New Statistics Canada data reveals 4.5 million Canadians struggle to access specialist care, with direct consequences for disability claims and plan costs
Nearly 4.5 million Canadians aged 45 and older could not get the specialist care they needed in 2024. That figure – drawn from Statistics Canada’s 2024 Survey on Health Care Access and Experiences – carries direct implications for group benefits plan sponsors across the country.
The study, published July 15, 2026 by Statistics Canada’s Health Analysis and Modelling Division, is one of the most comprehensive national examinations of specialist care access to date. It surveyed 23,473 Canadians aged 45 and older across the country’s 10 provinces.
In 2024, 27.8 per cent of middle-aged and older Canadians reported difficulty accessing specialist care. An additional 18 per cent – roughly three million people – reported unmet health care needs overall.
Access difficulties drive unmet care and longer claims
The study’s most striking finding concerns the relationship between access difficulties and unmet health needs.
Middle-aged adults who could not access specialist care were 6.2 times more likely to report unmet health needs. For older adults, that figure rose to 14 times more likely.
For plan sponsors and HR executives, this matters beyond the human cost. Delayed specialist care is a well-documented driver of longer disability claims. Research in the disability management space has consistently linked care access delays to prolonged absences, a dynamic that drives plan costs upward over time.
Employees who face specialist care difficulties and develop unmet health needs are more likely to deteriorate. That trajectory leads to absences, accommodation requests, and eventual disability claims.
Who faces the greatest barriers
The data reveals several consistent risk factors across age groups.
Employees with multiple chronic conditions face the steepest barriers. Those with four or more chronic conditions were 2.6 times more likely than those with no chronic conditions to face difficulty accessing specialists. Among older adults, that figure rose to 3.2 times more likely.
Employees with a disability showed similarly elevated rates: 43 per cent of middle-aged adults with a disability experienced access difficulties, versus 28.3 per cent of those without.
Immigrant employees also faced higher barriers. Immigrant middle-aged adults were 1.8 times more likely to report specialist care difficulties than Canadian-born individuals. For older immigrants, that figure was 1.4 times more likely.
The presence of a primary care provider made a measurable difference. Canadians with a family doctor or nurse practitioner were significantly more likely to access specialist care and significantly less likely to struggle with access. Among middle-aged adults without a primary care provider, 37.4 per cent faced specialist care difficulties.
As coverage on chronic care gaps in group benefits has shown, many plan members with complex conditions already feel underserved by their current coverage. This Statistics Canada data adds a structural layer to that picture: the public system is not reliably routing those members to the specialists they need.
Provincial variation creates uneven risk
Where an employee lives shapes their access profile significantly.
British Columbia showed the highest rates of access difficulty among middle-aged adults, with an adjusted odds ratio of 1.4 compared with Ontario.
Quebec followed at 1.3. The Atlantic provinces – Newfoundland and Labrador, Prince Edward Island, Nova Scotia, and New Brunswick – showed lower specialist use rates overall, pointing to structural supply shortages rather than demand issues.
Rural employees across Canada faced lower odds of accessing a specialist. Among middle-aged adults, rural residents were 30 per cent less likely to see a specialist than their urban counterparts, after adjustment.
Specialist care access difficulties by province
Prevalence of difficulty accessing specialist care among middle-aged Canadians (45–64), by province (2024)
Source: Statistics Canada, Survey on Health Care Access and Experiences – Primary and Specialist Care, 2024. Published July 15, 2026. Provinces ordered by difficulty rate, highest to lowest. Territories excluded from analysis.
Wait times compound the access problem
Among those who did reach a specialist, wait times added another layer of difficulty.
Around 20 per cent of middle-aged adults waited six months or longer between referral and initial consultation. Worry, anxiety, and stress were the most commonly reported effects of those waits – cited by 63.2 per cent of middle-aged adults and 58.3 per cent of older adults who were affected.
Longer waits translate directly into productivity loss, accommodation strain, and increased disability risk. Virtual care platforms have been positioned as one tool to reduce the burden while primary and specialist care capacity remains constrained – though they do not replace specialist consultations for complex conditions.
What this means for plan design
The Statistics Canada findings point to a specific design gap in many group benefit plans: navigation.
Employees with chronic conditions, disabilities, or complex health needs are the most likely to face specialist access barriers. They are also the most likely to develop unmet needs when those barriers persist. Yet most group benefit plans do not include active navigation support to help members move through the public system more efficiently.
Connecting plan members with primary care earlier – through virtual care, pharmacist networks, or nurse practitioner services – would address one of the study’s clearest findings. Those with a primary care provider consistently faced lower access barriers. Plan sponsors who can close that gap stand to reduce the cascade of downstream costs the data describes.
