Immigration Health is Public Health: Opportunities to improve hepatitis B and C prevention, diagnosis, and care for immigrants and newcomers to Canada
Abstract
Action Hepatitis Canada has created this report on the current landscape of viral hepatitis testing, treatment, and care for immigrants and newcomers in Canada, with recommended considerations for improving outcomes for immigrants and newcomers living with hepatitis B and C.
We approach this issue through a human rights and health equity lens and centering lived experience.
From January to April 2024, we consulted with people who have lived experience of viral hepatitis as newcomers and immigrants to Canada, clinicians, researchers, community-based advocates,
immigration legal experts, and others. We are also grateful to the staff at Immigration, Refugee and Citizenship Canada for assistance with the Pathways to Canada chart on page 7. We conducted an environmental scan of the current state of
immigrant and newcomer medical screening in Canada and a literature review.
While community-level education opportunities offer many benefits and provincial and territorial public health agencies play an important role in the immigration health system, this report
focuses on federal government policies and potential points of intervention within the immigration and integration processes.
As sometimes happens, we feel the value of the report lies as much in the process as in the final report itself. Through these
interviews and consultations, we began many meaningful conversations, at what seems to be an ideal time, about where the roles of Canada’s public health services and immigration services intersect. It is our hope that this report is a useful tool to
continue those conversations and ultimately improve health outcomes for immigrants and newcomers to Canada, reduce the burden of late-stage diagnosis on the healthcare system, and help move us closer to our viral hepatitis elimination targets
Notes
Location: Canada-wide
Key Recommendations:
- Eliminate provisions in immigration legislation that deny entry or stay in Canada based on medical conditions and instead prioritize linking people care.
- Decouple medical counselling and testing from the immigration application process and instead offer as part of integration services.
- Offer free, universal, and voluntary STBBI testing, including HBV and HCV, for the purpose of linking people to care and treatment, and clearly communicate that this is the purpose.
- Provide interpretation services free of charge at all medical appointments as part of the immigration or integration process for people who do not fluently speak the language in which the service is being provided.
- Establish policies to improve the competency of healthcare professional (including panel physicians) to ensure migrants receive culturally appropriate, non-stigmatizing care and accurate information.
- Amend the eligibility provision of the IFHP so that all migrants, including undocumented migrants, can access publicly funded healthcare. This includes primary care, language services, and referrals to specialists for all IFHP-eligible migrants.
- Update the national HBV vaccination guidelines to recommend birth dose vaccination for all babies, and universal, publicly-funded “catch-up” vaccinations for unvaccinated adults as needed.
Open Access:
Yes
Key Findings:
- Hepatitis B (HBV) is a preventable and treatable liver infections, and hepatitis C (HCV) is a preventable and curable liver infection.
- An estimated 8 people die each day in Canada from viral hepatitis.
- Immigrants and newcomers are an important group at increased risk for viral hepatitis.
- There are no systematic, targeted HBV or HCV screening or health promotion programs for immigrants before or after arrival in Canada.
