Improving Health Care Access for Immigrants With Disabilities in North America

A qualitative meta-synthesis explores the barriers, facilitators, and lived experiences of immigrants with disabilities (IWDs) accessing health care in the US and Canada, revealing structural and cultural obstacles that hinder access and highlighting the need for policy reforms to improve health care services for this marginalized population.

Research indicates that a significant percentage of immigrants in both countries report having a disability, with disparities observed among different ethnic groups. Despite facing multifaceted barriers to health care access, immigrants with disabilities are a marginalized group that necessitate a nuanced understanding of their experiences to inform policy and practice.

A theory-generating qualitative meta-synthesis approach was adopted for this study. The study conducted a thorough literature search of peer-reviewed articles on immigrant and refugee access to health care in the US and Canada, ultimately selecting 10 studies for analysis based on inclusion criteria and quality assessment.

Three major themes emerged: structural barriers, cultural and personal barriers, and facilitators of access. Structural barriers included bureaucratic challenges, health care costs, transportation issues, communication gaps, long wait times, and lack of integrated services. The challenges included lack of insurance due to legal status, financial strain on families, transportation difficulties, miscommunication with providers, and long waiting periods for diagnosis and services. Cultural barriers involve denial of disabilities, cultural beliefs impacting perceptions of disabilities, and delays in accepting diagnoses. These barriers highlight the need for improved access to health care services for immigrants with disabilities in North America. 

The researchers recommend policy and practice reforms to reduce paperwork and provide multilingual services to IWDs, including improved provider training and technological solutions. The need for providing economic support through employment opportunities and expanding affordable community-based health clinics to improve access and foster inclusive health care environments for IWDs was also highlighted. 

“We argue that these barriers and facilitators impact access to healthcare within both the United States and Canadian contexts, irrespective of the differences in the respective healthcare systems,” said researchers. “Improving access to healthcare for IWDs requires a multi-sectoral and integrated approach that involves policy and practice reform in the healthcare system, as well as the active participation of the immigrant community through education and community-based health centers.” 

Reference 
Ngondwe P, Tefera GM. Barriers and facilitators of access to healthcare among immigrants with disabilities: a qualitative meta-synthesis. Healthcare. 2025;13(3):313. doi:10.3390/healthcare13030313