The IMPACT Cross-Sectional Study: The socioeconomic experiences of US and non-US immigrants in Canada in the midst of the COVID-19 pandemic

doi:10.21203/rs.3.rs-2062345/v1

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Research Article

The IMPACT Cross-Sectional Study: The socioeconomic experiences of US and non-US immigrants in Canada in the midst of the COVID-19 pandemic

https://doi.org/10.21203/rs.3.rs-2062345/v1

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Background: The COVID-19 pandemic has exacerbated socioeconomic deficiencies within Canada's immigrant populations, yet the nature of these challenges is not well understood. Specifically, it is essential to understand the difference between immigrants from countries with similar language and resources (such as the US) and those from a different background (non-US countries). Accordingly, the IMPACT study at the centre of this article included a Canadian national survey that compared key domains of life in US immigrants with non-US immigrants to provide policymakers with a research-based path toward delivering culturally targeted and socially competent services.

Methods: Potential participants were recruited from various newcomer support services centers in Canada to complete the IMPACT survey. The survey comprised a series of questionnaires designed to assess participants' self-perceived impacts of COVID-19 on various socioeconomic markers. For each socioeconomic variable, we analyzed the experiential differences between US vs non-US immigrant subgroups. A chi-square analysis was used to analyze the differences between these geographic subgroups (significance level α=0.05).

Results: On average, non-US immigrants in Canada were less likely to disclose their COVID-19 health status than their US-based counterparts; this trend was correlated with reported concerns over discontinuation of one’s income. Qualitative themes within the non-US immigrant subgroup elucidated a mentality of “making it on [one’s]own”, and consequently, a reluctance to seek out external resources. Surprisingly, despite the US immigrant subgroup having better socioeconomic conditions before the onset of the pandemic, this subgroup was subject to a comparatively greater post-pandemic decrease in socioeconomic well-being, resulting in proportionally greater food and financial insecurities than non-US immigrants.

Conclusion: The study highlighted two key findings: (1) US immigrants faced a proportionally increased instability of their socioeconomic well-being; whilst (2) non-US immigrants faced greater social and intrapersonal barriers to external supports and experienced a greater incidence of COVID-19 infections, likely resulting from this cohorts reluctance to miss work on the basis of income generation. Government-funded immigration resources, newcomer support centers, and researchers require evidence-based, demographically-targeted initiatives to aid the diverse needs of Canadian immigrants and in the post-pandemic recovery period and in future public health emergencies.

Immigrants

Canada

economic

COVID-19

inclusion

employment

income

The COVID-19 pandemic has exacerbated deficiencies in employment and financial security, food security, and access to health care, throughout social and familial support networks within Canada's immigrant populations.. Subsequent pandemic government response efforts have underscored the need to study the impact of COVID-19 on marginalized groups, which may be disproportionately vulnerable to COVID-19 infection, hospitalization, and related implications. In the context of Canada, these vulnerable groups include low-income individuals and newcomers to Canada, such as immigrants, refugees, undocumented migrants, and international students.

Immigrants in Canada are defined as those who hold, or have ever held, permanent resident status in Canada, including naturalized citizens [1]. Canada is lauded for having the eighth most significant immigrant population (approximately 9 million as of 2022) in the world, with over a fifth of the total population being foreign-born. The vibrant immigrant community weaves the multicultural fabric of Canada with people from different countries, including but not limited to India, China, the Philippines, Nigeria, France, the United States, Brazil, Iran, Afghanistan and Pakistan [2]. However, immigrants in Canada are disproportionately represented in higher-risk (e.g., requiring physical contact or poor COVID-19 protection measures) jobs with greater exposure to COVID-19 (34% of such jobs are held by immigrants). Furthermore, immigrants in Canada are more likely to be employed by industries most affected by the pandemic, such as food production and hospitality services – compounding both health and economic risks [3].

Of the existing Canadian literature, such as Mo et al.’s (2020) publication, most have studied the impact of the pandemic on the immigrant population by treating immigrants as a binary variable (i.e. immigrants and non-immigrants) while focusing on the discrepancies faced in comparison to those born in Canada [4]. Barker’s (2021) publication focused on evaluating social integration for newcomers amidst social isolation due to the pandemic, revealing d discrepancies in critical vehicles for social integration such as language training. Additionally, employment support and social connections were similarly disrupted by COVID-19 in newcomer communities [5]. One of Barker’s five intersectional recommendations for migrants during COVID-19 was to “use intersectionality to approach future COVID‐19 research”. More specifically, it was noted that intersectional lenses do not represent a unified experience for immigrants, collectively. Thus, it is crucial to recognizethat individuals of marginalized subgroups, such as those from different countries of origin, have differing experiences with inequality and discrimination in Canada .

Beyond a Canadian context, many exploratory studies have converged on similar themes of immigration patterns and associated health outcomes; such studies have drawn conclusions about the increased extent and complexity of disparities across various migrant groups [6]. These studies comprise a body of literature that echoes the appeal of various international and intergovernmental healthcare bodies and relevant United Nations conventions (e.g., the proposed Sustainable Development Goals to achieve before 2030) that advocate for demographically-targeted immigrant health research to better understand the unique needs of different migrant groups. Currently, little to no research of this kind exists within the Canadian context. Exploring immigrant disparities based on immigrants' country of origin may benefit immigrant health research in Canada, especially with the onset of the pandemic and its subsequent socioeconomic challenges. Ultimately, various studies within the Canadian context have established a broad range of social, physical and economic barriers for immigrants. However, they have done so through the generalization of experiences of a population subgroup numbering millions, and with diverse backgrounds and experiences. As a result, the IMPACT study aimed to delve into these untouched experiences of immigrants to Canada from two subset origin-country groups: those who immigrated from the United States of America and those who immigrated from other source countries. The study results will pave the path toward creating evidence-informed inter-sectoral policies.

Immigrants from the United States of America amounted to 253,715 individuals or roughly 3.36% of the total immigrant population within Canada, thus forming one of the largest such groups in the country [7]. In 2021, 11,930 permanent residents (2.9% of the total) with US origins were admitted to Canada [7]. In parallel with the geographical origins of these immigrants, the COVID-19 pandemic has impacted subsets of immigrants in their unique disproportionate ways. However, we know very little about how the intersectionality of the realities experienced by immigrants from the United States can impact their access to health care, social services, education, employment and other social conditions during the pandemic compared to immigrants from other countries. Furthermore, there has been a staggering growth of immigrants moving from the US to Canada following the launch of the Express Entry Skilled Tradesstream in 2015 [8]. In light of this immigration initiative, skilled workers from the US have a competitive edge over immigrants from origin countries as they are fluent in English and have educational experience mirroring the qualities of the Canadian education system, with highly skilled professionals an asset. As such, over the past few years, an influx of Americans have obtained permanent residency through the Express Entry program. Ultimately, they have emerged as a prominent immigrant group in Canada alongside those from other backgrounds. The comparison between these groups sparks discussion on how geographical proximity, similar socioeconomic conditions between Canada and the United States and other factors such as English language proficiency, familiarity with government services and support systems may or may not play a role in the experience of immigrants during the COVID-19 pandemic. Furthermore, it is hypothesized that US immigrants, who performed better than their non-US counterparts before the pandemic, are expected to perform better amid the pandemic, given their increased access to social, financial and physical resources and support networks.

