Abstract
While immigrant subgroups may present vulnerabilities in terms of health status, health service use, and social determinants, comprehensive information on their health is lacking. To examine mortality (1980-1998) and health service utilization (1985-2002) patterns in Canadian immigrants, a record linkage pan-Canadian research initiative using immigration and health databases has been undertaken. Preliminary results indicate that overall mortality is low among Canadian immigrants as compared to the general population for most leading causes (thus supporting the notion of “healthy immigrant effect”), with causespecific exceptions. Moreover, results from British Columbia show that overall physician visits are low for immigrants, but not for all subgroups. Results from Ontario demonstrate a sharp increase in physician claims approximately three months following landing. Future analyses will address the short- and long-term health outcomes of immigrant subgroups, including less common diseases. Results are pertinent to practitioners working with immigrants and can inform immigrant health policy.
Résumé
On sait que certains sous-groupes d’immigrants sont relativement plus vulnérables en ce qui a trait à leur état de santé, à leur utilisation des services de santé et à leurs déterminants sociaux, mais on ne possède pas de renseignements exhaustifs sur leur santé. Pour examiner les tendances de la mortalité (1980-1998) et de l’utilisation des services de santé (1985-2002) chez les immigrants au Canada, nous avons mené un projet de recherche pancanadien à l’aide des bases de données sur l’immigration et la santé. Les résultats préliminaires semblent indiquer que la mortalité globale due aux principales causes de décès est plus faible chez les immigrants au Canada que dans la population générale (ce qui renforce la notion d’un « effet de l’immigrant en bonne santé »), à quelques causes près. De plus, les résultats obtenus en Colombie-Britannique montrent que les visites chez le médecin sont relativement peu nombreuses chez les immigrants dans leur ensemble, mais pas dans tous les sous-groupes. Les résultats obtenus en Ontario montrent une forte augmentation des demandes de paiement des médecins environ trois mois après l’établissement. Des analyses poussées devraient porter sur les résultats sanitaires à court et à long terme dans les sous-groupes d’immigrants, y compris pour les maladies moins communes. Leurs résultats intéresseront les praticiens qui travaillent auprès des immigrants et pourraient étayer la politique sanitaire en matière d’immigration.
References
- 1.Statistics Canada. 2001 Census: Analysis Series, Canada’s Ethnocultural Portrait–the Changing Mosaic. Ottawa, ON: Statistics Canada, Census Operations Division; 2003. [Google Scholar]
- 2.CitizenshipImmigration Canada. Facts and Figures–Immigration Overview. Ottawa, ON: Policy, Planning and Research, Citizenship and Immigration Canada; 2002. [Google Scholar]
- 3.Hyman I. Immigration and Health. Health Policy Working Paper Series. Working Paper 01-05. Ottawa, ON: Health Canada; 2001. [Google Scholar]
- 4.Kinnon D. Canadian Research on Immigration and Health–an Overview. Ottawa, ON: Health Canada; 1999. [Google Scholar]
- 5.Wen SW, Goel V, Williams JI. Utilization of health care services by immigrants and other ethnic/ cultural groups in Ontario. Ethn Health. 1996;1:99–109. doi: 10.1080/13557858.1996.9961775. [DOI] [PubMed] [Google Scholar]
- 6.Perez CE. Health status and health behaviour among immigrants. Health Rep. 2002;13(Suppl.):1–12. [Google Scholar]
- 7.Chen J, Ng E, Wilkins R. Health status of Canada’s immigrants in 1994–95. Health Rep. 1996;7:33–45. [PubMed] [Google Scholar]
- 8.Parakulam G, Krishnan V, Odynak D. Health status of Canadian-born and foreign-born residents. Can J Public Health. 1992;83(4):311–14. [PubMed] [Google Scholar]
- 9.Probert A, Semenciw R, Mao Y, Gentleman J. Analysis of immigration data: 1980–1994. Chapter 9; Record Linkage Techniques; 1997. [Google Scholar]
- 10.Weioft G, Gullberg A, Hjern A, Rosen M. Mortality statistics in immigrant research: Method for adjusting underestimation of mortality. Int J Epidemiol. 1999;28(4):756–63. doi: 10.1093/ije/28.4.756. [DOI] [PubMed] [Google Scholar]
- 11.Sheth T, Nargundkar M, Chagani K, Anand S, Nair C, Yusuf S. Classifying ethnicity utilizing the Canadian Mortality Data Base. Ethn Health. 1997;2:287–95. doi: 10.1080/13557858.1997.9961837. [DOI] [PubMed] [Google Scholar]
- 12.Vissandjée B, Dupéré S. Culture, migration et enquête: défis incontournables. J Int Migration and Integration. 2000;1(4):477–92. doi: 10.1007/s12134-000-1026-0. [DOI] [Google Scholar]
- 13.Vissandjée B, Weinfeld M, Dupéré S, Abdool S. Sex, gender, ethnicity and access to health care services: Research and policy challenges for immigrant women in Canada. J Int Migration and Integration. 2000;2(1):55–75. doi: 10.1007/s12134-001-1019-7. [DOI] [Google Scholar]
- 14.Trovato F, Clogg C. General and cause specific adult mortality among immigrants in Canada. 1971 and 1981. Canadian Studies in Population. 1992;19:47–80. doi: 10.25336/P6FS33. [DOI] [Google Scholar]
- 15.Reijneveld SA. The cross-cultural validity of selfreported use of health care: A comparison of survey and registration data. J Clin Epidemiol. 2000;53:267–72. doi: 10.1016/S0895-4356(99)00138-9. [DOI] [PubMed] [Google Scholar]
- 16.Citizenship and Immigration Canada. Citizenship and Immigration Canada information sources. Online at https://doi.org/www.cic.gc.ca/english/ srr/pdf/res4di.pdf.
- 17.Kliewer E, Kazanjian A. The Health Status and Medical Services Utilization of Recent Immigrants to Manitoba and British Columbia: A Pilot Study. Report prepared for Citizenship and Immigration Canada. 2000. p. 18. [Google Scholar]
- 18.Johnson BE. Tobacco and lung cancer. Prim Care. 1998;25:279–91. doi: 10.1016/S0095-4543(05)70064-6. [DOI] [PubMed] [Google Scholar]
- 19.Franco EL, Duarte-Franco E, Ferenczy A. Cervical cancer: Epidemiology, prevention and the role of human papillomavirus infection. CMAJ. 2001;164:1017–25. [PMC free article] [PubMed] [Google Scholar]