Harvard Public Health Review: A Student Publication

Commentary

Accepting Refugees: Alternative Arguments for Canada

The Canadian federal election came to an end on October 19, 2015, with Prime Minister Justin Trudeau promising to bring in 25,000 Syrian refugees to Canada by the end of 2015. This became a national priority when a photo of Alan Kurdi,1 a three-year-old boy, dead on a Turkish beach surfaced and knowledge spread of his family’s intention to come to Canada.

While this sad occurrence tugged on Canadian heartstrings, limited government resources to financially support relocation fees and social safety nets for accepted refugees often trump moral arguments to save refugees. Thus, first and foremost, thought must be given to resources required for refugee arrival. The media is doing just that, averring that Canada lacks the resources to handle the 25,000 refugees arriving by January 1st, 2016, an election promise2 made by the Liberal government in March of 2015 prior to the Federal election, who later won the majority of seats in the October 2015 election and subsequently formed government. The media has raised concerns over security3 amidst the attacks in Paris, time needed4 for host communities to receive refugees, public rejection5 of accepting refugees for reasons of time, too many refugees, and expenses, among other concerns. This is undoubtedly a large feat for such a short time period. While the military and religious community are assisting, Canada has previously evidenced its capacity to provide this degree of aid. In the past, Canada has demonstrated its capacity to accommodate refugees, as one of three main immigrant-accepting countries6 in the latter half of the 1971 to 1981 decade; including accepting 60,000 refugees of the Vietnam conflict7 from the late 1970s, when Canada’s population was just shy of 25 million.8 The argument that Syrian refugees will consume inordinate resources upon arrival is not unfounded. These individuals will inevitably rely on the social safety net to regain their footing in society. But their use of resources can be seen as a small investment for gains both economically, achieved through their daily work, and their contributions to the nation’s “greater good.” Many immigrants are proud to call Canada home and work hard to contribute to Canadian society. Given that English is not the first language of many refugees and their credentials may not be recognized upon entry in Canada, many will work low-wage service jobs. These jobs are essential for the economy, as they are the foundation on which other forms of employment are built and have the potential to boost the economy in have-not regions,9 with the potential to create wealth, create jobs, and increase tax revenue. Contribution to the greater good is best personified by a previous Governor General of Canada, Adrienne Clarkson, a Chinese refugee herself10 as well as the many Vietnamese refugees mentioned earlier who are thriving in Canada. These Vietnamese refugees now work as professors, in medical careers, factory workers, and are raising families, among others.11 A study of 1, 300 Vietnamese boat people found that within ten years of arrival, they had an unemployment rate 2.3% lower than the Canadian average and one in five had started a business.12 

In one study,13 a macro-econometric forecasting model was used to simulate the impact on the Canadian economy of a hypothetical increase in immigration. The study yielded only positive impacts on factors such as: real GDP, GDP per capita, aggregate demand, investment, productivity, and government expenditures, taxes, and especially net government balances, with essentially no impact on unemployment. Therefore, it is safe to expect that the work of refugees will push the Canadian economy further, and thus, potentially improving the well-being of all Canadians, as wealth is often spread throughout a nation.

This discussion on well-being may lead us to wonder about refugees’ well-being and the impact of a refugee population on the healthcare system of the host nation. Studies have demonstrated the presence of a “healthy immigrant effect,”14 in which the health of immigrants is generally higher than those born in the host country. Studies of mortality 15 found that the healthy immigrant effect is stronger for immigrants from poor or culturally distant countries. While the theory is relevant to immigrants in general, it particularly applies to Syrian refugees coming to Canada, given the difference in culture. It can be expected that these refugees will not heavily utilize healthcare services when they arrive. A 2002 study 16 found Canadian immigrants have lower odds of reporting chronic conditions, but these odds increased with time spent in Canada. While this underreporting and potential underutilization of healthcare services may be due in part to barriers faced, such as difficulties with: language, finances, transportation, mistrust of health care workers, perceived lack of access, and lack of familiarity navigating the health system, 17 it inevitably does not result in additional expenditures (unfortunately, there is a lack of longitudinal Canadian data18 on healthcare service utilization of refugees). This is particularly important when the nation has a largely single-tier healthcare system funded by the state. Regrettably, this can have implications on refugees’ health in the long-term.

Given Canada’s track record of accepting refugees in the past, the nation should continue to embrace Syrian refugees with open arms. There is a high likelihood that the accepted refugees will largely contribute to Canadian society and minimized chance these individuals will be high-end users of healthcare system resources upon arrival. Therefore, accepting refugees into a nation is not as financially burdensome as some may think.

