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Health Decline Among Recent Immigrants to Canada: Findings From a Nationally-representative Longitudinal Survey

  • Quantitative Research
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Canadian Journal of Public Health Aims and scope Submit manuscript

Abstract

Objective

The healthy immigrant effect suggests new immigrants to Canada enjoy better health, on average, than those born in Canada, yet crosssectional data suggest that immigrants who have been in Canada for decades have comparable health to their native-born peers. We analyzed prospective cohort data to identify the factors associated with health decline among new immigrants.

Methods

The Longitudinal Survey of Immigrants to Canada was conducted by Statistics Canada and Citizenship and Immigration Canada between April 2001 and November 2005. A probability sample of 7,716 recent immigrants from abroad was interviewed three times: at six months, two years and four years after arrival in Canada. Logistic regression was used to model predictors of a two-step decline in self-reported health (e.g., from excellent to good or from very good to fair).

Results

Among recent immigrants, 15% reported a two-step decline in health in the first four years after arrival in Canada. In comparison, only 6% of non-immigrants from a similar age cohort reported a two-step decline in health during the same time period. The characteristics associated with an increased likelihood of health decline among recent immigrants include initial health status, age, gender, marital status, language skills and place/region of birth. Experience of discrimination was also associated with health decline. One in four immigrants who experienced a health decline reported problems accessing Canadian health services.

Conclusions

The process of immigration is associated with health decline for some recent immigrants. These findings support Health Canada’s identification of immigration as a determinant of health. Strategies need to be developed to improve access to health care among new immigrants.

Résumé

Objectif

Selon l’effet de l’immigrant en bonne santé, les nouveaux immigrants au Canada devraient jouir d’une meilleure santé, en moyenne, que les personnes nées au Canada; pourtant, les données transversales donnent à penser que la santé des immigrants établis au Canada depuis plusieurs décennies est comparable à celle de leurs pairs nés au Canada. Nous avons analysé des données prospectives de cohortes pour repérer les facteurs associés au déclin de la santé chez les nouveaux immigrants.

Méthode

L’Enquête longitudinale auprès des immigrants du Canada a été menée par Statistique Canada et Citoyenneté et Immigration Canada entre avril 2001 et novembre 2005. Nous avons interviewé à trois reprises un échantillon probabiliste de 7 716 personnes ayant récemment immigré de l’étranger: à six mois, deux ans et quatre ans après leur arrivée au Canada. Par régression logistique, nous avons modélisé les prédicteurs d’une baisse de deux niveaux dans leur état de santé autodéclaré (p. ex., d’excellent à bon ou de très bon à moyen).

Résultats

Parmi les immigrants récents, 15 % ont déclaré une baisse de deux niveaux de leur état de santé au cours des quatre premières années suivant leur arrivée au Canada. À titre de comparaison, seulement 6 % des non-immigrants de cohortes d’âges similaires ont déclaré une baisse de deux niveaux durant la même période. Les caractéristiques associées à la vraisemblance accrue d’un déclin de la santé chez les immigrants récents étaient l’état de santé initial, l’âge, le sexe, l’état matrimonial, la maîtrise de la langue et l’endroit/la région de naissance. L’expérience d’une discrimination était aussi associée à un déclin de la santé. Un immigrant sur quatre dont la santé avait décliné a évoqué des problèmes d’accès aux services de santé canadiens.

Conclusion

Le processus d’immigration est associé à un déclin de la santé chez certains immigrants récents. Ces constatations confirment, comme le considère Santé Canada, que l’immigration est un déterminant de la santé. Il faudrait élaborer des stratégies pour améliorer l’accès des nouveaux immigrants aux soins de santé.

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Authors and Affiliations

  1. Department of Family and Community Medicine & Faculty of Social Work, University of Toronto, 246 Bloor St. West, Toronto, ON, M5S 1A1, Canada

    Esme Fuller-Thomson PhD (Professor & Sandra Rotman Chair)

  2. Department of Sociology, Ryerson University, Toronto, ON, Canada

    Andrea M. Noack PhD (Assistant Professor)

  3. Faculty of Community Services, Ryerson University, Toronto, ON, Canada

    Usha George PhD (Professor & Dean)

Authors
  1. Esme Fuller-Thomson PhD
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  2. Andrea M. Noack PhD
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  3. Usha George PhD
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Correspondence to Esme Fuller-Thomson PhD.

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Conflict of Interest: None to declare.

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Fuller-Thomson, E., Noack, A.M. & George, U. Health Decline Among Recent Immigrants to Canada: Findings From a Nationally-representative Longitudinal Survey. Can J Public Health 102, 273–280 (2011). https://doi.org/10.1007/BF03404048

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