Abstract
OBJECTIVES: Studies worldwide point to increased risk of mental health problems among immigrants. However, the data on Canadian immigrants’ mental health are ambiguous. To address this, we examined the relationship of both self-perceived mental health and reported diagnosis of mood disorders with age, gender, migration status, time since migration, and social determinants of health factors.
METHODS: We analyzed three cycles of the Canadian Health Measures Survey. Our outcome variables were self-perceived mental health and reported diagnosis of mood disorders. We used weighted logistic regression to model time since migration conditional on age, gender, income, community belonging, education, and employment status for 12 160 participants aged 15-79 years.
RESULTS: Recent (within 5 years) migrants reported better self-perceived mental health (odds ratio 3.98, 95% confidence interval [CI]: 2.06-7.70) but this effect disappeared with longer time since immigration. Other predictors were older age, higher income, better sense of community belonging, and being employed. Similarly, diagnosis of mood disorders was less likely to be reported in recent migrants (odds ratio 0.23, 95% CI: 0.10-0.53) with some weak evidence that this was also seen among longer-term migrant residents (>10 years). Diagnosis was also associated with older age, being a woman, lower income, weak sense of community belonging, and being unemployed.
DISCUSSION: Our findings indicate that migrants to Canada do not have worse mental health in general, though health and social policies need to attend to the socio-economic determinants, such as low income, unemployment, and a poor sense of community belonging, which contribute to population health outcomes.
Key Words: Canada, immigrants, immigration, mental health, social determinants of health
Mots Clés: Canada, immigrants, immigration, santé mentale, déterminants sociaux de la santé
Résumé
OBJECTIFS : Des études du monde entier font état d’un risque accru de troubles de santé mentale chez les immigrants. Les données sur la santé mentale des immigrants canadiens sont toutefois ambiguës. Pour y remédier, nous avons examiné les relations entre la santé mentale autoperçue et les déclarations de diagnostics de troubles de l’humeur, d’une part, et l’âge, le sexe, le statut migratoire, le temps écoulé depuis la migration et les déterminants sociaux de la santé d’autre part.
MÉTHODE : Nous avons analysé trois cycles de l’Enquête canadienne sur les mesures de la santé. Nos variables de résultats étaient la santé mentale autoperçue et les déclarations de diagnostics de troubles de l’humeur. Nous avons eu recours à la régression logistique pondérée pour modéliser le temps écoulé depuis la migration en tenant compte de l’âge, du sexe, du revenu, du sentiment d’appartenance à la collectivité, de l’instruction et de la situation d’emploi de 12 160 participants de 15 à 79 ans.
RÉSULTATS : Les migrants récents (depuis moins de 5 ans) ont fait état d’une meilleure santé mentale autoperçue (rapport de cotes 3,98, intervalle de confiance [IC] de 95 %: 2,06-7,70), mais cet effet disparaissait avec le temps écoulé depuis l’immigration. Les autres variables prédictives étaient l’âge plus avancé, le revenu plus élevé, un meilleur sentiment d’appartenance à la collectivité et le fait d’avoir un emploi. De même, le diagnostic de troubles de l’humeur était moins susceptible d’être déclaré par les migrants récents (rapport de cotes 0,23, IC de 95%: 0,10-0,53); quelques données probantes fragiles ont par ailleurs indiqué que ce diagnostic était présent chez les migrants résidents arrivés depuis plus longtemps (>10 ans). Le diagnostic était aussi associé à l’âge plus avancé, au sexe féminin, au revenu plus faible, au moindre sentiment d’appartenance à la collectivité et au chômage.
DISCUSSION : Nos constatations montrent que les migrants au Canada n’ont pas une moins bonne santé mentale en général, mais que les politiques sociosanitaires doivent s’attarder aux déterminants socioéconomiques comme le faible revenu, le chômage et la fragilité du sentiment d’appartenance à la collectivité, qui contribuent aux résultats de santé des populations.
Footnotes
Acknowledgements: Funding for this project was provided by PolicyWise for Children and Families. This research has been facilitated by the Women and Children’s Health Research Institute through the generous support of the Stollery Children’s Hospital Foundation. It was stimulated by funding from a World University Network RDF grant and is part of the Health Outcomes of Migration Events (HOME) programme of research (http://www.wun.ac.uk/wun/research/view/home-healthoutcomes-of-migration-events). Through access to the Statistics Canada Data Centre, the research was supported by funds to the Canadian Research Data Centre Network from the Social Sciences and Humanities Research Council, the Canadian Institutes of Health Research, the Canadian Foundation for Innovation, and Statistics Canada. Although the research and analysis are based on data from Statistics Canada, the opinions expressed do not represent the views of Statistics Canada or the Canadian Research Data Centre Network.
Conflict of Interest: None to declare.
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