Ongoing impacts of the COVID-19 pandemic on access to primary care among im/migrant communities in British Columbia, Canada

Background

The COVID-19 pandemic changed healthcare delivery in multiple ways, including a widespread shift to virtual care. Evidence of how these changes were experienced is mixed and varies among populations and Canadian provinces. We sought to generate new information about how these changes were experienced by im/migrants in British Columbia (BC), assessing their impact on access to virtual and in-person primary care.

Methods

We conducted in-depth, semi-structured interviews in Dari, English, Farsi, Spanish, and Tigrinya with im/migrants living in BC for less than 10 years. We analyzed 50 interviews using a team-based approach to reflexive thematic analysis to explore how changes in service delivery in the context of the COVID-19 pandemic impacted im/migrant's healthcare experiences and access in BC.

Results

Interview participants described impacts of changes in service delivery in terms of accessibility, human connections, quality of care, and safety. Impacts were experienced positively as opportunities or negatively as obstacles. Experiences were shaped by immigration status, English language fluency, having a regular source of primary care before the pandemic, and economic resources. An overarching theme was trust, with healthcare experiences during the pandemic either increasing or decreasing participants’ trust in the healthcare system.

Conclusions

Our findings reveal that within im/migrant communities, the same changes in health service delivery were experienced differently, depending on various determining factors. Whether people experienced opportunities or obstacles, and increased or decreased trust, was shaped by modifiable policies that predate the pandemic and will persist beyond the pandemic unless significant and intentional, evidence-based changes are implemented.