Unmet Health Care Needs for Syrian Refugees in Canada: A Follow-up Study

  • Andrew TuckEmail author
  • Anna Oda
  • Michaela Hynie
  • Caroline Bennett-AbuAyyash
  • Brenda Roche
  • Branka Agic
  • Kwame McKenzie
Original Paper


Unmet health care needs are under explored among refugees. Previously we found unmet health care needs in Syrian refugees may be higher than in the general Canadian population (Oda et al. CMAJ Open 5(2):E354–E358, 2017; Oda et al. J Immigr Minor Health, 2018. This follow-up study with Syrian refugees who entered Canada between July 2015 and July 2016 aimed to understand if there are changes in unmet health care needs 6 months to a year after baseline collection. The number reporting unmet needs was high (42.6%). Although some refugees had their needs met, unmet health needs persist, and it seems that they are linked with sponsorship pathway and post-migration socio-economic position. While caution should be used generalizing these results, they do suggest that greater coordination between services may be needed as many of the refugees report unmet needs within months of arriving and continue to report needs after being here for a period up to 2 years.


Syrian refugees Privately-sponsored (PSRs) Government-assisted (GARs) Unmet health care need Longitudinal 



This research was funded by the Social Sciences and Humanities Research Council of Canada (Grant No. 890-2016-4061).

Compliance with Ethical Standards

Ethical Approval

Ethics approval was obtained to conduct this research from the Centre for Addiction and Mental Health Research Ethics Board and Administrative Approval was received from the Office of Research Ethics at the University of Toronto and from the Human Participants Research Committee ethics review board of York University.


