Silent struggles: Healthcare access by precarious migrants working in Alberta under the Temporary Foreign Worker Program (TFWP)

Abstract

This study examines the migration and legal status trajectories of precarious migrant workers under Canada’s Temporary Foreign Worker Program (TFWP) in Alberta, focusing on barriers to accessing healthcare services. Drawing on the Social Determinants of Health (SDoH) framework and surveillance concepts of social sorting and surveillant assemblage, I examine how employer control, state policies, and service-provider practices shape migrants’ access to care and other essential services. Using 40 semi-structured interviews with migrant workers and key informants, alongside document analysis, the research shows that closed work permits, bureaucratic requirements, and racialised gatekeeping systematically restrict healthcare access, leaving many workers uninsured, misinformed, and afraid to seek care. This study argues that such barriers are not incidental flaws, but structural features of the TFWP designed to extract labour while denying rights and protections. I conclude with the recommendations of migrant workers and key informants, calling for the dismantling of the TFWP and its replacement with a rights-based, status-for-all program that ensures open work permits, universal access to healthcare, and recognition of migrant workers’ dignity and agency.