The IMPACT Study is a Canadian national survey conducted between November 2020 and June 2021 that collected responses from 2473 Canadians, including 1433 immigrants from the United States and 1040 immigrants from other countries. The survey included questions about life satisfaction, general health, changes in income and employment status since the onset of the COVID-19 pandemic, food insecurity, and homeschooling experiences; these questions were designed to ascertain the far-reaching impacts of the pandemic through a multidisciplinary and multifaceted lens. Ultimately, this study hopes to elucidate the dynamic interplay of socioeconomic factors operating at multiple social levels that shape the impact of immigrants’ COVID-19-related needs, in which amendments to social policies in Canada may better address. The onset of the pandemic and subsequent social policies enacted to mitigate its spread alongside projections of societal repercussions were based primarily on the needs of the general Canadian population. Their disregard for the unique needs and challenges of the immigrant population was evident by immigrants' increased risk of infection, hospitalization, and death, in addition to the multitude of social, economic and mental health setbacks. This investigation aimed to address the disparities between subsets of immigrant populations from the United States and other countries. Inevitably, this study will identify areas of need for policy development and resource allocation within the current pandemic or in light of future ones.

Aim

The overall aim of the study was to first gather a descriptive overview of the multifaceted impact that COVID-19 had on the health, relationships, jobs, education and support networks of immigrants in Canada. Secondly, the aim was to conduct a between-group comparison of immigrants from the US and those from other countries, in order to establish more efficient policy actions in the future.

Study Design and Setting

This cross-sectional survey study was completed using questions prepared for similar international studies from a similar preprint publication by Burton-Jeangros et al. [9]. The survey included questions about life satisfaction, general health, changes in income and employment status since the COVID-19 pandemic, food security and homeschooling. The survey also assessed the impact of COVID-19 lockdowns on immigrants, with respect to income, work, as well as health and food security. Data was collected using a survey software, Qualtrics, which is licensed through Queen’s University. Consent was built into the survey, with survey completion indicating consent. The survey was shared on LinkedIn, Facebook, and Twitter and was also sent to all available settlement organizations in Canada that are listed under the “Find free newcomer services near you” website on ircc.canada.ca [10]. The organizations that required ethics approval for sharing the survey on their website were sent all required documents. Except for the screening questions at the beginning to determine eligibility, none of the questions were mandatory to complete. These were taken into account in the data analysis used in Burton-Jeangros et al.’s study [9].

Characteristics of Participants

We invited the participation of adults (18+) who came to Canada as immigrants, international students, refugees or had an undocumented status. The first few questions asked if the participants were adults, born outside of Canada, and came to Canada 5 years ago. If the person answered ‘yes’ to the screening questions, they then received access to the rest of the questions. Otherwise, they were not able to proceed with the survey.

Analysis

Descriptive statistics, including both raw values and percentages, were conducted for each question and the data was presented individually for US and non-US immigrants, as well as in a totaled category. Chi-square tests were performed to compare US immigrants and non-US immigrants and decipher if differences between these groups in their responses to each question were statistically significant or not. P-values for individual questions were only reported if the results were statistically significant.

All statistical analyses were performed with IBM Statistical Package for Social Science (SPSS) version 28. Significant results were defined as p < .05.

Demographics

The study participants included a total of 2473 respondents with 1433 immigrants from the US and 1040 originating from other countries. US and non-US immigrants did not have statistically significant differences in their mean ages (31.49 years ± 7.83 years). However, some key differences were noted. First and foremost, there was a higher percentage of US immigrants identifying as male (54.6%) whereas Non-US immigrants had a higher proportion of those identifying as female (52.2%) (p<0.001). Furthermore, 82.8% of US immigrants had done some college or received their bachelor’s compared to just 73.7% of non-US immigrants (p=0.006). Additionally, US immigrants were more likely to have arrived in Canada over the last 5 years (58.5%) than compared to non-US immigrants (44.2%) who seemed to have arrived earlier as well (p<0.001). As presented in Tables 1-6, non-US immigrants were also noted to have not provided answers for some questions.

Table 1: General Demographics

Question	Answer	Total	Non-US Immigrants	US Immigrants
Gender *******	Male	1148 (46.4%)	366 (35.2%)	782 (54.6%)
	Female	1171 (47.4%)	543 (52.2%)	628 (43.8%)
	Do not identify within gender boundary	28 (1.1%)	21 (2.0%)	7 (0.5%)
	Prefer not to say	19 (0.8%)	6 (0.6%)	13 (0.9%)
	Missing	107 (4.3%)	104 (10.0%)	3 (0.2%)
Education **	High School or Less	409 (16.5%)	165 (15.9%)	244 (17.0%)
	Some college or an associate degree	1076 (43.5%)	391 (37.6%)	685 (47.8%)
	Bachelor's Degree or higher	876 (35.4%)	375 (36.1%)	501 (35.0%)
	Missing	112 (4.5%)	109 (10.5%)	3 (0.2%)
Year since the arrival to Canada *******	Last 5 years	1301 (52.6%)	460 (44.2%)	841 (58.5%)
	6 years or more	764 (30.9%)	218 (21.0%)	546 (38.1%)
	Missing	408 (16.5%)	362 (34.8%)	46 (3.2%)
Age ^ns	Mean Age (+ SD)	31.49 ± 7.83	31.58 ± 7.99	31.59 ± 7.80

^ns not statistically significant (p>0.05); * p<0.05; ** p<0.01; *** p<0.001.

Employment and Financial Security

As presented in Table 2, 84.4% of participants showed some degree of concern about the development of the COVID-19 crisis. Immigrants’ financial context, fears of infection by the virus, and concerns over retaining employment were the main concerns for over 40% of participants.

An overwhelming majority (93.5%) of immigrants from the United States were employed before the pandemic compared to just 79.1% of those from other countries (p<0.001). However, 65.6% of those from the United States and 53.4% from other countries experienced decreased hours of paid work when the pandemic hit and restrictions were enacted. The drops in employment were not statistically different between the two groups. These trends were subsequently tied to a common experience of declines in income faced by both groups. Furthermore, 6.5% of those from the United States and 5.4% from other countries reported being unemployed due to the pandemic.

