Ontario recently committed $1.8 billion in new funding with the intention to connect every Ontario resident who needs it with a primary care provider within four years. This is a commendable step, as 2.5 million people in Ontario currently lack a family doctor.
As the province works to bring this commitment to life however, we thought it would be helpful to understand the barriers that stand in the way of, and the strategies that could support success from the perspective of community members who face greater barriers than others accessing primary care.
Wellesley Institute engaged people from low income, Black and other racialized, and 2SLGBTQ+ communities across Ontario – those who have been historically underserved by or excluded from the system – as well as health and social service providers. We asked them to tell us about their experiences and their perspectives on primary care access in the province
Their voices confirm previous research finding that equity-deserving communities from low socioeconomic backgrounds face substantial challenges accessing primary care services. These barriers include challenges related to appointment logistics and difficulties navigating the healthcare system, language barriers, social and economic barriers, and discrimination and racism. These barriers often intersect to create heightened difficulties for patients trying to access primary care. The people we spoke to also identified areas and actions for addressing barriers.
They spoke about interventions to improve access to care including prioritizing anti-discrimination and cultural safety and improving education and training for providers. They also spoke about the need to address the economic barriers to care, such as the costs associated with travel or taking time off work. Similarly, the research participants spoke about needing greater access to language support services across the primary care system.
Participants emphasized that many models of primary care, such as Community Health Centres and multidisciplinary teams, are already working hard to serve equity-deserving groups. These models would be well positioned to scale up culturally responsive care, including anti-racist, gender-affirming and other approaches to improve equitable access across the system – if they were better resourced.
The research findings emphasize that access and attachment to care are key issues that need to be addressed, but the type and quality of care that patients from equity-deserving communities receive is also important for eliminating barriers to primary care access.
As the government continues its important work to improve primary care in Ontario, our participants pointed to the need for action that meaningfully addresses the social and economic determinants of health. This would avoid a world where, as one research participant said, they are “afraid to go to primary care.”
The solutions identified by the Ontarians in this research are a compelling start.
See Wellesley Institute’s full research report, which gives life to these ideas through the experiences and perspectives of individuals from diverse communities.