An empirical study of the

1
An empirical study of thehealthy immigrant
effect with Canadian Community Health
SurveyYimin (Gloria) Lou, M.A.
CandidateUniversity of Western Ontario

• Presentation at Canadian Population Society 2004
  Annual Meetings, University of Manitoba,
  Winnipeg.
• Session 1, Determinants of Health Socio-Economic
  Status, Immigration and Other Factors

2
Introduction

• Observed phenomenon the healthy immigrant
  effect in Canada, US and Australia
• Brief features
• the health of immigrants is better than that of
  the host population
• recent arrivals are more healthy than long-term
  arrivals
• the health of immigrants is getting worse over
  time

3
Previous Research

• the healthy immigrant effect has been examined
  in terms of
• Physical health
• Chen, Ng, and Wilkins 1996 (1994/95 NPHS)
• Pérez 2002 (2000/01 CCHS)
• Mental health
• Ali 2002 (2000/01 CCHS)

4
Why Healthy Immigrant Effect?

• Selectivity?
• Demographic and SES factors?
• Proficiency in official language?
• Employment status?
• Sense of belonging?
• Health behaviours?

5
Objectives of the Study

• To verify the existence of the healthy immigrant
  effect with a general health index
  self-perceived health.
• To explore the explanatory power of lifestyle to
  the healthy immigrant effect.

6
Methodology

• Data cycle 1.1 of 2000/01 CCHS
• The sample size is about 130,000. The
  Canadian-born population accounts for 86.4, new
  immigrants 2.8, old immigrants 10.1.
• Techniques
• Prevalence of self-perceived poor health by
  immigration status, sex or age is charted
• Two logistic regression models are fitted
  (baseline model and lifestyle model)
• All analyses are weighted

7
(No Transcript)
8
(No Transcript)
9
RESULTS
10
Data Source 2000/01 CCHS. 130821 cases, excluding 59 (0.05) missing response to self-perceived health
Significantly different from the reference group, Canadian-born population (plt0.001)
11

• Immigrants as a whole were less healthy than the
  Canadian-born population, for all respondents
  and for women.
• New immigrants were healthier, while old
  immigrants were less healthy, than their
  Canadian-born counterparts, for all respondents
  and for both sexes respectively.
• Lower prevalence of poor self-perceived health of
  men compared to women was true for the
  Canadian-born population as well as for
  immigrants, no matter length of residence in
  Canada.

12
Data Source 2000/01 CCHS. 130821 cases, excluding 59 (0.05) missing response to self-perceived health
Significantly different from the reference group, Canadian-born population (plt0.001)
13

• Immigrants as a whole were less healthy than the
  Canadian-born population, for all respondents
  and for women.
• New immigrants were healthier, while old
  immigrants were less healthy, than their
  Canadian-born counterparts, for all respondents
  and for both sexes respectively.
• Lower prevalence of poor self-perceived health of
  men compared to women was true for the
  Canadian-born population as well as for
  immigrants, no matter length of residence in
  Canada.

14
Data Source 2000/01 CCHS. 130821 cases, excluding 59 (0.05) missing response to self-perceived health
Significantly different from the reference group, Canadian-born population (plt0.001)
15

• Immigrants as a whole were less healthy than the
  Canadian-born population, for all respondents
  and for women.
• New immigrants were healthier, while old
  immigrants were less healthy, than their
  Canadian-born counterparts, for all respondents
  and for both sexes respectively.
• Lower prevalence of poor self-perceived health of
  men compared to women was true for the
  Canadian-born population as well as for
  immigrants, no matter length of residence in
  Canada.

16

• Data Source 2000/01 CCHS, 130821 cases,
  excluding 59 (0.05) missing response to
  self-perceived health

17
50-Year-Old Effect

• Compared with the Canadian-born counterparts
• Before age 50, new immigrants were healthier and
  old immigrants were less healthy. The immigrants
  as a whole were less healthy.
• After age 50, opposite results happened.

18
Table 1, Odds ratio for self-perceived poor
health, by lifestyle logistic regression model,
household population aged 20-64, excluding
pregnant women..
Lifestyle Variables Odds ratio
Body Mass Index 1.056
Daily consumption of fruits and vegetables 1.00
Type of smoker
Daily smoker (reference) 1.00
Not daily smoker 0.598
Type of Drinker
Regular drinker (reference) 1.00
Not regular drinker 1.724
Physical activity index
Active 0.533
Moderate 0.714
Inactive (reference) 1.00

• Data source 2000/01 CCHS

19
Table2, odds ratio for poor self-perceived health
by sex and by immigration status, household
population aged 20-64, excluding pregnant women.

• Data source 2000/01 CCHS (Canadian Community
  Health Survey)
• Odds ratios adjusted for age, sex, marital
  status, education, and household income.
• Odds ratios adjusted for age, sex (excluded for
  men group or women group), marital status,
  education, household income, body mass index,
  daily consumption of fruits and vegetables, type
  of smoker, type of drinker, and physical activity
  index.
• Reference category.
• Significantly different from reference
  category (plt0.05)

20
Concluding Remarks

• The healthy immigrant effect did not hold for
  immigrant group as a whole. It applied to new
  immigrants over age 50 and old immigrants under
  age 50.
• There was significant difference in lifestyle
  between the Canadian-born population and
  immigrants. However, it was not associated with
  the difference in self-perceived health between
  the two population groups.

21
Contact Information

• Yimin (Gloria) Lou
• M.A. Candidate
• Department of Sociology
• The University of Western Ontario
• London, ON, N6A 5C2
• Telephone [phone] ext. 85109
• E-mail ylou4_at_uwo.ca