveness and sustainability of care systems by breaking down silos between health, settlement and other services. 

As a people-centred approach, integrated care organizes services around the needs and perspectives of newcomers. This improves continuity of care and allows newcomers to gain timely access to the services they need through any door, without the burden of system navigation. Integrated care also reduces the risk for duplication of work and may minimize high-cost services, such as hospital admissions, by diverting clients away from the emergency room and encouraging a shift to preventative care.

The second main (and particularly timely) benefit of integrated care is that it helps service providers feel less burned out.

Burnout is prevalent among care professionals, a factor which has been proven time and again throughout the course of this pandemic, and which is often linked to reduced patient satisfaction and health outcomes. Statistics Canada reported that, in early 2021, the health-care sector saw one of the largest annual increase in job vacancies compared to other sectors, with a particular increase in job postings for nurses.

By building and co-ordinating relationships and support between providers, integrated care has been found to combat burnout and improve job satisfaction and well-being.

To be clear, integrated care in Canada is not a new thing. The challenge is that an integrated approach to health care and settlement services is not being implemented at a scale that can successfully settle Canada’s incoming and recently settled migrants.

Policy-makers, in collaboration with settlement providers, community agencies, health-care organizations, and other stakeholders, can help to address this issue by:

  • Improving access to stable resources for settlement service providers and physicians to effectively implement integrated care;
  • Offering newcomers of all statuses access to services, including individuals with insecure legal status and people who have been in Canada for years; and
  • Requiring race-based and sociodemographic data collection to ensure organizations have the information they need to track health equity outcomes and evaluate program performance, among other recommendations.

If Canada hopes to achieve a successful and resilient COVID-19 recovery (where newcomers can contribute to the economy while maintaining their own socio-economic well-being), we must commit to better integrating our health and settlement care systems to ensure that newcomers don’t just come here to live — but to thrive.


About Andrew
Andrew blogs and tweets public policy issues, particularly the relationship between the political and bureaucratic levels, citizenship and multiculturalism. His latest book, Policy Arrogance or Innocent Bias, recounts his experience as a senior public servant in this area.

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