Unmet Health Care Needs Across Canada: A cross-sectional analysis of the intersecting roles of race and ethnicity, immigration, and sex

PURPOSE: This study aimed to evaluate the association between racialized identity and unmet health care needs across Canada, and the modifying effect of intersecting sociodemographic factors. METHODS: Data were drawn from the 2019-2020 Canadian Community Health Survey. Quasibinomial regressions with interaction terms were used to evaluate the association between racialized minority identity, immigration status and sex assigned at birth on unmet health care needs. We obtained crude and adjusted risk ratios from overall and province-specific (Ontario, Quebec, British Columbia, and Manitoba) models. RESULTS: Trends towards super-multiplicative and super-additive interaction effects of immigration status and sex assigned at birth were observed. In fully adjusted models, racialized minority immigrants in Quebec faced more than twice the risk of unmet care needs and those in Manitoba experienced a 58% lower risk, compared to their counterparts. In comparison to non-racialized minority males, racialized minority females experienced an almost 3 times higher risk of unmet care needs in Quebec. CONCLUSION: Racialized minority identity interacts with immigration status and sex assigned at birth to shape risks of unmet needs. These findings highlight the importance of adapting health care provision through intersectional approaches that consider regional context and population nuances in care outcomes towards addressing health care inequities.