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Access to primary care amongst newcomers in Hamilton, Ontario.

Ramos-Acevedo, S.; de Souza, R. J.; Abdalla, N.; Azab, S. M.; Cameron, L.; Crea-Arsenio, M.; Desai, D.; DiLiberto, D. D.; Kandasamy, S.; Montague, P.; Stennett, R.; Williams, N. C.; Wahi, G.; Anand, S. S.

2025-12-19 public and global health
10.64898/2025.12.17.25342471 medRxiv
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BackgroundMore than one in five Canadians (6.5 million people) do not have a family doctor or nurse practitioner they see regularly. Access gaps are greater among immigrants and marginalized populations, who face systemic, cultural, and language barriers to care. ObjectivesTo evaluate access to primary care provider and dentist among residents of a neighborhood with a high proportion of visible minorities in Hamilton, ON. MethodsBetween 2022 and 2024, adults living in Riverdale, a neighbourhood in the city of Hamilton, Ontario in which 51% families were born outside the country, were invited to participate in a cross-sectional survey. Determinants of access to these services were identified using multivariable logistic regression modelling. Results930 people completed the survey. Of these, 48% were not born in Canada. The median age of participants was 39 years, with a median time living in Canada of 28 years. Of those who responded, 79.6% had a primary care provider; and 57.1% had a dentist. In multivariable models, living in Canada < 5 years (OR = 0.10; 95% CI: 0.05, 0.20), male sex (OR= 0.56; 95%CI: 0.38, 0.82) and being unmarried (OR = 0.41; 95% CI: 0.27, 0.64) were associated with lower odds of having a primary care provider. Living in Canada for < 5 years (OR = 0.20; 95% CI: 0.11, 0.35), male sex (OR =0.74; 95% CI: 0.55, 0.99), and employment while living below the poverty line (OR=0.50; 95% CI: 0.29, 0.90) were linked to lower access to dental care. ConclusionIn a neighborhood with high proportion of visible minority newcomers in Hamilton, ON, 20% of those surveyed did not have access to a primary care provider, and 43% did not have access to a dentist. Access to primary care was lowest amongst newcomers (within 5 years), men, and those who are unmarried.

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