Investigating the Experiences of Racialized Immigrant Women throughout the Continuum of Emergency Medical Care

Abstract

Background: Racialized immigrant women in Canada experience a unique set of barriers when navigating healthcare systems, yet little is known about how they experience emergency medical care. Medical emergencies can encompass interactions with informal peer networks, emergency medical services (EMS), and in-hospital staff. Across these encounters, access is shaped by perceptions of candidacy; the ongoing process through which individuals negotiate their eligibility for care.

Research Questions: (1) How do racialized immigrant women recognize and define medical emergencies in relation to their social, cultural, and prior healthcare system contexts? (2) When reflecting on their emergency care experiences, how do racialized immigrant women perceive their health encounters across the continuum of emergency care? (3) How do racialized immigrant women negotiate candidacy for emergency medical care, and how do interactions with providers affect their perceptions of legitimacy, deservingness, and future help-seeking behaviours?

Methods: An exploratory qualitative study design was employed. Purposive and snowball sampling methods were used to recruit 10 participants who were racialized immigrant women (n=10). Semi-structured interviews were conducted to understand participants’ emergency care experiences in the Kitchener-Waterloo (KW) region and the Greater Toronto Area (GTA). Interviews were interpreted using the candidacy framework. Data analysis was carried out using reflexive thematic analysis (RTA) to identify themes across the interviews.

Findings: Participants experienced compounding barriers across the emergency care continuum, with perceptions of candidacy continuously contested. Findings identified emergency experiences marked with perceptions of gender bias, limited health system literacy, symptom dismissal, and long wait times. As a result, participants often self-managed acute distress, delayed care-seeking, and/or relied on informal support networks.

Implications: These findings highlight several strategies to mitigate barriers in receiving high-quality emergency care, as highlighted by participants: (1) Implementation of education to support health system literacy for newcomers; (2) Gender-sensitive and culturally informed protocols across EMS and emergency hospital staff; and (3) Improved communication strategies.

Conclusions: This exploratory study is one of the first in Canada to explore racialized immigrant women's experiences across the emergency care continuum. Candidacy for care was continuously contested, and participants often internalized negative encounters as personal failures rather than gaps in the system. This lead many to develop distrust towards providers and hesitancy around future help-seeking. These findings point to the need for gender-sensitive, culturally responsive, and communication-focused interventions to provide more equitable care for racialized immigrant women.