15.0% of immigrants from the United States and 21.2% of immigrants from other source countries did not have enough savings to meet their needs (the difference was significant, p<.001), and for 62.4%, these savings would last for two months or less. Many participants of the study (36.8%) had borrowed money or considered borrowing money, and a third of both groups refused to consider loans as an option.

Over 66.3% of immigrants from the United States and 57.2% of those from other countries had difficulty paying their bills and around half were worried about paying their rent and health insurance. The average number of people that were supported by the respondent’s income (ranging from 1 to 12) was 2.99 ± 1.34 individuals for US immigrants which was higher than the 2.72 ± 1.46 individuals supported by non-US immigrants (p<0.001) . Immigrants from the United States who responded to our survey experienced several other limitations and problems in their life: 52.2% could not pay an unexpected bill of $2000 and 42.4% experienced worsened house situations (between-group differences were not statistically significant for non-US immigrants and their values were 47.4% and 39.0% respectively). A majority (72.7%) of US immigrants were worried that they might lose their living place compared to 61.0% of non-US immigrants (p=0.002). Additionally, 16.5% of US immigrants reported that they would have no place to live in the event that they lost their present accommodations, which was compared to 21.9% of non-US immigrants (p<.001).

Table 2: Survey results for the ‘Employment and Financial Security’ subcategory.

Question	Answer	Total	Non-US Immigrants	US Immigrants
Level of concern with the COVID-19 crisis ^ns	Not worried at all	256 (10.4%)	109 (10.5%)	147 (10.3%)
	Slightly worried	1288 (52.1%)	471 (45.3%)	817 (57.0%)
	Very worried	800 (32.3%)	347 (33.4%)	453 (31.6%)
	Missing	129 (5.2%)	113 (10.9%)	16 (1.1%)
Area of main worries during lockdown ^ns	Financial situation	1333 (53.9%)	521 (50.1%)	812 (56.7%)
	Risk of becoming infected with COVID-19	1104 (44.6%)	423 (40.7%)	681 (47.5%)
	Job	1080 (43.7%)	415 (39.9%)	665 (46.4%)
Did you have a job before the outbreak of the COVID-19 crisis? *******	No	197 (8.0%)	112 (10.8%)	85 (5.9%)
	Yes	2163 (87.5%)	823 (79.1%)	1340 (93.5%)
	Missing	113 (4.6%)	105 (10.1%)	8 (0.6%)
Impact of COVID-19 on hours of paid work ^ns	Stayed the same	598 (24.2%)	232 (22.3%)	366 (25.5%)
	Increased	58 (2.3%)	29 (2.8%)	29 (2.0%)
	Decreased	1495 (60.5%)	555 (53.4%)	940 (65.6%)
Magnitude of decrease ^ns	About half	410 (16.6%)	156 (15.0%)	254 (17.7%)
	Well below half	792 (32.0%)	278 (26.7%)	514 (35.9%)
	Still more than half	131 (5.3%)	58 (5.6%)	73 (5.1%)
	Not working anymore	149 (6.0%)	56 (5.4%)	93 (6.5%)
Are your savings sufficient to meet your current needs *******	Yes	1866 (75.5%)	686 (66.0%)	1180 (82.3%)
	No	435 (17.6%)	220 (21.2%)	215 (15.0%)
	Missing	172 (7.0%)	134 (12.9%)	38 (2.7%)
For how long you can meet your basic needs ^ns	< a month	453 (18.3%)	180 (17.3%)	273 (19.1%)
	1 to 2 months	1091 (44.1%)	429 (41.3%)	662 (46.2%)
	>3 months	758 (30.7%)	297 (28.6%)	461 (32.2%)
	Missing	171 (6.9%)	134 (12.9%)	37 (2.6%)
Did you borrow money?^ns	Yes	1393 (56.4%)	536 (51.5%)	857 (59.9%)
	No but considering it	183 (7.4%)	80 (7.7%)	103 (7.2%)
	No, not considering it as an option	726 (29.4%)	293 (28.2%)	433 (30.3%)
	Missing	169 (6.8%)	131 (12.6%)	38 (2.7%)
Have difficulty with paying bills? ^ns	No	758 (30.7%)	316 (30.4%)	442 (30.8%)
	Yes	1545 (62.5%)	595 (57.2%)	950 (66.3%)
	Missing	170 (6.9%)	129 (12.4%)	41 (2.9%)
Bills unable to pay: ^nsMultiple Answers Allowed	Rent	856 (57.3%)	320 (53.8%)	536 (56.4%)
	Health Insurance	851 (56.9%)	308 (51.8%)	543 (57.2%)
	Travel Pass	366 (24.5%)	124 (20.8%)	242 (25.5%)
	Electricity Charges	332 (22.2%)	146 (24.5%)	186 (19.6%)
	Internet	324 (21.7%)	152 (25.5%)	172 (18.1%)
	Phone	197 (13.2%)	113 (19.0%)	84 (8.8%)
	Other	13 (0.9%)	11 (1.85%)	2 (0.2%)
Can you pay an unexpected bill of $2000 ^ns	No	1241 (50.2%)	493 (47.4%0	748 (52.2%)
	Missing	211 (8.5%)	147 (14.1%)	64 (4.5%)
	Yes	1021 (41.3%)	400 (38.5%)	621 (43.3%)
Change in housing condition ^ns	No, stayed the same	1186 (48.0%)	461 (44.3%)	725 (50.6%)
	Yes, got worse	1014 (41.0%)	406 (39.0%)	608 (42.4%)
	Yes, improved	102 (4.1%)	42 (4.0%)	60 (4.2%)
	Missing	171 (6.9%)	131 (12.6%)	40 (2.8%)
Are you worried about losing your place to live? **	Yes	1676 (67.8%)	634 (61.0%)	1042 (72.7%)
	No	612 (24.7%)	270 (13.0%)	342 (11.9%)
	Missing	185 (7.5%)	136 (6.5%)	49 (1.7%)
If you lose your place to live, will you have a person to accommodate you for a short period of time? *******	Yes	1826 (73.8%)	677 (34.8%)	1149 (40.6%)
	No	472 (19.1%)	228 (21.9%)	244 (16.5%)
	Missing	175 (7.1%)	135 (6.9%)	40 (1.4%)
Number of people supported by income *******	Mean individuals supported (± SD)	2.89 ± 1.38	2.72 ± 1.46	2.99 ± 1.34

^ns not statistically significant (p>0.05); * p<0.05; ** p<0.01*** p<0.001.

