Health Equity/Social Determinants of Health
Health Equity/Social Determinants of Health 7
Chioma Nwebube, B.Sc (Hons) (she/her/hers)
MAP Centre for Urban Health Solutions, Unity Health Toronto
Toronto, Ontario, Canada
We explored how RCY, their caregivers, service providers and health care providers understand and utilize the healthcare system after arrival in Canada.
This was a qualitative study using community-based participatory action methodology. In-depth interviews (IDIs) were conducted with RCYs (10-18y), their caregivers, community service providers and health care providers (HCPs) that worked with RCYs in a large urban Canadian city in English or with an interpreter, recorded and transcribed. Transcripts were coded using inductive coding methods, and analysed within and across stakeholder groups using thematic analysis.
A total of 27 IDIs were conducted (8 HCPs, 9 community service providers, 5 caregivers, and 5 RCYs). RCYs and caregivers had little to no understanding of how the healthcare system operated in Canada, including how IFHP provided coverage. Most explained that their limited knowledge about the healthcare system was provided by informally by through social contacts, or their community service providers, who in turn expressed limited understanding of IFHP coverage and difficulty finding IFHP registered providers. Although healthcare providers similarly found IFHP difficult to navigate, they did not appreciate how little RCYs and their families understood the healthcare system, nor the difficulties placed on community service providers. RCYs stated that a youth-oriented, multi-lingual resource that explained how to access care in Canada would be a useful tool to help them feel empowered to advocate for themselves and their families.
Although policies exist to provide coverage for medical care for RCYs, there are many barriers that prevent them from accessing care, including limited knowledge of the system and few navigation supports. Our findings suggest that working with RCY themselves to co-develop a youth-centered approach to understanding the healthcare system may increase youth empowerment and access to care.