Navigating healthcare access and utilization in rural and Northern Ontario: Immigrants’ experiences amid regionalization and dispersal policies

Background Immigration to Canada has historically concentrated in major metropolitan areas, with over half of newcomers settling in Ontario’s urban centres in 2019. However, recent government initiatives seek to address labour shortages and stimulate regional development by encouraging immigrant settlement in five rural Northern communities. As policies increasingly direct newcomers to these regions, it becomes essential to understand their unique settlement experiences and ensure that local services effectively meet their needs, especially healthcare needs. Yet, the limited research focusing on immigration in rural and northern contexts constrains the development of evidence‑based programs and supports. Objective To explore the experiences of immigrants in accessing and utilizing healthcare services in rural and northern Ontario in the context of post-government regionalization and dispersal policies. Methods This qualitative descriptive study was conducted in North Bay, Ontario. Purposive sampling was employed to recruit 20 immigrants who had settled in North Bay through the Rural Community Immigration Pilot, along with four key informants who work with immigrant populations, to participate in virtual interviews. Data were analyzed thematically. Ethical approval was obtained from the Nipissing University Research Ethics Board (File No. 103946) on April 17, 2025. Findings Findings indicate that healthcare access for immigrants is not a single encounter, but an ongoing, complex care journey shaped by barriers before, during, and after contact with services. Four interrelated themes characterized this journey: Getting In, which reflected challenges initiating care due to information gaps, limited primary care attachment, transportation and distance barriers, language readiness, and fear of discrimination; Getting Through, which captured participants’ struggles to obtain timely, understandable, respectful, and culturally safe care amid language barriers, long waits, fragmented referrals, and rushed encounters; Getting On, which described the post-visit consequences of unclear follow-up, diminished trust, and constrained self-management; and Getting the System Better, which highlighted participants’ recommendations for improving immigrant healthcare access through earlier orientation, peer navigation, transportation and financial supports, targeted immigrants services, reliable language access, multilingual resources, cultural competence training, and stronger follow-up systems. Conclusion This study underscores the need to move beyond narrow definitions of healthcare access and toward a more holistic, immigrant-responsive model of care. Improving access requires proactive, coordinated, and culturally safe health system supports that build trust, strengthen continuity, and ensure that immigrants are not only able to reach services but are also meaningfully supported throughout their care journey.