Food Insecurity

More than half (59%) of immigrants accessed food banks, community services, or faith groups for food; this trend was not significantly different between immigrants from the United States (62.4%) and those from other countries of origin (54.4%). As per their mental health, a staggering 69.1% of immigrants from the United States worried about not having enough to eat compared to 55.2% of immigrants from other countries (p<.001). A slightly greater proportion of US immigrants had to buy cheaper or lower quality food because they did not have money or external financial support (58.6%) compared to those from other countries (51.7%), however,this difference was not statistically significant. Evidence of food insecurity was prominent amongst half the immigrant population, as 52.1% of immigrants from the United States reported skipping meals or eating less which was not statistically different from that of non-US immigrants (42.8%). Of those that did skip meals or eat less (48.2%), there were no statistically significant differences reported between both groups as 41.0% of US immigrants decided not to eat because they did not have enough money, and 31.2% had to go a whole day without eating (these figures are compared to 33.8%, and 24.8% respectively for immigrants from other countries).

Table 3: Survey results for the ‘Food Insecurity’ subcategory.

Question	Answer	Total	Non-US Immigrants	US Immigrants
Have you used the food bank, service or faith group for food? ^ns	Yes	1460 (59.0%)	566 (54.4%)	894 (62.4%)
	No	812 (32.8%)	330 (31.7%)	482 (33.6%)
	Missing	201 (8.1%)	144 (13.8%)	57 (4.0%)
Have you ever been worried about not having enough to eat? *******	Yes	1564 (63.2%)	574 (55.2%)	990 (69.1%)
	No	700 (28.3%)	315 (30.3%)	385 (26.9%)
	Missing	209( 8.5%)	151 (14.5%)	58 (4.0%)
Have you ever had to buy cheaper/poorer quality food because you didn’t have money or support? ^ns	Yes	1378 (55.7%)	538 (51.7%)	840 (58.6%)
	No	890 (36.0%)	356 (34.2%)	534 (37.3%)
	Missing	205 (8.3%)	146 (14.0%)	59 (4.1%)
Have you ever had to eat less or miss meals because you didn’t have enough food? ^ns	Yes	1192 (48.2%)	445 (42.8%)	747 (52.1%)
	No	1076 (43.5%)	449 (43.2%)	627 (43.8%)
	Missing	205 (8.3%)	146 (14.0%)	59 (4.1%)
Have you ever been hungry but decided not to eat, because you didn’t have enough money for food? ^ns	Yes	940 (38.0%)	352 (33.8%)	588 (41.0%)
	No	250 (10.1%)	92 (8.8%)	158 (11.0%)
	Missing	2 (0.1%)	1 (0.1%)	1 (0.1%)
Have you ever had to go a whole day w/o eating? ^ns	Yes	705 (28.5%)	258 (24.8%)	447 (31.2%)
	No	232 (9.4%)	93 (8.9%)	139 (9.7%)
	Missing	255 (10.3%)	94 (9.0%)	161 (11.2%)

^ns not statistically significant (p>0.05); * p<0.05; ** p<0.01*** p<0.001.

Health and Access to Care

As shown in Table 4, both immigrants from the United States and other countries expressed positivity towards their health and healthcare experiences. Most immigrants felt that their healthcare needs had been met during the pandemic, a figure more pronounced with US immigrants (64.3%) compared to 51.5% of non-US immigrants (p=.001). Both groups of immigrants reported that they were generally in excellent or very good health, however, US immigrants were more likely to feel that their health status remained unchanged or improved (86%) during the COVID-19 pandemic (p=.005). Despite these results, the mental health states of both immigrant groups plummeted during the pandemic in which 82.1% of US immigrants and 72.3% of non-US immigrants reported feeling worried, sad, or anxious. Both groups did not have statistically significant differences in their responses to whether they felt more worried, sad or anxious before the pandemic (42.4% of US immigrants and 36.4% of non-US immigrants).

Non-US Immigrants were reportedly subject to slightly higher rates of infection from COVID-19 (5.3% vs 4.3% of those who immigrated from the United States) (p<.001). However, larger disparities existed among individuals that thought they had COVID-19 but did not test themselves, as reported by 23.6% of non-US immigrants relative to 18.2% of those from the United States (p<.001). A fifth of immigrants from both the United States (20.5%) and slightly more from other countries (21.5%) did not self-isolate as mandated by federal law (p=.040), citing employment (45.6%) and obligations to take care of family and relatives (42.9%) as the most common reasons. These results arose despite the fact that 87.4% of immigrants from the United States and 73.9% of immigrants from other countries were aware of the COVID-19 measures imposed by Canadian authorities (p<.001).

Despite needing to visit a doctor or a hospital, there were no statistically significant differences in the proportions of US immigrants (61.1%) and non-US immigrants (51.8%) who did not access primary healthcare services during the pandemic. The reduced access to health services was attributed to fears of contracting COVID-19 (41.6%), financial reasons (18.1%) and guilt of contributing to the overall burden on the already strained healthcare system (18.9%) by both groups. Furthermore, both groups (60.7% of US and 56.0% of non-US immigrants) had participants reporting that they did not have a family doctor in Canada, which was another limiting factor in accessing healthcare services. Of the smaller proportion of immigrants that did have access to a family doctor (33.4%), most reported accessing them during the pandemic and these individuals were also more likely to hold positive self-evaluations of their overall health.

Table 4: Survey results for the ‘Health and Access to Care’ subcategory.

