This is the second in a five-part series examining the role of art in health care.
Ontario’s Primary Care Action Plan to connect everyone to a primary care team by 2029 is a significant first step in improving health care for Ontarians. But for many, including newcomers, it is not sufficient.
Sustained and trusting relationships with care providers are critical to improving health outcomes. Developing a consistent relationship with a trusted care team is essential, particularly across key moments such as intake and assessment, waiting periods between appointments, times of crisis or transition and how providers communicate with patients.
As health promoters, we often emphasize repetition and consistency as key drivers of change, whether building new neural pathways, adopting healthier habits or strengthening self-care. Equally important, however, is recognizing that change doesn’t happen in isolation. Ongoing support through community or accountability partnerships can make incremental lifestyle changes more sustainable. This invites us to consider what it means to experience care as continuous and relational, rather than limited to episodic appointments.
A 2022 study on virtual care estimated that patients visit community health centres approximately five to six times per year and physicians two to four times per year. For many newcomers, health is part of myriad needs and navigation challenges.
“For many refugees, accessing healthcare might be just one among many competing priorities for settlement, such as finding housing, a job, childcare for their children, and more,” explains Ellen Tang, a social worker at Crossroads Clinic, a refugee health clinic Women’s College Hospital in Toronto.
As a result, newcomers are more likely to access health care in acute situations rather than through preventive care. These limited touchpoints and competing priorities raise an important question: does this level of contact meaningfully support trust and long-term engagement with care?
Previous work on newcomer health in Ontario has highlighted that the challenge is not identifying disparities, but implementing effective, sustainable solutions that lead to long-term connections. Dr. Meb Rashid, founder and medical director of the Crossroads Clinic, emphasizes that newcomers benefit from connecting with primary care early in the migration process, even when they are healthy.
Prior to becoming a social worker, I worked for many years in community arts. I observed the inherent nature of the arts to build trust. Community artists are skillful in animating places and communities by inviting people to connect. Transitioning from the arts world, I saw that community artists were already playing an underrecognized role in supporting primary care connections by creating accessible, culturally responsive entry points. They also play a role in emerging holistic approaches to care, such as social prescribing.
The Alliance for Healthier Communities highlights pathways to care that extend beyond clinical settings. These include community-based and arts-driven approaches that engage newcomers and support individuals in navigating their own health decisions. Familiarity builds trust in care.
When health care reflects patients’ identities, experiences and values through culturally responsive communication and practice, individuals are more likely to move from passive recipients to active participants in their care. At Crossroads Clinic, one patient described her physician as feeling like “home, he felt familiar and comforting. He had a personal way of helping me voice my concerns, even beyond health.” At Access Alliance, we hear similar sentiments.
When this alignment is missing, trust decreases and individuals may delay or avoid seeking care. Cultural mismatches and a lack of culturally responsive care can contribute to hesitation among newcomers to seek medical help.
Creative, community-based spaces can help bridge this gap by fostering familiarity, confidence and connection. Arts is one intervention that can have powerful outcomes: “Coming here felt distant and difficult at first. I was isolated, afraid and had forgotten how to connect,” a participant in a women’s wellness program told us. “I never saw art as a form of expression until I experienced it. Step by step, I adapted, gained confidence, and found energy in rebuilding those habits.”
In this context, care extends beyond medical treatment. Patients are supported not only with their physical health concerns, but also through their broader settlement processes, strengthening both access to care and long-term well-being. The World Health Organization has found that arts-based approaches are particularly effective in multicultural settings, especially when building trust around sensitive health topics.
Research from Pathways2Prosperity highlights that among newcomers the lack of integration between health and social services contributes to health inequities, particularly in areas such as mental health. First points of contact are important gateways to other health-care services and referrals. Low-tech, high-touch engagement helps newcomers feel more comfortable, confident and willing to engage with health services.
Arts-based approaches offer exactly that.
Community artists help humanize both health care and settlement experiences by creating accessible, relational entry points. They foster connection, build trust and support individuals in developing confidence to navigate health systems. They strengthen not only initial attachment to care, but also long-term engagement and understanding of what a health-care team can offer.
If Ontario’s Primary Care Action Plan is to succeed through a health equity lens, it must move beyond attachment to a health team as a metric and focus on meaningful connection. Integrating community artists into health and settlement systems is one way to do that.
