“Several Canadian studies have shown that the main determinants of health are not rooted in medical or behavioural factors, but rather in a host of social, economic and environmental factors that expose individuals to various health risks and barriers and produce health disparities between more and less advantaged groups (Waldron, 2010, p.263)”

Several factors contribute to inequities for the immigrant and refugee populations, including but not limited to the following:

• Poverty, economic and financial challenges

  Immigrants and refugees are over-represented in poverty and they tend to experience higher rates of unemployment/underemployment because of their inability to have credentials recognized and transferred in Canada (e.g., education, professional training) (Colour of Poverty, 2019; Lai, Shankar, & Khalema, 2017). Moreover, these populations often are confused about and unfamiliar with Canadian job market standards, the job application process and the cultural elements of networking (Lai, Shankar, & Khalema, 2017).

• Discrimination in health care access, use, and quality of care

  Immigrants and refugees experience a number of systemic barriers to health care, such as long wait times to receive health care services and lack of familiarity with the health care system. Some immigrants and refugees also have low English/French language proficiencies and some health facilities lack interpreter services, causing more barriers to adequate health and mental health services (Salami et al., 2020). In addition, provincial/territorial insurance plans do not cover some of the health services that low-income immigrant and refugee families require.

• Immigration status

  Depending on their status, some immigrants and refugees (i.e., refugee claimants, migrant workers and undocumented individuals) are not eligible for federally funded settlement services that will help them improve their language skills and integration experiences. Another form of inaccessibility to support is the exclusion of those with precarious immigration status from receiving the Canada Child Benefit program, which was designed to prevent poverty (Colour of Poverty, 2019).