Workers’ Immigration Status is a Health Issue

Over the last couple of decades, Canada’s immigration policy has shifted to bring in many more immigrants with temporary status, compared to those immigrants that have permanent status. Approximately 1.2 million (mainly racialized) people in Canada are on a temporary work, study, or refugee claimant permit. Prior to this policy shift, most immigrants had permanent status and were able to put down roots in our communities, stay together with families, and access the same education, health and social services as those born in Canada.

Temporary immigration is designed to make use of the labour of migrant workers and to keep them in the country only as long as they remain useful to their employer. A worker’s ability to stay in the country is tied to their employer through a work permit, which prevents workers from finding a new job with a different employer in the event of poor working conditions or ill-treatment.

Despite workers’ temporary status, jobs on farms, in meat-processing factories, and caring for children and the elderly are not temporary. Employers in all of these sectors where migrant workers are commonly employed cite a permanent need for workers with the necessary skills. 

Rights for workers with temporary status

Workers with temporary immigration status are protected by employment standards, workplace safety and health, and other labour legislation. However, it is very difficult for workers to exercise these rights when employers can and do commonly terminate their work permit and send them back to their country of origin if they raise concerns, are injured, or even become pregnant. The result is that workers with temporary status are forced to accept low pay and poor working conditions that put their health at risk.

Workers with temporary immigration status are not eligible for many social services such as language classes and other settlement services available to newcomers with permanent status. This contributes to a lack of integration with the wider community and social isolation. Many of these workers are also not eligible for provincial public health care coverage. Those who are currently not eligible for public health care coverage in Manitoba include denied refugee claimants, migrant workers with work permits of less than one year, international students, and undocumented residents.

High costs to pay for health services out of pocket deter those without public health care coverage from seeking care when needed. They may postpone receiving health care until their condition becomes very severe, more difficult to treat, and with poorer outcomes. Pregnant migrants without public healthcare coverage are in desperate situations and unable to afford the high costs of labour and delivery in local hospitals, not to mention prenatal and perinatal care.

Migrants who have lost their status and have become undocumented may avoid health care due to a fear of deportation if healthcare providers share their immigration status and personal information with immigration authorities. In Manitoba, recent reports in the media have identified this practice by health authorities who have reported a number of international students to the Canada Border Services Agency when they had health concerns that led to hospital stays.

The risks of detention

Immigration detention has serious and long-lasting effects on mental health. A 2021 report by Amnesty International and Human Rights Watch outlined the extremely negative consequences for individuals detained in Canada. Canada is one of the few countries without a legal limit on the length of detention, and individuals may be held indefinitely. Immigrants with mental health conditions and people of colour, particularly those who are Black, are often held for longer periods of time, and held in provincial jails, despite not serving criminal sentences. Many who are detained live with psychosocial disabilities, developed during their incarceration, for months and even years after their release from detention, also affecting their children, families, and communities.

What needs to change

Immigration status must be understood as a key social determinant of health — the non-medical factors related to an individual’s place in society that influence health outcomes. According to the World Health Organization, “these circumstances are shaped by the distribution of money, power, and resources at global, national, and local levels.” Research shows that social determinants can be more important than health care or lifestyle choices in influencing health. These social circumstances, such as gender, social and economic class, race/ethnicity, and immigration status are responsible for health inequities among different groups of people in a society.

Changes to Canada’s immigration system are long overdue, particularly in the context of a global conversation about systemic racism and emerging from a pandemic that highlighted the essential work performed by low-waged migrant workers in agriculture, meat processing, health care, and transportation. Organizations representing and advocating for migrant workers and other people with temporary immigration status are calling for a comprehensive regularization program for all undocumented people currently within Canada, and permanent residence for all migrants, particularly those in low-waged jobs. Regularization is a process for people without status who are already in the country to be provided legal permanent status. Regularization is a feature of immigration policy in the European Union and Ireland is currently regularizing almost all undocumented people in the country who meet a basic residency requirement. Between 1996 and 2008, 24 of 27 EU Member States implemented regularization programs, and some several times. Canada should follow their example as part of a broader transformation of the immigration system.

Permanent status for all migrants recognizes that migration is not temporary, but a permanent part of our reality. It is the best way to ensure that migrants have access to the same rights, protections, and services as other workers and residents. It will help ensure that workers can exercise their workplace rights as well as have access to Canada’s universal public health care system, education, and social services. And it will build a healthier, more inclusive, and just society.