Abstract
Objective: It has been reported that being part of a minority group may be negatively associated with self-perceived health. The objective of this analysis was to determine whether there are differences in perceived health between the Francophone minority and Anglophone majority in New Brunswick, the only officially bilingual province in Canada.
Methods: Data from the first four primary cycles of the Canadian Community Health Survey (2001 to 2007) were obtained for 17,729 New Brunswick residents. Odds of reporting good health among Francophones and Anglophones were compared using multivariate logistic regressions accounting for age, health-related behaviours, socio-demographic variables, and medical conditions.
Results: In the final models, Francophone men and women were less likely than Anglophones to report their health as being good, although these differences were not statistically significant (Odds ratio, 95% confidence interval: 0.88, 0.61–1.26; 0.71, 0.49-1.04, in men and women, respectively).
Conclusion: This study suggests that being part of the linguistic minority in New Brunswick is not associated with statistically significant differences in self-perceived health.
Key Words: Minority, language, self-perceived health, disparity
Résumé
Objectif: Faire partie d’un groupe minoritaire peut être lié à une moins bonne santé perçue. L’objectif de cette analyse est de déterminer s’il existe des différences au niveau de la santé perçue entre la minorité francophone et la majorité anglophone du Nouveau-Brunswick, la seule province officiellement bilingue au Canada.
Méthodes: Les données des quatre premiers cycles de l’Enquête sur la santé dans les collectivités canadiennes (2001 à 2007) ont été obtenues pour 17 729 résidents du Nouveau-Brunswick. Les chances de rapporter une bonne santé chez les francophones et les anglophones ont été comparées en utilisant des rapports de côtes prenant en considération les variables âge, comportements liés à la santé, facteurs sociodémographiques, et conditions médicales.
Résultats: Dans les modèles finaux, les hommes et femmes francophones étaient moins enclins que les anglophones à rapporter une bonne santé, mais ces différences n’étaient pas statistiquement significatives (rapport de côtes, intervalle de confiance à 95 %: 0,88, 0,61–1,26; 0,71, 0,49–1,04, chez les hommes et les femmes, respectivement).
Conclusion: Cette étude suggère que le statut de francophone en situation minoritaire au Nouveau-Brunswick n’est pas lié à une différence statistiquement significative de la santé perçue.
Mots Clés: minorité, langue, santé, auto-évaluée, disparité
Footnotes
Acknowledgement of support: The analyses were performed in the context of research programs funded by the Canadian Institutes of Health Research (Bouchard et al. Les déterminants de la santé des minorités francophones une analyse secondaire de l’ESCC) and the Consortium national de formation en santé, volet Université de Moncton (Bourque et al.).
Conflict of Interest: None to declare.
References
- 1.Commission on Social Determinants of Health. Final Report: Closing the gap in a generation: Health equity through action on the social determinants of health. Geneva, Switzerland: World Health Organization; 2008. [DOI] [PubMed] [Google Scholar]
- 2.Marmot M. Social determinants of health inequalities. Lancet. 2005;365(9464):1099–104. doi: 10.1016/S0140-6736(05)74234-3. [DOI] [PubMed] [Google Scholar]
- 3.Tarlov AR. Public policy frameworks for improving population health. Ann N Y Acad Sci. 1999;896:281–93. doi: 10.1111/j.1749-6632.1999.tb08123.x. [DOI] [PubMed] [Google Scholar]
- 4.Kawachi I. Social capital and community effects on population and individual health. Ann N Y Acad Sci. 1999;896:120–30. doi: 10.1111/j.1749-6632.1999.tb08110.x. [DOI] [PubMed] [Google Scholar]
- 5.Willams DR, Collins C. US socioeconomic and racial differences in health: Patterns and explanations. Annu Rev Sociol. 1995;21:349–86. doi: 10.1146/annurev.so.21.080195.002025. [DOI] [Google Scholar]
- 6.Davey S G, Neaton JD, Wentworth D, Stamler R, Stamler J. Mortality differences between black and white men in the USA: Contribution of income and other risk factors among men screened for the MRFIT. MRFIT Research Group. Multiple Risk Factor Intervention Trial. Lancet. 1998;351(9107):934–39. doi: 10.1016/S0140-6736(05)60603-4. [DOI] [PubMed] [Google Scholar]