Question	Answer	Total	Non-US Immigrants	US Immigrants
Do you feel that your health care needs have been met during the pandemic *	Yes	1458 (59.0%)	536 (51.5%)	922 (64.3%)
	No	824 (33.3%)	359 (34.5%)	465 (32.4%)
	Missing	191 (7.7%)	145 (13.9%)	46 (3.2%)
In general, you would say your health is: ^ns	Excellent	491 (19.9%)	189 (18.2%)	302 (21.2%)
	Very good	809 (32.7%)	305 (29.3%)	504 (35.2%)
	Good	760 (30.7%)	299 (28.8%)	461 (32.2%)
	Fair	151 (6.1%)	70 (6.7%)	81 (5.7%)
	Poor	49 (2.0%)	25 (2.4%)	24 (1.7%)
	Missing	213 (8.6 %)	152 (14.6%)	61 (4.3%)
In comparison to before the COVID-19 outbreak, do you think your health has: **	Improved	202 (8.2%)	70 (6.7%)	132 (9.2%)
	Slightly improved	686 (27.7%)	249 (23.9%)	437 (30.5%)
	Stayed the same	1134 (45.9%)	471 (45.3%)	663 (46.3%)
	Slightly worsened	224 (9.1%)	87 (8.4%)	137 (9.6%)
	Worsened	31 (1.3%)	20 (1.9%)	11 (0.8%)
	Missing	196 (7.9%)	143 (13.8%)	53 (3.7%)
Overall, do you feel sad, worried, or anxious in the context of Covid-19 ^ns	Yes	1928 (39.0%)	752 (72.3%)	1176 (82.1%)
	No	341 (6.9%)	139 (13.4%)	202 (0.6%)
	Missing	204 (4.1 %)	149 (14.3%)	55 (3.8%)
In comparison to before the Covid-19 crisis, would you say that you currently feel ^ns	More depressed or more worried	987 (39.9%)	379 (36.4%)	608 (42.4%)
	The same	642 (26.0%)	249 (23.9%)	393 (27.4%)
	Less sad or less worried	296 (12.0%)	124 (11.9%)	172 (12.0%)
	Missing	548 (22.2%)	288 (27.7%)	260 (18.1%)
Have you been sick with Covid-19? *******	No	1665 (67.3%)	600 (57.7%)	1065 (74.3%)
	I think so but I was not tested	506 (20.5%)	245 (23.6%)	261 (18.2%)
	Yes	116 (4.7%)	55 (5.3%)	61 (4.3%)
	Missing	186 (7.5%)	140 (13.5%)	46 (3.2%)
Have you isolated yourself at home for at least 14 days because of Covid-19? *	Yes	1773 (71.7%)	678 (65.2%)	1095 (76.4%)
	No	518 (20.9%)	224 (21.5%)	294 (20.5%)
	Missing	182 (7.4%)	138 (13.3%)	44 (3.1%)
If not, why haven’t you self-isolated? ^ns	Not enough room in my home	97 (18.7%)	41 (18.3%)	56 (19.0%)
	I had to work	236 (45.6%)	95 (42.4%)	141 (48.0%)
	I had to take care of my family/relatives	222 (42.9%)	86 (38.4%)	136 (46.3%)
	Being isolated was too difficult	80 (15.4%)	40 (17.9%)	40 (13.6%)
	I didn’t know about this measure	23 (4.4%)	15 (6.7%)	8 (2.7%)
	Other	26 (5.0%)	22 (9.8%)	4 (1.4%)
Do you know about Covid-19 measures imposed by Canadian authorities *******	Yes	2022 (81.8%)	769 (73.9%)	1253 (87.4%)
	No	268(10.8%)	132 (12.7%)	136 (9.5%)
	Missing	183 (7.4%)	139 (13.4%)	44 (3.1%)
Have you decided to not go to the doctor/hospital because of Covid-19?^ns	Yes	1414 (57.2%)	539 (51.8%)	875 (61.1%)
	No	854 (34.5%)	358 (34.4%)	496 (34.6%)
	Missing	205 (8.3%)	143 (13.8%)	46 (3.2%)
Why did you decide to NOT go to the doctor/hospital? ^ns	For financial reasons	447 (18.1%)	166 (16.0%)	281 (19.6%)
	For fear of getting Covid -19	1030 (41.6%)	385 (37.0%)	645 (45.0%)
	For fear of making it too hard for the doctors/hospital	468 (18.9%)	155 (14.9%)	313 (21.3%)
	For fear of police at the hospital’s entrance	82 (3.3%)	30 (2.9%)	52 (3.6%)
	Other	7 (0.3%)	6 (0.6%)	1 (0.1%)
Do you have a family doctor? ^ns	Yes	826 (33.4%)	313 (30.1%)	513 (35.8%)
	No	1452 (58.7%)	582 (56.0%)	870 (60.7%)
	Missing	195 (7.9%)	145 (13.9%)	50 (3.5%)
If you accessed your family doctor, were you happy with your visit? ^ns	Yes	622 (26.8%)	241 (23.2%)	421 (29.4%)
	No	25 (1.0%)	13 (1.3%)	12 (0.8%)
	Missing	4 (0.2%)	3 (0.3%)	1 (0.1%)

^ns not statistically significant (p>0.05); * p<0.05; ** p<0.01*** p<0.001.

Physical Support Networks

To get information, financial or material assistance, 63.6% of immigrants from the United States and 54.9% from other countries referred to associations and institutions, and differences were not statistically significant between studied groups. For both immigrant groups, financial and material assistance was the most sought (85%). Additionally, for immigrants from the United States, the most reported reasons for not seeking out aid from associations and institutions included not needing help (16.0%) and worries about their residence permit (9.8%). On the other hand, for immigrants from other source countries, the most reported reasons for not seeking out aid from associations and institutions included not needing help (11.4%) and a desire to resolve their concerns autonomously (11.3%). Support from employers was consistent amongst both groups, with one-third receiving financial help (35.5%) and another third receiving material support from their employers (28.8%), whilst another third did not receive any help from their employer (35.4%). A surprising number of participants (67.8%) reported their fears of eviction from properties. Concerningly, many (16.5%) of the studied immigrants from the United States and 21.9% from other countries reported that in the event that they lost their current housing, they did not know of someone who would be able to provide some form of short-term accommodation, and the number was significantly higher for non-US immigrants (p<0.001).

Table 5: Survey results for the ‘Physical Support Networks’ subcategory.

Question	Answer	Total	Non-US Immigrants	US Immigrants
Because of Covid-19, have you asked institutions or associations for info/financial/material assistance? ^ns	Yes	1483 (60.0%)	571 (54.9%)	912 (63.6%)
	No	786 (31.8%)	321 (30.9%)	465 (32.4%)
	Missing	204 (8.2%)	148 (14.2%)	56 (3.9%)
Why have you decided not to ask for help from institutions/associations ^ns	I do not need help	348 (14.1%)	119 (11.4%)	229 (16.0%)
	I am worried about my residence permit	221 (8.9%)	81 (7.8%)	140 (9.8%)
	I would rather make it on my own	214 (8.7%)	118 (11.3%)	96 (6.7%)
	Missing	3 (0.4%)	3 (0.9%)	0 (0.0%)
What kind of help did you ask for? ^ns	Financial Assistance	927 (42.6%)	336 (41.7%)	591 (43.2%)
	Material Assistance	1003 (42.4%)	362 (38.4%)	641 (45.0%)
	Information	233 (10.7%)	96 (11.9%)	137 (10.0%)
	Other	12 (0.6%)	12 (1.5%)	0 (0.0%)
Help received from employer ^ns	None	817 (35.4%)	329 (37.9%)	488 (33.8%)
	Yes (Financial Help)	820 (35.5%)	308 (35.5%)	512 (35.5%)
	Yes (Material Help)	665 (28.8%)	225 (26.0%)	440 (30.5%)
	Other	7 (0.3%)	5 (0.6%)	2 (0.1%)
Are you worried about losing your place to live? ^ns	Yes	1676 (67.8%)	634 (61.0%)	1042 (72.7%)
	No	612 (24.7%)	270 (26.3%)	342 (23.9%)
	Missing	185 (7.5%)	131 (13.6%)	49 (3.4%)
If you lose your place to live, will you have a person to accommodate you for a short period of time? *******	Yes	1826 (73.8%)	677 (34.8%)	1149 (40.6%)
	No	472 (19.1%)	228 (21.9%)	244 (16.5%)
	Missing	175 (7.1%)	135 (6.9%)	40 (1.4%)

^ns not statistically significant (p>0.05); * p<0.05; ** p<0.01*** p<0.001.

