Healthcare access among children and youth aged 1 to 17 in Canada: Results from the 2023 Canadian Health Survey on Children and Youth, cross-sectional component
Released: 2025-03-10
To better understand healthcare access among children and youth in Canada, the cross-sectional component of the 2023 Canadian Health Survey on Children and Youth (CHSCY) asked parents of 1- to 17-year-olds living in one of the provinces if their child had a regular healthcare provider. Results showed that 91% of children and youth aged 1 to 17 years had a regular healthcare provider. However, this proportion decreased with age, with 94% of those aged 1 to 4 years having a regular healthcare provider, compared with 92% of those aged 5 to 11 years, and 89% of youth aged 12 to 17 years. Among adults aged 18 years and older, the 2023 Canadian Community Health Survey (CCHS) reported that 83% had a regular healthcare provider.
Having a regular healthcare provider also varied by province of residence (Table 1). In CHSCY 2023, Ontario (96%) had the highest proportion of children and youth with a regular healthcare provider while Prince Edward Island (78%) had the lowest proportion. Access was similar by rurality (see Note to readers), with 91% of children and youth residing in rural areas and 92% of those residing in population centres having a regular healthcare provider.
Access to healthcare is a critical and widely discussed topic in Canada, with challenges like physician shortages and long wait times making it difficult for many to receive timely care. These issues are especially concerning for children and youth, who require a strong primary care foundation for healthy development and overall physical and mental well-being. Early and consistent access to healthcare helps ensure that children and youth grow up with the support they need for a healthy future.
This Daily article, based on the cross-sectional 2023 CHSCY being released today, follows a previous release which used the CHSCY 2023 longitudinal component to examine changes in mental health among children and youth from 2019 to 2023.
Having a regular healthcare provider varied by household income and parental education level
Results showed that a higher proportion of children and youth in higher income households (94%) had a regular healthcare provider compared with those in lower income households (89%) (Table 2).
Having a regular healthcare provider also varied by parental education level (Table 3). For children and youth where the highest level of parental education was a high school diploma, equivalency certificate or less, 88% had a regular healthcare provider, compared with 92% where the highest level of parental education was a bachelor's degree or higher.
Nearly one in three children and youth without a regular healthcare provider had theirs leave or retire
Parents who reported their child did not have a regular healthcare provider were asked to specify the reasons for this lack of care and could select more than one reason. Among the 9% of children and youth who did not have a regular healthcare provider, 27% had no one available in their area, 28% had no one in the area taking new patients, and 9% had not tried to find one (Table 4). Additionally, 30% of children and youth without a regular healthcare provider had their healthcare provider leave or retire. This proportion varied among provinces, with Nova Scotia (45%) having the highest proportion whose provider had left or retired and Quebec (23%) having the lowest proportion.
Results also showed that 44% of children and youth who did not have a regular healthcare provider were currently on a waitlist to be attributed to a regular healthcare provider. The proportion of children and youth without a regular healthcare provider on waitlists for a healthcare provider varied by province, ranging from 9% in Saskatchewan to 74% in Prince Edward Island and New Brunswick. It should be noted that these proportions may be influenced by the different approaches to managing waitlists among provinces, with some having centralized waiting lists for residents without a regular primary care provider.
Over half of immigrant youth had a regular healthcare provider within a year of arriving in Canada
Recent immigrant families can encounter barriers to accessing healthcare, such as a shortage of providers accepting new patients, language barriers, cultural differences, and a lack of familiarity with the healthcare system, all of which can result in unmet care needs. In 2023, 86% of immigrant children and youth had a regular healthcare provider compared with 92% of their Canadian-born counterparts.
Chart 1
Percentage of youth in Canada with a regular healthcare provider, by immigration status and years since arriving in Canada, population aged 12 to 17 (excluding territories), 2023
To study whether having a regular healthcare provider had changed with more time since arriving in Canada (that is, time since becoming a permanent resident), analysis was limited to youth aged 12 to 17 years, and immigrant youth were grouped by their time since arriving in Canada (up to and including 10 years since arrival). Results showed that for immigrant youth in the "0 to 1 years" since arrival group, over half (58%) had a regular healthcare provider (Chart 1).
Access to a regular healthcare provider increased over time for immigrant youth. So, 10 to 12 years after arriving in Canada, the proportion of immigrant youth (91%) who had a regular healthcare provider was similar to that of Canadian-born youth (90%) (Chart 1).
Lack of available providers in the area was the most cited reason for not having a regular healthcare provider for Indigenous children and youth
Extensive travel to the nearest care facility is one of the identified systemic barriers faced by Indigenous people in accessing healthcare. Data from the 2024 Survey Series on First Nations People, Métis and Inuit highlighted challenges with accessing care among Indigenous people aged 15 years and older, with 18% of First Nations people living off reserve, 16% of Métis, and 40% of Inuit having travelled outside of their community, city or village and having to be away from home for at least one night to access healthcare services in the 12 months prior to the survey.
Results from the 2023 CHSCY showed that 88% of Indigenous children and youth living off-reserve in the provinces had a regular healthcare provider, compared with 92% of non-Indigenous children and youth. By rurality, among Indigenous children and youth residing in a rural area, 86% had a regular healthcare provider while 88% residing in a population centre had a regular healthcare provider.
Among the 12% of Indigenous children and youth without a regular healthcare provider, the most cited reason for not having one was "no one was available in the area" (41%) (Table 5).
