Research on immigrant health often suggests that immigrants tend to be healthier than Canadian-born individuals but experience a decline in health over time. This trend is thought to be influenced by several factors, including a surprising lack of social mobility after arriving in Canada. It’s commonly believed that immigrant parents make sacrifices to benefit their children, assuming that prioritizing good education will make those sacrifices worthwhile.
However, recent studies indicate that this lack of mobility persists into the next generation. I have spent over ten years researching immigrant and refugee health and am part of a growing group of researchers who recognize that immigrants in Canada come from diverse backgrounds and have varied experiences that influence their interaction with structural and social health determinants. This diversity shapes their health outcomes and access to healthcare, challenging the view that immigrants have uniform health and social trajectories. The “healthy immigrant effect” and the belief in upward social mobility for the next generation are popular academic theories, but I worry these ideas may lead policymakers to overlook the complex needs of immigrant communities. This oversight became evident during the early days of the COVID-19 pandemic, as reports showed that many essential workers who were immigrants were disproportionately affected by the virus.
Statistics later confirmed these findings. Toronto Public Health, the first in Canada to gather race-based data during the pandemic, discovered that racialized residents of Toronto (mostly immigrants and those in diasporic communities) had higher rates of infection and hospitalization due to COVID-19. An upcoming study revealed that during the first half of the pandemic, immigrants in Ontario were more likely to suffer adverse outcomes than other provincial residents. The key factors include a mismatch between their qualifications and their employment and employer discrimination, resulting in immigrants being over-represented in essential, low-wage, precarious jobs. These roles carry a higher risk of COVID-19 exposure and often do not provide paid sick leave.
Fortunately, Ontario’s government focused on equitable vaccine distribution, and programs like Toronto’s Community Health Ambassadors—run by immigrant-serving organizations—helped reduce negative COVID-19 outcomes, according to the upcoming study. However, the subsequent discontinuation of these programs and policies, originally designed to overcome vaccination barriers for immigrants and their increased COVID-19 risk, suggests that immigrants may once again be unduly affected by the ongoing virus spread and mutation. Policy neglect has also contributed to the current primary-care crisis in Canada, with existing inequities exacerbated by the pandemic. Racialized and low-income Canadians are least likely to have a primary-care physician, while family doctors nearing retirement manage patients facing numerous social barriers to health and healthcare access. These groups likely include a significant number of immigrant and diasporic community members. To prioritize the health and well-being of immigrants—often praised as driving Canada’s economy—and future generations, elected officials need to meaningfully engage with immigrants at all life stages and avoid promoting xenophobia.
Additionally, immigrants with Canadian citizenship, especially those in Canada for less than a decade, are less likely to participate in federal elections. Initiatives to connect immigrants’ priorities to political platforms and encourage voting are essential. Non-citizen immigrants cannot vote at any government level and thus have no say in how their tax money is used. Addressing this voting gap is crucial, particularly given the many permanent and temporary residents settling in Toronto and other Canadian cities.
These potential future citizens are valued for filling labor shortages and contributing economically but are not adequately represented in political decision-making affecting their lives. The misconception of the healthy immigrant effect and the assumption of second-generation upward mobility have been perpetuated by overlooking the diverse identities and experiences of immigrants in major cities like Toronto. These assumptions might have led to neglecting their health and healthcare needs. Addressing the voter participation inequities among immigrants and migrants in Canada could finally highlight the social and economic challenges these communities have faced for years, along with the negative impact on their health and healthcare access.