Social and Familial Support Networks

A greater proportion of immigrants from the United States (62.4%) than those from other countries (53.3%) reported social rifts and conflicts in their romantic relationships (p=0.002). No statistically significant differences in levels of conflict were reported amongst the people that lived with the respondents, with 65.4% of those from the United States and 60.5% of those from other countries reporting some conflicts. Almost a third of all immigrants reported to be victims of abuse including psychological abuse (20.7% from the United States and 17.2% from other countries), physical abuse (8.7% from the United States and 8.2% from other countries) and both forms of abuse (6.3% from the United States and 5.3% from other countries). However, differences between groups were not statistically significant.

Additionally, 11.0% of non-US immigrants were concerned about the well-being of their separated family in their countries of origin, and this difference was not statistically significant when compared to those from the United States (6.9%). However, immigrants from the United States were more likely to begin sending money back to their families in their country of origin with the onset of the pandemic, or continued pre-existing financial aid to their families abroad, albeit in smaller monetary amounts (p=.003).

No statistically significant differences were found between immigrants from the United States that had children who attend school in Canada (68.7%) compared to their counterparts (58.4%), while both groups reported difficulties in educating their children at home. Of those who reported challenges with homeschooling, helping their children with assigned homework and assignments (44.4%) and having access to physical supplies needed for their children’s education (42.5%) were most commonly reported. Additionally, 25.1% of all immigrant parents reported difficulties in obtaining child day care while they worked.

Table 6: Survey results for the ‘Social and Familial Support Networks’ subcategory.

Question	Answer	Total	Non-US Immigrants	US Immigrants
Has COVID-19 created social problems or caused conflicts in your romantic relationships? **	Yes	1448 (58.6%)	554 (53.3%)	894 (62.4%)
	No	748 (30.2%)	293 (28.2)	455 (31.8%)
	I am not in a relationship	103 (4.2%)	58 (5.6%)	45 (3.1%)
	Missing	174 (7.0%)	135 (13.0%)	39 (2.7%)
Has COVID-19 created social problems or caused conflicts among the people you live with? ^ns	Yes	1566 (63.3%)	629 (60.5%)	937 (65.4%)
	No	673 (27.2%)	247 (23.8%)	426 (29.7%)
	I live alone	61 (2.5%)	31 (3.0%)	30 (2.1%)
	Missing	173 (7.0%)	133 (12.8%)	40 (2.8%)
Have you been a Victim of Abuse? ^ns	Yes, physical abuse	210 (8.5%)	85 (8.2%)	125 (8.7%)
	Yes, psychological abuse	475 (19.2%)	179 (17.2%)	296 (20.7%)
	Yes, both	145 (5.9%)	55 (5.3%)	90 (6.3%)
	No	918 (37.2%)	376 (36.2%)	542 (37.9%)
	Missing	720 (29.2%)	343 (33.0%)	377 (26.4%)
Area of main worries during the lockdown ^ns	Situation of family living in the country of origin	114 (11.0%)	99 (6.9%)	213 (8.6%)
Do you continue to send money to your family in your country of origin? **	No. I don’t	632 (25.6%)	268 (25.8%)	364 (25.4%)
	Yes, but smaller amount	1188 (48.0%)	435 (41.8%)	753 (52.5%)
	Yes, the same amount	313 (12.7%)	121 (11.6%)	192 (13.4%)
	No, I did not send any money before the crisis	169 (6.8%)	84 (8.1%)	85 (5.9%)
	Missing	171 (6.9%)	132 (12.75%)	39 (2.7%)
Do you live with children who attend school in Canada? ^ns	Yes	1592 (64.4%)	607 (58.4%)	985 (68.7%)
	No	687 (27.8%)	291 (28.0%)	396 (27.6%)
	Missing	194 (7.8%)	142 (13.7%)	52 (3.6%)
What are the difficulties of educating your children at home? (Multiple Answers Allowed) ^ns	Having enough space for your children to learn	211 (31.1%)	81 (29.2%)	130 (32.4%)
	Having access to the supplied your children need for their education	288 (42.5%)	112 (40.4%)	176 (43.9%)
	Helping your children with their assignments/homework	301 (44.4%)	101 (36.5%)	200 (49.9%)
	Finding someone to care for your children when you are working	170 (25.1%)	52 (18.8%)	118 (29.4)

^ns not statistically significant (p>0.05); * p<0.05; ** p<0.01*** p<0.001.

Summary of Results

The study results highlighted the common struggles that immigrants from the United States and other countries faced during the COVID-19 pandemic. These striking parallels in life satisfaction, general health, changes in income and employment status, homeschooling experiences and more were in spite of the unique challenges faced byUS and non-US immigrants, respectively. However, key differences were still noted that shed light on the unique circumstances specific to these subgroups. These offer avenues to further ensure public policy platforms better accommodate such unique concerns.

1. Despite being in desperate conditions, non-US immigrants were reluctant to seek out external resources and presented a mentality of “making it on their own”

Results were indicative of non-US immigrants being more reluctant to seek out external resources (e.g., food banks, help from employers, friends, or other organizations) amidst their desperate social and economic positions during the pandemic. Going into the pandemic, more non-US immigrants did not have a job or available support (e.g., additional financial resources or social connections that could assist them in emergency scenarios) [11]. These results are also striking in that many non-US immigrants living in Canada are isolated from more direct means of contact and support from their family and friends of their countries of origin whereas, for US immigrants, these support networks are a lot more accessible. Many non-US immigrants likely hold higher socioeconomic status than their families in their countries of origin, given that the vast majority of these immigrants came from developing countries which are subject to lower average wages and increased rates of poverty [12]. As a result, these non-US immigrants may find themselves in a position of not having a social network to reach out to if they need support.

On the other hand, as many of these people are leaving their countries of origin, culture, stigmatization and related pressures may reinforce ideals of independence, self-sufficiency and thus the need to “make it on their own” in an effort to uphold one’s sense of self-respect and self-esteem. Although a marker of resiliency, these pressures may pose a deterrent for seeking out support and lead them to rely on their already strained sources of income and other official support from employers. Furthermore, racialized communities are subject to increased rates of neglect from social services and marginalization as many of the support systems currently in place by employers and other institutions are effectively inaccessible to those with limited knowledge of Canada’s official languages [13]. Rates of food insecurity were high for both groups amid soaring inflation of goods for all Canadian, but the lower likelihood of non-US immigrants seeking out support such as food banks may be attributed to not wanting to feel or present themselves as ‘poor’, a lack of culturally competent resources available, a lack of ethnic foods in these networks, and cultural and dietary restrictions [14, 15].

