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Background: Through medicare, residents in Canada are entitled to medically necessary physician services without paying out of pocket, but still many people struggle to access primary care. We conducted a survey to explore people's experience with and priorities for primary care. Methods: We conducted an online, bilingual survey of adults in Canada in fall 2022. We distributed an anonymous link through diverse channels and a closed link to 122 053 people via a national public opinion firm. We weighted completed responses to mirror Canada's population and adjusted for sociodemographic characteristics using regression models. Results: We analyzed 9279 completed surveys (5.9% response rate via closed link). More than one-fifth of respondents (21.8%) reported having no primary care clinician, and among those who did, 34.5% reported getting a same or next-day appointment for urgent issues. Of respondents, 89.4% expressed comfort seeing another team member if their doctor recommended it, but only 35.9%, 9.5%, and 12.4% reported that their practice had a nurse, social worker, or pharmacist, respectively. The primary care attribute that mattered most was having a clinician who 'knows me as a person and considers all the factors that affect my health.' After we adjusted for respondent characteristics, people in Quebec, the Atlantic region, and British Columbia had lower odds of reporting a primary care clinician than people in Ontario (adjusted odds ratio 0.30, 0.33, and 0.39, respectively; p < 0.001). We also observed large provincial variations in timely access, interprofessional care, and walk-in clinic use. Interpretation: More than 1 in 5 respondents did not have access to primary care, with large variation by province. Reforms should strive to expand access to relationship-based, longitudinal care in a team setting., Research over decades has shown that health systems with strong primary care have better health outcomes, better equity in outcomes, and lower costs. (1,2) Yet, worldwide, countries have struggled with [...]

ABSTRACTSocial norms are based on expectations of what others believe and do, and so they can shift in response to what trendsetters—highly visible media or political leaders—say or do. There is evidence that former President Trump as a trendsetter has weakened norms against expressing anti-immigrant attitudes in the US. As such, we ask: can trendsetters affect anti-immigrant norms across national borders? Can such spillovers be mitigated by countervailing norms attached to a national identity? We conduct two survey experiments to determine if there is potential for a Trump spillover effect in Canada and whether it can be mitigated by norms attached to Canadian identity. We find that priming Trump can weaken norms against expressing anti-immigrant sentiment in Canada. We also find that priming Canadian identity can mitigate the Trump as trendsetter effect, and attaching pro-immigrant norms to Canadian identity can strengthen norms against expressing anti-immigrant attitudes. The potential for a political trendsetter to have effects on immigration attitudes across national borders and the potential for national identity norms to mitigate such effects are important to understand given the recent global spread of anti-immigrant sentiment.