Abstract
Objectives
The purpose of this study was to determine whether there are differences in self-rated health by immigration and generational status, and the role of health literacy in this relationship.
Methods
Data were from the Canadian component of the 2003 International Adult Literacy and Skills Survey (IALSS) undertaken by Statistics Canada. The sample comprised a total of 22,818 persons, of whom 3,861 were immigrants and 18,957 non-immigrants. The study employed logistic regression to examine the relationship between health literacy and self-rated health. The analysis separately compared: immigrants and non-immigrants; immigrant groups defined by region of origin and recency of arrival in Canada; and the local-born defined by generation.
Results
Logistic regression results indicated that immigrants compared to non-immigrants, and recent immigrants not from Europe or USA compared to established immigrants from Europe or USA, were more likely to report good self-rated health. On the other hand, compared to the third-plus generation, the second generation were less likely to report good self-rated health. Health literacy was positively associated with good self-rated health. However, its effect was largely accounted for by discordance between mother tongue and language of survey administration among immigrants, and by literacy practices at home, education, place of residence, and income among non-immigrants.
Conclusion
Health literacy is important in the health of both immigrants and non-immigrants, but with different underlying mechanisms. For nonimmigrants, engaging in literacy practices at home would benefit both health literacy and overall health, whereas for immigrants, it would be improving proficiency in either English or French.
Key words: Health literacy, health status, immigrants, generations
Résumé
Objectifs
Cette étude vise à déterminer s’il existe des différences dans l’état de santé auto-évalué selon le statut d’immigrant et le statut générationnel, et le rôle que joue la littératie en santé dans cette relation.
Méthode
Les données proviennent de la composante canadienne de l’Enquête internationale sur l’alphabétisation et les compétences des adultes (EIACA) de 2003 menée par Statistique Canada. Notre échantillon comptait 22 818 personnes en tout, dont 3 861 immigrants et 18 957 non-immigrants. Par régression logistique, nous avons établi un lien entre la littératie en santé et l’état de santé auto-évalué. L’analyse comparait séparément: les immigrants et les non-immigrants; les groupes d’immigrants définis selon leur région d’origine et la récence de leur arrivée au Canada; et les gens nés au Canada définis selon leur génération.
Résultats
Les résultats de la régression logistique montrent que les immigrants sont plus susceptibles de se déclarer en bonne santé que les non-immigrants; et que les immigrants récents non originaires d’Europe ou des États-Unis sont plus susceptibles de se déclarer en bonne santé que les immigrants établis originaires d’Europe ou des États-Unis. Par ailleurs, la deuxième génération est moins susceptible que la troisième et les suivantes de se déclarer en bonne santé. La littératie en santé est positivement liée à un bon état de santé auto-évalué. Toutefois, ses effets s’expliquent en grande partie par la différence entre la langue maternelle et la langue d’administration de l’enquête (chez les immigrants) et par la pratique de la lecture à la maison, la scolarité, le lieu de résidence et le revenu (chez les non-immigrants).
Conclusion
La littératie en santé est importante pour la santé des immigrants et des non-immigrants, mais ses mécanismes sous-jacents sont différents. Pour les non-immigrants, c’est en pratiquant la lecture à la maison qu’ils peuvent améliorer leur littératie en santé et leur santé en général, tandis que pour les immigrants, c’est en perfectionnant leurs connaissances du français ou de l’anglais.
Mots clés: compétences informationnelles en santé, état de santé, immigrants, generations
Footnotes
Acknowledgement: This study was supported by funding from the Canadian Council on Learning.
Conflict of Interest: None to declare.
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