2. Despite presumably having better conditions before the pandemic–such as employment and income–US immigrants faced a greater decline in socioeconomic wellbeing and greater food instabilityin the pandemic, causing them to face food and financial difficulty to greater lengths

Despite being in better conditions before the pandemic, specifically in aspects of employment status, profitable occupations, and subsequent income, US immigrants faced a greater socioeconomic decline and food instability during the pandemic, which caused them to face proportionally greater food insecurity and financial difficulties than non-US immigrants. One of the factors that may be attributed to this trend would be that US immigrants were supporting a larger number of people with their income streams, and it is likely that caring for children played a notable role here. With the steadily rising costs of childcare, inflation and cost of goods within Canada over recent years [16], US immigrants–who had more children on average than their non-US counterparts–likely faced the greater extent of these financial challenges. We speculate that this may be due to the number of people supported by their income which may have predisposed them to increased rates of food insecurity and other financial difficulties amidst lower rates of income as a result of the pandemic. Furthermore, US immigrants were much more likely to continue sending money back to their families and relatives in the United States. US immigrants continued to send money despite their issues pertaining to decreased working hours and reduced income and thus reducing financial resources available for their direct use and exacerbating their already precarious financial situation.

The disparity seen between the US and non-US immigrants could also be influenced by the fact that non-US immigrants may practice more conservative spending and saving habits[17]. This may be attributed to the fact that non-US immigrants often come from relatively far away countries and thus do not have the same ability to draw upon resources from their home countries while living in Canada. US immigrants, on the other hand, have more readily accessible resources with their neighboring border. US immigrants’ typically greater reliance on social and familial resources for financial assistance, coupled with the increased number of people supported by their income streams, may have led to increased relationship tensions (including reported social rifts and conflicts in their romantic relationships). The impact of these social rifts would once again reinforce feelings of anxiety and depression amongst US immigrants, thus adding to their decline in quality of life due to the pandemic. With non-US immigrants more statistically likely to be working lower-wage essential services, it is plausible that US immigrants are slightly more likely to be laid off or terminated from their work placements as seen by their slightly higher rates of unemployment (6.5% VS 5.4%) [18]. This difference would once again trigger financial insecurities and may have been a factor in increased proportions of US immigrants seeking out support from their employers and other institutions during the pandemic.

3. A greater proportion of non-US immigrants were impacted by clinical affects of COVID-19, and they were more likely not to disclose their state to continue making income

This study uncovered that non-US immigrants had a greater incidence of positive COVID-19 tests as compared to their US counterparts9. This trend is supported by numerous sources of data in Canada, which uncovered that racialized communities, includingBlack Canadians and Canadians of Arab, Southeast Asian, East Asian, Latin American and Filipino descent (i.e., the studied demographics that make up the significant majority of non-US immigrants) faced higher rates of COVID-19 infection, hospitalization, and mortality coupled with increased rates of vaccine hesitancy and pandemic disinformation [19]. One of the explanations for this includes systemic discrimination and the lack of multilingual, culturally competent resources available to racialized communities, all of which have been historic and ongoing social issues that have only been exacerbated in communications about COVID-19. Differences between individualist cultures of Western societies (US immigrants) and the collectivist culture of many cultures that form the bulk of non-US immigrants may leave the latter more prone to infection. This can be due to collectivist cultures promoting familial ties which could increase avenues for the virus to spread whereas individualistic cultures may potentially positively reinforce one’s chances of complying with self-isolation requirements given less frequent interactions with smaller familial units. Non-US immigrants, who tend to come from racialized backgrounds, are also known to have higher employment rates within the services industry which is prone to precarious working conditions [20]. These services were deemed essential during the pandemic which may offer insight into the increased rates of exposure to the virus amongst non-US immigrants whilst US immigrants were increasingly laid off or terminated from their relatively more opportune employment contracts. Despite having lower COVID rates, non-US immigrants were much more likely to not disclose their COVID-positive status and thus fail to fully comply with federal regulations on mandatory self-isolation. Likely, the convergence of political polarization and a lack of culturally-competent resources regarding COVID-19 precautions alongside pressing concerns around employment and family obligations may explain higher rates of nondisclosure of COVID-19 status and lack of isolation among non-US immigrants.

Limitations

Despite the high response rate within this study, one of the most prominent study limitations was the number of missing responses, as answering each of the questions was deemed voluntary to ensure ethical expectations and psychological well-being were respected for survey participants. These values were accounted for in the descriptive statistics presented in the investigation as they were deemed to be important to understanding the differences between groups. It was noted that non-US immigrants were much more likely to leave out answers to many questions and thus pointed to an increased rate of participants feeling uncomfortable disclosing information about the social and financial insecurities they faced during the pandemic or also perhaps to difficulty interpreting the survey which was in English. Thus, these practices may have skewed some data results and compromised the accurate and fulsome comparison between US and non-US groups; however, statistical analysis did show statistically significant results between the two groups as presented in the results. Another limitation was the average age of participants did not reflect what is typically seen as a younger demographic within Canada’s immigrant communities. The low presence rate of younger adults in this study may have masked greater financial difficulties young people face, in light of their less developed careers and thus limited accumulated savings to adapt with the circumstances of the pandemic. Table 1 also highlighted key demographic differences between both groups such as gender, level of education and time since arrival to Canada. It is probable that these demographic differences may have acted as confounders behind some of the trends discussed. Additionally, the survey identified immigrants based on their countries of origin and did not collect race-based or ethnicity-based data thus analysis related to these variables was done by relying on statistics from other sources such as census results. Although we do not expect these results to differ too much from the analysis, there is still a chance that the collection of such demographic data may have shed light on the differences between racialized and non-racialized immigrant populations or the lack thereof.

Implications

The implications of these study results are vast for newcomer support services, provincial and federal governments, stakeholders and future researchers within the field.

