Marginalized Women's Systemic Barriers Within Canada's Healthcare System
Marginalized women in Canada can face significant challenges when accessing healthcare, including racism, racial bias, stigma, discrimination, long wait times, rushed appointments and difficulties navigating the healthcare system. Social determinants of health, such as income, education, housing, transportation and employment benefits, can create additional barriers to receiving timely and appropriate care.
These challenges can affect whether women feel comfortable discussing their health concerns with healthcare providers, accessing necessary treatment or seeking follow-up care. For racialized women, experiences of discrimination can further complicate their interactions with the healthcare system.
A 2024 study by Olukotun and colleagues examined the healthcare experiences of 30 Black women living in Alberta. The researchers explored how race, gender, socioeconomic circumstances and other aspects of identity intersect to influence access to healthcare. Their findings identified three major barriers: socioeconomic challenges, healthcare system issues and racism.
Socioeconomic circumstances played a significant role in participants' ability to access healthcare. Some women reported difficulties related to gaps in insurance coverage, transportation expenses, distance to medical facilities and the time required to attend appointments.
Although Canada has a publicly funded healthcare system, not all health-related expenses are covered. The study found that some participants delayed obtaining prescribed medications or accessing certain services because of out-of-pocket costs. Even women with employer-sponsored insurance sometimes struggled to afford necessary care.
Transportation was another important barrier. Participants described having to choose between driving and paying for parking or relying on public transportation, which could involve lengthy travel times. For women with complex health conditions requiring regular follow-up appointments or bloodwork, these expenses and logistical challenges could become particularly burdensome.
The time required to attend medical appointments also affected participants' financial circumstances. Some women needed to take time off work to travel to healthcare facilities, resulting in lost income. For those balancing employment, caregiving responsibilities and household expenses, attending appointments could create additional financial pressure.
Beyond socioeconomic barriers, participants reported experiences of racism, discrimination and racial bias when seeking healthcare.
The study highlighted how negative encounters with healthcare providers could affect women's willingness to discuss their symptoms and seek treatment. Some participants described feeling stereotyped or having their health concerns dismissed. These experiences contributed to mistrust and hesitation when interacting with healthcare professionals.
Stereotypes surrounding Black patients' pain tolerance and assumptions about substance use can also influence how healthcare providers interpret patients' concerns. Such biases risk undermining appropriate assessment and treatment while making patients feel uncomfortable requesting care or medication.
Difficulties navigating the healthcare system created further challenges. Some participants reported long wait times, rushed appointments and difficulties finding family physicians accepting new patients. Without an established family doctor, women sometimes relied on walk-in clinics, which could make continuity of care more difficult.
However, the study also identified factors that helped participants access healthcare and develop more positive experiences.
Having an established family physician was particularly valuable. Participants described how a trusted physician could make it easier to obtain referrals to specialists, arrange follow-up appointments and address ongoing health concerns.
Positive patient-provider relationships also played an important role. When healthcare professionals listened to patients, treated them with respect and took their concerns seriously, women reported feeling more comfortable discussing their health needs.
Proximity to healthcare facilities was another factor that improved access. Participants found it easier to attend appointments when clinics were located closer to their homes or when several healthcare services were available within the same medical centre. Having multiple providers in one location could reduce transportation costs, travel time and the need to take additional time off work.
Community organizations and social services also provided valuable support. Some participants benefited from organizations that helped them navigate the healthcare system, access information and address barriers affecting Black and other racialized communities. These services could offer assistance that was more responsive to their circumstances and needs.
The findings demonstrate that access to healthcare involves more than the availability of medical services. Financial circumstances, transportation, employment conditions, discrimination and relationships with healthcare providers can all influence whether someone receives appropriate care.
While the study focused specifically on Black women in Alberta, it highlights broader questions about how healthcare systems respond to people facing overlapping forms of marginalization.
Improving healthcare access requires attention not only to medical treatment, but also to the social and institutional conditions that shape patients' experiences. Addressing discriminatory practices, strengthening patient-provider relationships and reducing practical barriers to care are important considerations in building a more accessible and equitable healthcare system.