While Alan Kurdi did not make it to Canada, the tragic image of his lifeless body sparked both outrage and action. Accepting refugees speaks directly to what the people of Canada stand for: a fair and just society. He reignited the dormant values of justice and compassion in the hearts of Canadians, with February 27th, 2016 marking the day the 25, 000th Syrian refugee arrived in Canada.19

References

  1. Barnard, A. & Shoumali, K. (2015, September 3). Image of Drowned Syrian, Aylan Kurdi, 3, Brings Migrant Crisis Into Focus. The New York Times. Retrieved from: http://www.nytimes.com/2015/09/04/world/europe/syria-boy-drowning.html?_r=1.
  2.  The Canadian Press. (2016, January 5). Syrian Refugees In Canada: Here’s What We’ve Done Since 2012. Huffington Post. Retrieved from: http://www.huffingtonpost.ca/2015/12/31/a-chronology-of-canada-s-response-to-the-syrian-refugee-crisis-since-2012_n_8900468.html.
  3.  Shulman, M. & Leung, M. (2015, November 16). Trudeau holds firm on timeline for 25,000 refugees. CTV News. Retrieved from: http://www.ctvnews.ca/politics/trudeau-holds-firm-on-timeline-for-25-000-refugees-1.2660689.
  4.  Mas, S. & Harris, K. (2015, November 24). Liberals won’t meet deadline to bring 25,000 Syrian refugees to Canada by year’s end. CBC News. Retrieved from: http://www.cbc.ca/news/politics/liberal-plan-syrian-refugees-1.3333623.
  5.  Donnelly, A. (2015, November 18). Majority of Canadians oppose Trudeau’s plan to bring 25,000 Syrian refugees over in just six weeks: poll. National Post. Retrieved from: http://news.nationalpost.com/news/canada/majority-of-canadians-oppose-trudeaus-plan-to-bring-25000-syrian-refugees-over-in-just-six-weeks-poll.
  6.  Kalbach, W. (2015, October 6). Population. Historica Canada. Retrieved from: http://www.thecanadianencyclopedia.ca/en/article/population/
  7.  Trinh, J. (2015, September 11). Vietnamese boat people of more than 3 decades ago now thriving, proud Canadians. CBC News. Retrieved from: http://www.cbc.ca/news/canada/ottawa/vietnamese-boat-people-of-more-than-3-decades-ago-now-thriving-proud-canadians-1.3223505.
  8.  Statistics Canada. (2015, August 26). Estimated population of Canada, 1605 to present. Retrieved from: http://www.statcan.gc.ca/pub/98-187-x/4151287-eng.htm.
  9.  Tencer, D. (2015, November 30). Syrian Refugees Will Boost Economy In Canada’s Have-Not Regions, Experts Say. Huffington Post. Retrieved from: http://www.huffingtonpost.ca/2015/11/26/refugees-economy-canada_n_8658076.html.
  10.  Clarkson, A. (2015, October 7). Canada Knows How to Respond to a Refugee Crisis. The New York Times. Retrieved from: http://www.nytimes.com/2015/10/08/opinion/adrienne-clarkson-canada-knows-how-to-respond-to-a-refugee-crisis.html?_r=1.
  11.  Multicultural Canada. (n.d.) Vietnamese Boat People Collection. Retrieved from: http://multiculturalcanada.ca/contentdm_results/browse/0/0/vietnamese.
  12.  Beiser, M. (1999). Strangers at the Gate: The “Boat People’s” First Ten Years in Canada. University of Toronto Press.
  13.  Dungan, P., Fang, T. & Gunderson, M. (2012, July 19). Macroeconomic Impacts of Canadian Immigration: Results from a Macro Model. British Journal of Industrial Relations, 51(1): 174–195. Retrieved from: http://onlinelibrary.wiley.com/doi/10.1111/j.1467-8543.2012.00905.x/abstract;jsessionid=C8D8A68D8BF1DC7381D177C6361AB122.f03t04?userIsAuthenticated=false&deniedAccessCustomisedMessage=.
  14.  Ng, E. (2015, November 27). The healthy immigrant effect and mortality rates. Statistics Canada. Retrieved from: http://www.statcan.gc.ca/pub/82-003-x/2011004/article/11588-eng.htm.
  15.  Vang, Z., Sigouin, J., Flenon, A. & Gagnon, A. (2015, February). The Healthy Immigrant Effect in Canada: A Systematic Review. Population Change and Lifecourse Strategic Knowledge Cluster Discussion Paper Series, 3, 1: Article 4. Retrieved from: http://ir.lib.uwo.ca/pclc/vol3/iss1/4.
  16.  Pérez, c. (2002). Health Status and Health Behaviour Among Immigrants. Statistics Canada, Catalogue 82-003. Retrieved from: http://www.statcan.gc.ca/pub/82-003-s/2002001/pdf/82-003-s2002005-eng.pdf.
  17.  Gabriel, P., S., Morgan-Jonker, C., Phung, C. M. W., Barrios, R. & Kaczorowski, J. (2011). Refugees and Health Care – The Need for Data: Understanding the Health of Government-assisted Refugees in Canada Through a Prospective Longitudinal Cohort. Canadian Journal of Public Health, 102(4): 269-72. Retrieved from: http://journal.cpha.ca/index.php/cjph/article/viewFile/2425/2456.
  18.  Gabriel, P., S., Morgan-Jonker, C., Phung, C. M. W., Barrios, R. & Kaczorowski, J. (2011). Refugees and Health Care – The Need for Data: Understanding the Health of Government-assisted Refugees in Canada Through a Prospective Longitudinal Cohort. Canadian Journal of Public Health, 102(4): 269-72. Retrieved from: http://journal.cpha.ca/index.php/cjph/article/viewFile/2425/2456
  19.  CBC News. (2016, February 27). 25,000th Syrian refugee lands in Canada. Retrieved from: http://www.cbc.ca/news/canada/montreal/25-000th-syrian-refugee-lands-in-canada-1.3467886.