Abstract
Background
Most immigrants to Canada now come from Asia, the Middle East, the Caribbean and Africa, where cultures and languages often differ significantly from the Canadian context. Subgroups of immigrants experience disparities in health. Inability to communicate in an official language in Canada may be a marker of risk for poor health due to both pre- and post-migration factors. We aimed to study the relationship between language proficiency and self-reported health.
Methods
We conducted a cross-sectional analysis of the first two surveys of the Longitudinal Survey of Immigrants to Canada (2001, 2003), a population-based cohort study of new immigrants to Canada. Specifically, we used logistic regression analyses to examine the relationship between self-reported health and language proficiency by sex, controlling for a range of health determinants at 6 months (wave 1) and 2 years (wave 2) after arrival.
Results
After controlling for covariates (age, sex, education, region of birth, immigrant class, job satisfaction, access to health care), analysis of the wave 1 survey showed that poor proficiency in English or French is significantly related to the self-reported poor health (OR=2.0, p<0.01). And this relationship was consistent in the wave 2 survey (OR=1.9, p<0.01). We also found that this statistically significant association between poor language proficiency and self-reported health holds only for women (wave 1 survey OR=2.6, p <0.01, wave 2 survey OR=2.2, p<0.01), not for men.
Conclusion
The association between poor language proficiency and poor self-reported health, and particularly its significantly greater impact on women, has implications for language training, health care and social services, and health information.
Keywords: Language proficiency, gender, self-reported health, immigrants and refugees
Résumé
Contexte
La plupart des immigrants au Canada viennent de l’Asie, du Moyen-Orient, des Caraïbes et de l’Afrique, où souvent les cultures et les langues diffèrent énormément du contexte canadien. Les sous-groupes d’immigrants présentent des disparités sur le plan de la santé. L’incapacité de communiquer dans l’une des langues officielles du Canada peut être un indicateur de risque de mauvaise santé résultant de facteurs pré- et post-migratoires. Nous avons voulu étudier la relation entre l’auto-évaluation de la santé et les compétences linguistiques.
Méthode
Nous avons mené une analyse transversale des deux premières Enquêtes longitudinales auprès des immigrants du Canada (2001, 2003), des études représentatives de cohortes de nouveaux immigrants. Spécifiquement, nous avons procédé par analyse de régression logistique pour examiner le rapport entre l’auto-évaluation de la santé et les compétences linguistiques par sexe, en tenant compte de divers déterminants de la santé, dans un délai de six mois (première vague) et de deux ans (deuxième vague) après l’arrivée au Canada.
Résultats
Compte tenu des effets des covariables (âge, sexe, scolarité, classe d’immigrants, satisfaction au travail, accès aux soins de santé), l’analyse de la première vague de l’enquête indique que les compétences linguistiques faibles en anglais ou en français présentent une association statistiquement significative avec la mauvaise santé déclarée par l’intéressé (rapport de cotes (RC) = 2,0, p<0,01). Ce rapport se maintient dans la deuxième vague de l’enquête (RC=1,9, p<0,01). De plus, nous avons constaté que cette association significative entre les faibles compétences linguistiques et la santé auto-déclarée s’applique seulement aux femmes (première vague: RC=2,6, p<0,01, deuxième vague: RC=2,2, p<0,01) et non aux hommes.
Conclusion
Le rapport entre les faibles compétences linguistiques et la mauvaise santé déclarée par l’intéressé, et en particulier son impact beaucoup plus important sur les femmes, a des conséquences pour la formation linguistique, les soins de santé, les services sociaux et l’information sur la santé.
Mots clés: compétence linguistique, genre, auto-évaluation de la santé, immigrants et réfugiés
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