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Abstract Background We investigated the relationship between neighbourhood income quintile and mental health service use by immigration experience among youth and explored changes during the COVID-19 pandemic. Method We used administrative data to examine mental health service use among youth aged 10 to 24 in British Columbia, Canada, between April 1, 2019, and March 31, 2022. We compared rates of community-based mental health service use, emergency department visits, and hospitalizations and the proportion of involuntary admissions by neighbourhood income quintile and immigration. We used models stratified by immigration to estimate the relationship with income. Results Non-immigrant youth used substantially more services than immigrant youth. Service use increased following the pandemic’s start and peaked between January and March 2021. We observed a clear income gradient for community-based service use among both immigrant and non-immigrant youth, but the direction of the gradient was reversed. Service use was highest among non-immigrant youth in lower-income neighbourhoods and lowest for immigrant youth in lower-income neighbourhoods. We observed similar patterns of income gradient for non-immigrant youth for emergency department visits and hospitalization. The proportion of involuntary admissions was higher for immigrant youth. Conclusions Mental health service use was substantially lower among immigrant youth than non-immigrant youth, but higher proportions of immigrant youth were hospitalized involuntarily. The reverse income gradient patterns observed for community-mental health service use are noteworthy and suggest significant barriers to accessing preventable care among immigrant youth, particularly those living in lower-income neighbourhoods.

Abstract Background The onset of the COVID-19 pandemic drove a rapid and widespread shift to virtual care, followed by a gradual return to in-person visits. Virtual visits may offer more convenient access to care for some, but others may experience challenges accessing care virtually, and some medical needs must be met in-person. Experiences of the shift to virtual care and benefits of in-person care may vary by immigration experience (immigration status and duration), official language level, and age. We examined use of virtual care and return to in-person visits in the Canadian province of British Columbia (BC), comparing patterns by age and across immigration groups, including length of time in Canada and language level (official languages English and French) at time of arrival. Methods We used linked administrative health and immigration data to examine total primary care visits (virtual or in-person) and return to in-person visits during the COVID-19 pandemic (2019/20–2021/2) in BC. We examined the proportion of people with any primary care visits and with any in-person visits within each year as measures of access to primary care. We estimated the odds of any primary care visits and any in-person visits by immigration group and official language level assessed prior to arrival: non-immigrants, long-term immigrants, recent immigrants (

Objectives We aim to respond to health care barriers experienced by immigrant and migrant (im/migrant) communities through community-engaged research using population-based multi-sectoral linked health and immigration data, alongside qualitative methods. We describe lessons learned with respect to analytic choices and interpretation of findings from data linkage research. Approach We linked Canadian federal immigration data and health data from the province of British Columbia to analyze access to health care services during the COVID-19 pandemic. Immigration data include date and class of arrival, level of education, language ability at arrival, countries of birth and origin, and other personal characteristics. Provinces also collect documentation of immigration status as part of ascertaining health insurance eligibility, data not previously used for research. Planning and carrying out this analysis involved people who come from different countries and have different immigration journeys, such as people with precarious im/migration status, refugees, workers and students. Results Findings underscore that care should be taken in choosing categories to group people using administrative immigration systems data that are relevant to research questions, considering class of arrival, current status, time since arrival, and language ability, alongside intersecting characteristics. In studying COVID-19 infection and access to care, current status (temporary or permanent) was particularly important, as this is tied to both workplace protections/risks and access to care. Time since arrival in Canada and language ability were important in examining questions related to health system navigation, including access to virtual and in-person care. Immigration information recorded at time of registration for provincial insurance offers a new opportunity to include immigration data in analysis, and is particularly helpful in studying impacts of temporary status. Conclusion A strength of linked immigration data is that it directly captures administrative categories that are modifiable and that structurally determine health. In interpreting analysis we must emphasize that immigration records and class captured at time of registration for health insurance reflect administratively imposed categories, but may not reflect identities.