  1. 1.
  2. 2.
    Catanzaro A, Moser RJ. Health status of refugees from Vietnam, Laos, and Cambodia. JAMA. 1982;247(9):1303–8.CrossRefPubMedGoogle Scholar
  3. 3.
    Gerritsen AAM, Bramsen I, Devillé W, van Willigen LHM, Hovens JE, van der Ploeg HM. Physical and mental health of Afghan, Iranian and Somali asylum seekers and refugees living in the Netherlands. Soc Psychiatry Psychiatr Epidemiol. 2006;41:18–26.CrossRefPubMedGoogle Scholar
  4. 4.
    Cheng IH, Drillich A, Schattner P. Refugee experiences of general practice in countries of resettlement: a literature review. Br J Gen Pract. 2015; e171–6.
  5. 5.
    Shannon PJ, Vinson GA, Cook TL, Lennon E. Characteristics of successful and unsuccessful mental health referrals of refugees. Adm Policy Mental Health Mental Health Serv Res. 2016;43(4):555–68.CrossRefGoogle Scholar
  6. 6.
    Beiser M. Resettling refugees and safeguarding their mental health: lessons learned from the Canadian refugee resettlement project. Transcult Psychiatry. 2009;46(4):539–83.CrossRefPubMedGoogle Scholar
  7. 7.
    Allin S, Grignon M, Le Grand J. Subjective unmet need and utilization of health care services in Canada: What are the equity implications? Social Sci Med. 2010;70:465–72.CrossRefGoogle Scholar
  8. 8.
    Nelson CH, Park J. The nature and correlates of unmet health care needs in Ontario, Canada. Soc Sci Med. 2006;62:2291–300.CrossRefPubMedGoogle Scholar
  9. 9.
    Redwood-Campbell L, Thind H, Howard M, Koteles J, Fowler N, Kaczorowski J. Understanding the health of refugee women in host countries: Lessons from the Kosovar re-settlement in Canada. Prehosp Disaster Med. 2008;23(4):322–7.CrossRefPubMedGoogle Scholar
  10. 10.
    Morris MD, Popper ST, Rodwell TC, Brodine SK, Brouwer KC. Healthcare barriers of refugees post-resettlement. J Community Health. 2009;34:529–38.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Mental Health Commission of Canada [MHCC]. The case for diversity: building the case to improve mental health services for immigrant, refugee, ethno-cultural and racialized populations 2016; Ottawa, Ontario: Mental Health Commission of Canada. Accessed Nov 2017.
  12. 12.
    Khuu BP, Lee HY, Zhou AQ. Health literacy and associated factors among Hmong American immigrants: addressing the health disparities. J Community Health. 2018;43(1):11–8.CrossRefPubMedGoogle Scholar
  13. 13.
    Citizenship, Canada I [CIC]. IP3 In Canada processing of convention refugees abroad and members of the humanitarian protected persons abroad classes: part 1 (general). 2011; Ottawa. Ontario: Government of Canada. Accessed Oct 2018.
  14. 14.
    Government of Canada. Guide to private sponsorship of refugees program. 2015; Ottawa, Ontario: Government of Canada. Accessed Oct 2018.
  15. 15.
    Oda A, Hynie M, Tuck A, Agic B, Roche B, McKenzie K. Health needs and service use of newly arrived Syrian refugees in Toronto: a cross-sectional study. CMAJ Open. 2017;5(2):E354–8.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Oda A, Hynie M, Tuck A, Agic B, Roche B, McKenzie K. Differences in self-reported health and unmet health needs between Government Assisted and Privately Sponsored Syrian Refugees: a cross-sectional study. J. Immigr Minor Health. 2018. Scholar
  17. 17.
    Bryant T, Leaver C, Dunn J. Unmet healthcare need, gender, and health inequalities in Canada. Health Policy. 2009;91:24–32.CrossRefPubMedGoogle Scholar
  18. 18.
    Setia MS, Quesnel-Vallee A, Abrahamowicz M, Tousignant P, Lynch J. Access to health-care in Canadian immigrants: a longitudinal study of the National Population Health Survey. Health Soc Care Community. 2011;19(1):70–9.CrossRefPubMedGoogle Scholar
  19. 19.
    Casey R. Disability and unmet health care needs in Canada: a longitudinal analysis. Disabil Health J. 2015;8(2):173–81.CrossRefPubMedGoogle Scholar
  20. 20.
    Sanmartin C, Houle C, Tremblay S, Berthelot J-M. Changes in unmet health care needs. Health Rep. 2002;13(3):15–21.PubMedGoogle Scholar
  21. 21.
    Immigration, Refugees and Citizenship Canada [IRCC]. Rapid impact evaluation of the syrian refugee initiative. 2016; Ottawa. Canada. Accessed Nov 2017.
  22. 22.
    Statistics Canada. Health fact sheets: unmet health care needs. 2014. Statistics Canada 2015. Accessed 1 Nov 2017
  23. 23.
    Dunlop S, Coyte PC, McIsaac W. Socio-economic status and the utilization of physicians’ services: results from the Canadian National Population Health Survey. Soc Sci Med. 2000;51:123–33.CrossRefPubMedGoogle Scholar
  24. 24.
    Veugelers PJ, Yip AM. Socioeconomic disparities in health care use: Does universal coverage reduce inequalities in health? J Epidemiol Community Health. 2003;57:424–8.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Wu Z, Penning MJ, Schimmle CM. Immigrant status and unmet health care needs. Can J Public Health. 2005;96(5):369–73.PubMedGoogle Scholar
  26. 26.
    Government of Canada. Interim Federal Health Program Policy 2016; Accessed Feb 2018.
  27. 27.
    Government of Ontario. What OHIP covers 2017; Accessed Nov 2017.

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Andrew Tuck
    • 1
    Email author
  • Anna Oda
    • 1
    • 2
  • Michaela Hynie
    • 2
  • Caroline Bennett-AbuAyyash
    • 3
  • Brenda Roche
    • 4
  • Branka Agic
    • 1
  • Kwame McKenzie
    • 1
    • 4
  1. 1.Centre for Addiction and Mental HealthTorontoCanada
  2. 2.Department of PsychologyYork UniversityTorontoCanada
  3. 3.Dala Lana School of Public HealthUniversity of TorontoTorontoCanada
  4. 4.Wellesley InstituteTorontoCanada

Personalised recommendations