A compelling new observational study conducted by ICES and The Hospital for Sick Children (SickKids) has shed significant light on healthcare utilization patterns among recently arrived refugee and immigrant children in Ontario. The investigation, encompassing a vast cohort of 458,597 children—including 113,098 refugee and immigrant children followed during their first four years after arrival, alongside 345,499 Ontario-born children in the same timeframe—presents groundbreaking insights into how these populations engage with emergency and primary care services. This large-scale analysis challenges prevailing misconceptions about healthcare usage among newcomers and reveals complex dynamics shaping access to care.
One of the study’s most striking revelations is that refugee and immigrant children were less inclined to visit emergency departments (ED) for minor illnesses, such as respiratory infections, when compared to their Ontario-born counterparts. Instead, these children demonstrated a markedly higher frequency of primary care visits for similar health concerns. This pattern indicates not only a more judicious use of emergency services but also suggests that refugee and immigrant families may possess higher engagement with continuous, preventive care infrastructures early after resettlement.
Researchers posit that the structured healthcare-navigation support provided during the early resettlement period is likely a critical factor in this differentiated pattern of healthcare utilization. Government-assisted and privately sponsored refugees in Canada often receive settlement worker support and sponsorship during their initial year. This framework appears to facilitate better navigation of primary healthcare services, thereby reducing unnecessary strains on emergency departments, especially for non-urgent conditions. Such support may empower families with the knowledge and resources needed to access appropriate care settings efficiently.
However, the landscape alters notably after the first two years of arrival. Data from the study shows a downturn in primary care visits for minor illnesses among resettled refugee children accompanied by a corresponding increase in non-urgent emergency department visits. This shift has been interpreted by the authors as potentially stemming from the reduction in resettlement financial assistance, which peaks within the first year and tapers off thereafter. Additionally, the challenges of aligning primary care appointments with families’ work schedules likely exacerbate barriers to accessing timely and appropriate healthcare. These systemic issues illuminate the fragile nature of healthcare navigation support over time for newcomer populations.
Contrary to assumptions that immigrants might misuse healthcare services by overburdening emergency departments, the study robustly counters this narrative. Dr. Susitha Wanigaratne, a Senior Research Associate at SickKids and ICES, emphasizes that this growing body of evidence dispels the myth of newcomer healthcare misuse. Instead, the findings underscore that equitable and inclusive healthcare access not only improves outcomes but can also contribute to significant cost savings within the broader healthcare system—insights that resonate beyond Canada’s borders.
A deeper dive into the study reveals that while resettled refugees exhibited greater affiliation with community health centres compared to other immigrant groups, this variable did not fully account for their more appropriate patterns of healthcare use. This suggests that the nuances in healthcare utilization are influenced by a complex interplay of factors including settlement services beyond mere affiliation with primary care providers. The broader social determinants of health, including financial support mechanisms and cultural competency in healthcare delivery, likely play critical roles.
Conversely, children born in Ontario were statistically the most likely group to present at emergency departments for non-urgent health problems but the least likely to engage in primary care visits for similar minor illnesses. This counterintuitive finding highlights a potential gap in healthcare-seeking behaviors and familiarity with healthcare navigation, even among native populations. The reasons behind such patterns may involve differences in parental perceptions, healthcare literacy, and available social supports.
The implications of these findings are multifaceted for public health policymakers and healthcare providers alike. They suggest that maintaining or expanding settlement-based healthcare navigation resources beyond the initial two-year period could stabilize and further improve primary care utilization among resettled refugee families. Moreover, addressing socioeconomic barriers—such as incompatible working hours affecting appointment attendance—may be critical to ensuring sustained equitable access to healthcare.
It is vital to note the study’s limitations. The analysis did not adjust for certain sociodemographic factors including parental employment status and education level, which undoubtedly impact caregiver decision-making regarding healthcare use. Understanding these variables better would strengthen insights into the drivers of healthcare-seeking behavior. Nonetheless, the current findings provide a robust foundation for shaping interventions aimed at reducing unnecessary emergency department strain and enhancing care delivery efficiency.
This research is part of a growing corpus of evidence demonstrating that inclusive healthcare approaches tailored to migrant populations are both ethically sound and economically beneficial. Countries with comparable healthcare infrastructures might draw lessons from Canadian settlement and health service integration models to optimize outcomes for newcomers. The study underscores that well-supported transitions into new health systems produce long-term dividends for individual and public health.
The publication of this research in the February 2026 edition of JAMA Network Open heralds it as an influential contribution to migrant health research and health services evaluation. By leveraging comprehensive administrative health data, the investigators provided an unprecedented longitudinal view of healthcare access trends within vulnerable pediatric populations. This type of population-level evidence is pivotal in informing future healthcare policy, resettlement programming, and equitable resource allocation.
Ultimately, this study reframes the narrative around refugee and immigrant children’s healthcare use, replacing outdated presumptions of misuse with data-supported understanding of their prudent and adaptive engagement with healthcare systems. The findings advocate for sustained, targeted support structures that recognize the shifting needs of newcomer families over time and reaffirm America’s and Canada’s commitments to health equity through inclusive, accessible care for all children regardless of origin.
Subject of Research: People
Article Title: Emergency department visits for minor illnesses among recent refugee and immigrant children
News Publication Date: 27-Feb-2026
Web References: 10.1001/jamanetworkopen.2025.60070
References: Emergency department visits for minor illnesses among recent refugee and immigrant children, JAMA Network Open, February 2026
Keywords: Health equity, Health care delivery, Refugee health, Immigrant health, Pediatric healthcare utilization, Emergency department visits, Primary care access, Healthcare navigation, Settlement support, Health services research
