ArticleBMJ open2021
Qualitative evaluation of a mandatory health insurance 'wait period' in a publicly funded health system: understanding health inequities for newcomer im/migrant women.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Health outcomes, health services utilization, and costs consequences of medicare uninsurance among migrants in Canada: a systematic review.BMC health services research · 2023Pooled it
- Material deprivation and its correlates in treatment-naïve migrants with HIV with rapid access to B/F/TAF at no cost: A sub-study of the ASAP cohort.HIV medicine · 2026Article
- Key considerations for applying intersectionality theory to partner and stakeholder engagement in public health.Canadian journal of public health = Revue canadienne de sante publique · 2025Article
- Administrative burden in primary care: Critical review.Canadian family physician Medecin de famille canadien · 2025Review
- "They wanted to, but they just couldn't get there": GBA + implementation and gaps during the COVID-19 pandemic in Canada.International journal for equity in health · 2025Article
- How immigration shapes health disadvantages and what healthcare organizations can do to deliver more equitable care.Healthcare management forum · 2025Article
- Stigma, Discrimination and Other Social-Structural Factors Associated with Barriers to Counselling or Therapy among Women Living with HIV Who have Experienced Violence in Metro Vancouver, Canada.AIDS and behavior · 2024Article
- Contraceptive access and use among women with migratory experience living in high-income countries: a scoping review.BMC public health · 2024Article
- Article
- Gaps in health coverage for racialized im/migrant sex workers in metro Vancouver: Findings of a community-based cohort study (2014-2021).Journal of migration and health · 2024Article
- Respectful community engagement in health research with diverse im/migrant communities.BMJ open · 2023Review
- Perceptions of the benefits of the basic medical insurance system among the insured: a mixed methods research of a northern city in China.Frontiers in public health · 2023Article
- '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 · 2023Article
- COVID-19 Pandemic and Im/migrants' Elevated Health Concerns in Canada: Vaccine Hesitancy, Anticipated Stigma, and Risk Perception of Accessing Care.Journal of immigrant and minority health · 2022Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
Abstract
objectivesTo 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.
designThe 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.
settingMetro Vancouver, British Columbia, Canada from July 2018 to January 2020.
participantsData collected from community focus groups (four groups, n=29) of both service providers and im/migrant women was used. Following this, qualitative interviews with service providers (n=10) and im/migrant women (n=47) were conducted. Eligible participants self-identified as women; were aged 18-49 and had arrived in Canada from another country. Eligible providers were employed in the health, social or legal sectors working with im/migrant women.
resultsThe wait period resulted in mistrust and internalised stigma for racialised im/migrant women, for whom the policy resulted in feeling 'undeserving' of care. Resulting administrative burden produced delays and unmet need for care, particularly related to sexual and reproductive healthcare and children's health. Unexpected costs meant difficult choices between survival and care. Negative health outcomes included the inability to family plan, difficulties during pregnancy, as well as hardships related not being able to seek help for sick children. Community-based organisations provided support in many areas but could not fill all gaps produced by this policy.
conclusionsFindings highlight severe, yet commonly overlooked, health inequities produced by a mandatory health coverage wait period within a purportedly 'universal' healthcare system. Health system policies such as mandatory 'waiting periods' produce discriminatory and inequitable outcomes for im/migrant women. Policy reforms towards full 'healthcare for all' are urgently needed to affirm the health and human rights of all im/migrants.
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