Canadian Journal of Public Health

, Volume 109, Issue 1, pp 15–26 | Cite as

Linguistic mortality gradients in Quebec and the role of migrant composition

  • Ernest Lo
  • Mai Thanh Tu
  • Normand Trempe
  • Nathalie Auger
Quantitative Research
  • 19 Downloads

Abstract

Objective

Anglophones and Allophones in Quebec (Canada) have lower mortality than Francophones, despite being linguistic minorities. This study assesses whether (1) language is a risk factor for mortality after accounting for migrant composition and (2) interprovincial migrants differ in mortality with respect to Quebec-born individuals.

Methods

We analyzed death records between 2004 and 2008 from Quebec (all-cause and main causes) and population data from the 2006 census to estimate age-adjusted mortality rates according to language and migrant status. Risk ratios by language and migrant status, adjusted for age, sex, and socioeconomic status, were estimated using Poisson generalized estimating equations.

Results

Francophone Quebec-borns had the highest mortality. Among Quebec-borns, Anglophones [RR= 0.85, 95% CI (0.79–0.91)] and Allophones [RR = 0.16, 95 %CI (0.12–0.22)] had lower mortality relative to Francophones. Interprovincial migrants had lower mortality (Anglophones [RR = 0.58, 95% CI (0.53–0.63)], Francophones [RR = 0.55, 95% CI (0.50–0.60)]) relative to Francophone Quebec-borns (Allophones were excluded due to small sample size). Among immigrants, mortality was lower for Francophones [RR = 0.62, 95% CI (0.57–0.67] and Allophones [RR = 0.35, 95% CI (0.31–0.38], but not Anglophones [RR = 0.92, 95% CI (0.84–1.01)], relative to Francophone Quebec-borns.

Conclusion

In Quebec, linguistic disparities in mortality remained after accounting for migrant status, and both Francophone and Anglophone interprovincial migrants in Quebec had lower mortality than Quebec-born Francophones. Public health initiatives to reduce linguistic disparities in health should account for migrant status.

Keywords

Mortality Minority language Healthy immigrant effect Moderation Quebec 

Résumé

Objectif

Les anglophones et les allophones du Québec (Canada) ont un taux de mortalité inférieur à celui des francophones, malgré leur statut de minorité linguistique. Cette étude évalue si: 1) la langue est un facteur de risque de mortalité, après avoir contrôlé pour le statut migratoire; 2) la mortalité chez les migrants interprovinciaux diffère de celle des individus nés au Québec.

Méthode

Nous avons analysé les données de décès qui ont eu lieu de 2004 à 2008 au Québec (toutes causes confondues et selon les principales causes) et les données de population du recensement 2006, afin d’estimer les taux de mortalité ajustés pour l’âge selon la langue et le statut migratoire. Les risques relatifs par langue et par statut migratoire, ajustés selon l’âge, le sexe et le statut socioéconomique, ont été estimés en utilisant les équations d’estimation généralisées de Poisson.

Résultats

Les Francophones nés au Québec avaient le risque de mortalité le plus élevé. Parmi les personnes nées au Québec, les anglophones [RR = 0,85, IC 95% (0,79–0,91)] et les allophones [RR = 0,16, IC 95% (0,12–0,22)] avaient un risque relatif de mortalité plus faible comparativement aux francophones. Les migrants interprovinciaux avaient des risques relatifs de mortalité plus faibles (anglophones [RR = 0,58, IC 95% (0,53–0,63)], francophones [RR = 0,55, IC 95% (0,50–0,60)]), comparativement aux francophones nés au Québec (les allophones ont été exclus des analyses en raison de leur faible taille d’échantillon). Parmi les immigrants, le risque relatif de mortalité était plus faible pour les francophones [RR = 0,62, IC 95% (0,57–0,67)] et les allophones [RR = 0,35, IC 95% (0,31–0,38)], mais pas pour les anglophones [RR = 0,92, IC 95% (0,84–1,01)], comparativement aux francophones nés au Québec.

Conclusion

Au Québec, les différences linguistiques dans la mortalité demeurent après avoir contrôlé pour le statut migratoire. Les migrants interprovinciaux, autant pour les francophones que pour les anglophones, ont un taux et un risque relatif de mortalité plus bas que les francophones nés aux Québec. Les initiatives en santé publique pour réduire les différences linguistiques en santé devraient prendre en considération le statut d’immigrant.

Mots-clés

Mortalité Langue minoritaire Effet de l’immigrant en santé Modération Québec 

Notes

Acknowledgements

We thank Jérôme Martinez and Marie-Hélène Lussier for the useful discussions. We thank an anonymous reviewer whose comments greatly helped to improve the quality of this work.

Compliance with ethical standards

Conflict of interest

This study is part of a series of projects funded by Health Canada through the Community Health and Social Services Network (CHSSN).

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Copyright information

© The Canadian Public Health Association 2018

Authors and Affiliations

  • Ernest Lo
    • 1
    • 2
  • Mai Thanh Tu
    • 1
  • Normand Trempe
    • 1
  • Nathalie Auger
    • 1
    • 2
    • 3
  1. 1.Institut national de santé publique du QuébecMontréalCanada
  2. 2.Department of Epidemiology, Biostatistics and Occupational HealthMcGill UniversityMontréalCanada
  3. 3.University of Montreal Hospital Research CentreMontréalCanada

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