First and foremost, these results present opportunities for newcomer support services to better target immigrants during emergencies such as future pandemics. Currently, immigrants can access settlement services by Immigration, Refugees and Citizenship Canada (IRCC) and the Ministry of Immigration, Francisation and Integration (MIFI) for Quebec-bound newcomers. Though most immigrants use these services pre-arrival, many are unaware of their services post-arrival nor know about the services offered by other third-party organizations that receive funding from the federal government. This was evident by alarming rates of food and financial insecurity faced by both groups of immigrants. Newcomer support services can take these results into account and potentially develop culturally-competent and targeted strategies to ensure that non-US immigrants–especially those that cannot speak English and French–are aware of resources and workshops offered in their mother tongue. Furthermore, these support services can further cater to racialized immigrants who form the bulk of the non-US immigrant population and work to connect them with appropriate resources that are tailored to their unique needs. Cultural competent resources would increase awareness and willingness to seek out external resources and would also contribute to addressing pandemic disinformation which might encourage immigrants from partaking in risky behaviors that pose them at risk of contracting or spreading COVID-19. In addition, these services should also work to ensure equity in their services and support programs such as by completing background checks on income distribution within families and amounts of resources sent back to countries of origin to ensure immigrants such as those from the United States have their specific concerns accounted for. Furthermore, the federal government needs to ensure that funding for these newcomer support services is proportional to the increased number of yearly immigrants immigrating to Canada, especially given plans to resume accepting almost 400,000 immigrants annually to account for diminished immigration initiatives during the pandemic [21]. Government funding for these organizations should also be cognizant of the disparities fuelled by primarily focusing on Canada’s 3 main immigrant hub cities (Toronto, Montreal and Vancouver), where immigrants are increasingly settling to other destinations, such as the Prairies and Atlantic Canada; this is especially important as the cost of living in these major Canadian cities continues increase astronomically beyond even the comfort of Canadian-born residents. These concerns were addressed in May 2022 upon a $14-million investment from the federal government to expand critical resettlement capacity and settlement services in Saskatchewan, Alberta and Manitoba [22]. However, these steps were taken too late into the pandemic and resulted in many immigrants, especially those from a racialized background and those from underfunded provincial jurisdictions, facing the brunt of the pandemic without adequate assistance.

In addition to ensuring regular funding of newcomer services, the Government of Canada should increase pandemic-related support (including communication and awareness of such supports ) for immigrants, including financial alleviation measures, such as the Canada Emergency Response Benefit (CERB). Funding of such programs would alleviate financial-related insecurities due to the pandemic and avoid risky health-compromising behaviors such as failure to disclose positive-case results to evade isolation requirements to meet employment and family obligations. This is beneficial for US immigrants and would ensure stability during times of emergency. Federal and provincial government stakeholders including pandemic response teams need to be cognizant of the disproportionate impact of restrictions and lockdowns on immigrants, especially non-US immigrants who are more likely to work in precarious working conditions and have less physical and social supports available to resort to in the event of unemployment [23]. As a result, governments should ensure that financial supports for those rendered unemployed are consistent throughout the pandemic whilst also fostering safety measures such as funding PPE distribution and facilitating safe infrastructures (ex: plexiglass barriers and ventilation to prevent airborne transmission of the virus) in workplaces to mitigate heightened risks faced by essential workers. These can also be coupled with adequate funding for food banks and other donation centers for clothing and household items to ensure that these support systems are not overwhelmed during emergencies during the pandemic. Furthermore, governments should also take steps to combat the alarming rates of immigrants without a family doctor, as these concerns were well pronounced during the pandemic and represent systemic barriers for all newcomers to accessing Canada’s healthcare system. Additionally, such support would also increase compliance with public health protocols and ensure healthy outcomes at a population level, given this would foster accurate pandemic-related information to immigrant communities.

Ultimately, researchers should consider the benefit of not treating immigrants as a binary variable and instead examine the differences between immigrant subgroups. Future researchers within the field should delve into other subgroups of immigrants based on age, sex, ethnicity, religion, family size and income to better ascertain fundamental differences amongst immigrants. Subsequently, this would uncover each group's unique needs and allow policymakers to take on targeted measures. Furthermore, these studies should also build upon the limitations presented within this study. We suggest focusing on younger age demographics to reflect a more accurate distribution of immigrant populations, collecting race-based or ethnicity-based data to understand systemic barriers, and implementing survey designs that ensure the maximum comfortability of participants to voluntarily disclose information about their experiences in the context of emergency scenarios. Additionally, future research in the field should also aim to explore the unique experiences and needs of refugees, undocumented immigrants and international students to build a more holistic understanding of the impact of COVID-19 on newcomer populations as a whole.

Inevitably, the results of this investigation were indicative of shared experiences of insecurities in a myriad of social and economic markers for both US and non-US immigrants. Despite the many shared experiences, some notable findings shed light on the unique circumstances that each immigrant subgroup faces. First and foremost, non-US immigrants were driven by the mentality of “making it on their own” and were more reluctant to seek out external resources. Secondly, despite having better conditions before the pandemic, such as more opportune employment and stable income, immigrants from the United States were subject to a greater socioeconomic decline and instability during the pandemic, causing them to face disproportionate food and financial difficulty relative to their non-US immigrant counterparts. Finally, COVID-19 physically impacted more non-US immigrants, and they were more likely to become infected with COVID-19, and simultaneously not to disclose their COVID-19 infection status, to continue making income. These results offer various avenues of support to be taken by multiple stakeholders, including increased marketing of services provided by newcomer support services to ensure better outreach and fill the void left by a limited means of social and physician support networks for immigrants. Furthermore, governments should also increase funding and associated distributions of assistance for such support systems to meet the demands of the growing immigrant populations. Lastly, this investigation offers a foundation for further research in the field to build a more holistic understanding of the impact of COVID-19 on newcomer populations as a whole.

US: United States

Ethics approval and consent to participate

Ethical approval for this study was obtained from the Ethics Review Board at Queen’s University. Informed consent was obtained electronically from each participant, after the participants received adequate information from the research about the aim and procedure of the study through screening questions. All the data obtained from the subjects was kept confidential through use of password-protected files on encrypted networks, accessed solely by pertinent research members, for research purposes only. Furthermore, all methods were carried out in accordance with relevant guidelines and regulations.

Consent for publication

Not applicable.

Availability of data and materials

The datasets generated and/or analysed during the current study are not publicly available due confidentiality purposes but are available from the corresponding author on reasonable request.

Competing interests

The authors of this study have no competing interests to report.

Funding

The authors have no funding to report.

Authors' contributions

Anwar Subhani: Conducted data analysis and results, interpreted findings and prepared drafts of the paper to be submitted.
Setareh Ghahari: As the Principal Investigator of the project, designed the study, conducted data collection and analysis and oversaw the study

Acknowledgements

A special thanks to the Kingston Community Health Center (KCHC) which helped distribute our survey to our target populations.

Authors' information (optional)

N/A

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No competing interests reported.

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The IMPACT Cross-Sectional Study: The socioeconomic experiences of US and non-US immigrants in Canada in the midst of the COVID-19 pandemic

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Abstract

Background

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Results

Food Insecurity

Health and Access to Care

Discussion

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