- 7.Australian Bureau of Statistics/Australian Institute of HealthWelfare. The Health and Welfare of Australian’s Aboriginal and Torres Strait Islander Peoples. Commonwealth of Australia: The Australian Government; 2008. [Google Scholar]
- 8.Kobayashi KM, Prus S, Lin Z. Ethnic differences in self-rated and functional health: Does immigrant status matter? Ethn Health. 2008;13(2):129–47. doi: 10.1080/13557850701830299. [DOI] [PubMed] [Google Scholar]
- 9.Kopec JA, Williams JI, To T, Austin PC. Cross-cultural comparisons of health status in Canada using the Health Utilities Index. Ethn Health. 2001;6(1):41–50. doi: 10.1080/13557850125061. [DOI] [PubMed] [Google Scholar]
- 10.Bouchard L, Gaboury I, Chomienne M-H, Gilbert A, Dubois L. La santé en situation linguistique minoritaire. Healthcare Policy. 2009;4(4):33–40. [PMC free article] [PubMed] [Google Scholar]
- 11.Bouchard L, Gilbert A, Landry R, Deveau K. Social capital, health, and Francophone minorities. Can J Public Health. 2006;97(Suppl2):S16–S20. [PubMed] [Google Scholar]
- 12.Institut Franco-Ontarien/Programme de recherche, d’éducation et de développement en santé publique. Deuxième rapport sur la santé des francophones de l’Ontario. Ontario: Office of Francophone Affairs; 2005. [Google Scholar]
- 13.Desjardins L. La santé des francophones du Nouveau-Brunswick. 2003. p. 258. [Google Scholar]
- 14.Robichaud J-B. La santé des francophones. Moncton, Nouveau-Brunswick: Éditions Acadie; 1985. p. 189. [Google Scholar]
- 15.Thomas S, Wannell B. Combining cycles of the Canadian Community Health Survey. Health Report. 2009;20(1):53–58. [PubMed] [Google Scholar]
- 16.Bouchard L, Gaboury I, Dubois L, Gilbert A, Chomienne MH, Beauregard N, Berthelot JM. Disparités de santé et francophonie minoritaire; 2005. [Google Scholar]
- 17.Idler EL, Benyamini Y. Self-rated health and mortality: A review of twentyseven community studies. J Health Soc Behav. 1997;38(1):21–37. doi: 10.2307/2955359. [DOI] [PubMed] [Google Scholar]
- 18.Rao JNK, Wu CFJ, Yue K. Some recent work on resampling methods for complex surveys. Survey Methodology. 1992;18(2):209–17. [Google Scholar]
- 19.Shetterly SM, Baxter J, Mason LD, Hamman RF. Self-rated health among Hispanic vs. non-Hispanic white adults: The San Luis Valley Health and Aging Study. Am J Public Health. 1996;86(12):1798–801. doi: 10.2105/AJPH.86.12.1798. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 20.Spencer SM, Schulz R, Rooks RN, Albert SM, Thorpe RJ, Jr, Brenes GA, et al. Racial differences in self-rated health at similar levels of physical functioning: An examination of health pessimism in the health, aging, and body composition study. J Gerontol B Psychol Sci Soc Sci. 2009;64(1):87–94. doi: 10.1093/geronb/gbn007. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 21.Bailis DS, Segall A, Chipperfield JG. Two views of self-rated general health status. Soc Sci Med. 2003;56(2):203–17. doi: 10.1016/S0277-9536(02)00020-5. [DOI] [PubMed] [Google Scholar]
- 22.Quesnel-Vallée A. Self-rated health: Caught in the crossfire of the quest for “true” health. Int J Epidemiol. 2007;36(6):1161–64. doi: 10.1093/ije/dym236. [DOI] [PubMed] [Google Scholar]
- 23.Commission on the Future of Healthcare in Canada. Building on values: The Future of Health Care in Canada, Final Report. Ottawa, ON: Health Canada; 2002. [Google Scholar]
- 24.Bowen S. Language Barriers in Access to Health Care/Barrières linguistiques dans l’accès aux soins de santé. 2001. [Google Scholar]
- 25.Schofield A, Bourgeois D. Socially responsible medical education: Innovations and challenges in a minority setting. Med Educ. 2010;44(3):263–71. doi: 10.1111/j.1365-2923.2009.03573.x. [DOI] [PubMed] [Google Scholar]
- 26.Nyqvist F, Finnäs F, Jakobsson G, Koskinen S. The effect of social capital on health: The case of two language groups in Finland. Health Place. 2008;14(2):347–60. doi: 10.1016/j.healthplace.2007.09.001. [DOI] [PubMed] [Google Scholar]
- 27.Komar M, Nagymajtényi L, Nyari T, Paulik E. The determinants of self-rated health among ethnic minorities in Hungary. Ethn Health. 2006;11(2):121–32. doi: 10.1080/13557850500485378. [DOI] [PubMed] [Google Scholar]
- 28.Marmot M. Status Syndrome. London, UK: Bloomsbury Publishing; 2004. p. 288. [Google Scholar]
- 29.Wilkinson RG. Health, hierarchy and social anxiety. Ann N Y Acad Sci. 1999;896:48–63. doi: 10.1111/j.1749-6632.1999.tb08104.x. [DOI] [PubMed] [Google Scholar]
- 30.St-Pierre M, Béland Y. Mode Effects in the Canadian Community Health Survey: A Comparison of CAPI and CATI; 2004. [Google Scholar]