Experiences of healthcare accessibility and its relationship to mental health among Arab Canadians in the CAN-HEAL study

Equitable healthcare is a public health priority and a foundational structural determinant of health and well-being. Yet, healthcare accessibility remains an unsolved challenge for many vulnerable populations. Immigrants/refugees are at high risk for healthcare inequities owing to different socio-economic, ecological and cultural barriers. This paper explored healthcare accessibility and its relationship to mental health (MH) among Arab Canadians. A collaborative community-based participatory research and integrated knowledge translation approach was used in this project. Qualitative interviews and Photovoice sessions were implemented with 50 and 26 Arab Canadian adults, respectively. Participants were recruited throughout October 2021-June 2022 with convenience, purposive and snowball techniques. Research findings revealed multi-dimensional healthcare accessibility challenges across five domains (approachability, availability, affordability, acceptability, and appropriateness) that related to negative MH among Arab Canadians. Long wait times, rushed appointments, frequent medical errors, health coverage gaps, lack of cultural safety, disrespect of patient autonomy and racism were major healthcare barriers that gave rise to anxiety and psychological distress among participants. Intersections between different socio-demographic characteristics/factors (e.g., income, gender, religion, parenthood) exacerbated healthcare inequities and MH disparities within the Arab Canadian community. Intersectoral collaboration and movement-building focused on systems change and advanced public health capacity is needed to address power imbalances and structural barriers to healthcare among Arab Canadians and other similar vulnerable populations.