Perception of care in immigrant and nonimmigrant persons with inflammatory bowel disease: a survey-based study

Immigrants are at a heightened risk of developing inflammatory bowel disease (IBD) after relocating, and their interactions with the healthcare system differ from those of nonimmigrants. This study aimed to explore the challenges and perspectives of immigrants living with IBD regarding their healthcare.

We recruited persons aged 18 or over with IBD, including those with and without an immigration history, to complete an anonymous online survey. Descriptive statistics were presented as frequencies, and cross-group comparisons were performed using the Chi-square test.

We included 75 immigrants and 150 nonimmigrants with similar baseline demographics, with many indicating poorly controlled IBD. Immigrants were more likely to report no access to formal translation services during their appointments (24 [32%] vs 6 [8%]), despite many not speaking the same language as their gastroenterologist (31 [41.3%] vs 3 [2%]). Immigrants were more often unable to miss work for healthcare appointments (24 [32%] vs 17 [11.3%]). Many were diagnosed after immigration (58 [77.3%]). Despite this, 29 [38.7%] contacted physicians in their home countries and purchased medications from their countries of origin (8 [10.7%]). Most immigrants expressed concerns that "Western" foods in their current country of residence contributed to their flares (44 [58.7%]) compared to only 11 [14.7%] who were concerned about foods from their home country.

Immigrants encounter significant obstacles in accessing healthcare, including communication, financial barriers, and cultural factors such as food preferences, which hinder their ability to receive the care they need.