Nearly one in five children and youth who needed mental healthcare in the past year had partially met or unmet needs
Considering the decline in youth mental health over time reported in the CHSCY 2023 longitudinal survey, which followed participants from the 2019 CHSCY cohort, it is important to understand access to mental health services for children and youth. In particular, children and youth without access to a regular healthcare provider may face additional barriers to receiving mental healthcare, such as difficulties receiving specialist referrals, as well as a lack of coordination of follow-up care and treatment.
The 2023 CHSCY asked parents about their child's mental healthcare needs over the past year. Among the 19% of children and youth who needed mental health support in the previous year, 81.8% had their needs fully met (Table 6), meaning they received the care they needed and did not require any further care. However, nearly one in five (18.2%) did not have all their mental healthcare needs addressed: 14.5% had their needs partially met, and 3.7% received no care at all.
For the 91% of children and youth with a regular healthcare provider, 19% needed mental healthcare in the previous year. Of these, 83% had their needs fully met, 14% had their needs partially met, and 3% had their needs completely unmet. Among the 9% of children and youth without a regular healthcare provider, 17% needed mental healthcare in the previous year. Of these, just under two-thirds (64%) had their needs fully met, one-quarter (25%) had their needs partially met, and 11% received no care at all.
By age group, children aged 1 to 4 years had the lowest proportion needing mental healthcare (7%) compared with 5- to 11-year-olds (19%) and 12- to 17-year-olds (26%). For 1- to 4-year-olds, 84% had their mental healthcare needs fully met, compared with 83% of 5- to 11-year-olds and 80% of 12- to 17-year-olds.
To help understand the impact of unmet mental healthcare needs, the survey asked parents how the lack of access to relevant care affected their child's condition. Response options included "not at all worse," "a little worse," and "a lot worse." Parents reported that 63% of children and youth who needed but did not receive mental healthcare had their mental health either worsen a little (46%) or a lot (17%).
These results highlight the importance of children and youth in Canada receiving timely professional help for their mental health, and that this is especially important for those without a regular healthcare provider, who face additional barriers to accessing mental healthcare.
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Note to readers
The cross-sectional component of the 2023 Canadian Health Survey on Children and Youth (CHSCY) covers the population aged 1 to 17 as of January 31, 2023, living in the provinces. Excluded from the survey's coverage are children and youth living in the territories, on First Nations reserves and other Indigenous settlements in the provinces, children and youth living in foster homes and the institutionalized population.
The 2023 CHSCY was developed by Statistics Canada, the Public Health Agency of Canada, and a national research team led by the Offord Centre for Child Studies at McMaster University. The Public Health Agency of Canada received funding from Budget 2022 to directly support the cross-sectional data collection as an investment in public health surveillance data. The Ontario Ministry of Health funded an oversample in Ontario. The data were collected from March 2023 to March 2024.
The response rates for the cross-sectional component of the 2023 CHSCY were 41.9% for 1- to 4-year-olds, 49.1% for 5- to 11-year-olds and 38.1% for 12- to 17-years-olds, which resulted in 69,522 children and youth. Survey sample weights were applied so that the analyses are representative of the 2023 Canadian population for children and youth aged 1 to 17.
Data were collected from the person most knowledgeable (PMK) about the preselected child or youth. The PMK was usually the birth, step or adoptive parent of the selected child or youth. For simplicity, the term "parent" is used in this release.
Regular healthcare provider refers to a healthcare professional that a parent can consult when they need care or advice for their child's health.
The term Immigrant refers to children or youth who were reported as landed immigrants or Canadian citizens by naturalization. The term Canadian-born refers to children or youth who were reported as being born in Canada or Canadian citizens by birth.
Indigenous identity of the child or youth is based on the parent-reported answer to whether or not the child is First Nations, Métis or Inuk (Inuit). Here, First Nations (North American Indian) includes Status and Non-Status Indians. The cross-sectional component of CHSCY 2023 does not contain data on children and youth residing on First Nations reserves in the provinces. Consequently, the results discussed for Indigenous people exclude those living on reserve.
The concept of rurality was defined using Statistics Canada's Population Centre and Rural Area Classification. A population centre has a population of at least 1,000 and a population density of 400 persons or more per square kilometre, based on population counts from the current Census of Population. All areas outside population centres are classified as rural areas. Taken together, population centres and rural areas cover all of Canada.
Access to a regular healthcare provider was based on a question which asked parents of 1- to 17-year-olds if their child had a regular healthcare provider. For those who reported their child did not, they were asked to select one or more reasons from this list: "currently on a waitlist", "no one available in the area", "no one in the area is taking new patients", "have not tried to find one", "had one who left or retired" and "other."
The perceived need for mental healthcare indicator is defined based on two questions: The first question asked parents of 1 to 17-year-olds if there was a time in the past 12 months where they had consulted a professional(s) about concerns with their child's mental health. Those who did selected the type of professional from this list: "Family doctor or pediatrician's office", "School", "A mental health professional's office, such as a psychologist, psychiatrist, social worker or other counselor", "A community mental health or addictions agency or clinic", "A walk-in clinic", "An urgent care clinic or emergency room", "A hospital", "A phone helpline or crisis hotline" and "Other".
The second question asked parents of 1- to 17-year-olds if there was a time in the last 12 months when they needed professional help for a mental health concern with their child but did not receive it. Those who responded "yes" were asked to select one or more reasons from this list: "Currently on a waitlist", "Difficulty getting a referral", "Service not available in our area", "Transportation problems", "Scheduling problems", "Limited or no access to technology or internet to access remote or virtual services", "Cost", "Was told you were not eligible for service", "Don't know how to access professional help" and "Other". Based on responses to both questions, respondents are grouped into categories based on whether a need was reported, and if so, whether their needs were met, partially met, or unmet.
Contact information
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