Abstract
BackgroundImmigrants from culturally, ethnically, and linguistically diverse countries face many challenges during the resettlement phase, which influence their access to healthcare services and health outcomes. The “Healthy Immigrant Effect” or the health advantage that immigrants arrive with is observed to deteriorate with increased length of stay in the host country.MethodsAn exploratory qualitative design, following a community-based research approach, was employed. The research team consisted of health researchers, clinicians, and community members. The objective was to explore the barriers to healthcare access among immigrants with limited English language proficiency. Three focus groups were carried out with 29 women and nine men attending English language classes at a settlement agency in a mid-sized city. Additionally, 17 individual interviews were carried out with healthcare providers and administrative staff caring for immigrants and refugees.ResultsA thematic analysis was carried out with transcribed focus groups and healthcare provider interview data. Both the healthcare providers and immigrants indicated that limited language proficiency often delayed access to available healthcare services and interfered with the development of a therapeutic relationship between the client and the healthcare provider. Language barriers also impeded effective communication between healthcare providers and clients, leading to suboptimal care and dissatisfaction with the care received. Language barriers interfered with treatment adherence and the use of preventative and screening services, further delaying access to timely care, causing poor chronic disease management, and ultimately resulting in poor health outcomes. Involving untrained interpreters, family members, or others from the ethnic community was problematic due to misinterpretation and confidentiality issues.ConclusionsThe study emphasises the need to provide language assistance during medical consultations to address language barriers among immigrants. The development of guidelines for recruitment, training, and effective engagement of language interpreters during medical consultation is recommended to ensure high quality, equitable and client-centered care.
Highlights
Immigrants from culturally, ethnically, and linguistically diverse countries face many challenges during the resettlement phase, which influence their access to healthcare services and health outcomes
This study explores the impact of language barriers at each point of contact with the healthcare delivery system, from the perspective of immigrants and healthcare providers in a Canadian province that is witnessing a rapid influx of immigrants [2]
Impacts of limited English language proficiency have been summarized under four main themes as follows
Summary
Immigrants from culturally, ethnically, and linguistically diverse countries face many challenges during the resettlement phase, which influence their access to healthcare services and health outcomes. Individuals without local language proficiency are more likely to have lower income, and face considerable challenges with economic and social integration [6,7,8]. These settlement challenges increase the risk of poor health outcomes among newcomers with limited language proficiency [9]. Most newcomers are healthier than the general population, an effect referred to as the “healthy immigrant effect.” This effect is observed to decline over time [11,12,13]. Limited language proficiency is associated with decline in self-reported health status of new immigrants during the first 4 years of stay in Canada [9]
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