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Disparities in Mortality Patterns Among Canadian Immigrants and Refugees, 1980–1998: Results of a National Cohort Study

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Abstract

This study examines mortality patterns among Canadian immigrants, including both refugees and non-refugees, 1980–1998. Records of a stratified random sample of Canadian immigrants landing between 1980–1990 (N = 369,936) were probabilistically linked to mortality data (1980–1998). Mortality rates among immigrants were compared to those of the general Canadian population, stratifying by age, sex, immigration category, region of birth and time in Canada. Multivariate analysis examined mortality risks for various immigrant subgroups. Although immigrants presented lower all-cause mortality than the general Canadian population (SMR between 0.34 and 0.58), some cause-specific mortality rates were elevated among immigrants, including mortality from stroke, diabetes, infectious diseases (AIDS and hepatitis among certain subgroups), and certain cancers (liver and nasopharynx). Mortality rates differed by region of birth, and were higher among refugees than other immigrants. These results support the need to consider the heterogeneity of immigrant populations and vulnerable subgroups when developing targeted interventions.

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References

  1. Statistics Canada: 2001 Census: Analysis Series, Canada’s Ethnocultural Portrait–-The Changing Mosaic. Ottawa: Statistics Canada; 2003

    Google Scholar 

  2. Statistics Canada [Online]. 2003 [cited 2003 Aug 5]; Available from URL: http://www.statcan.ca/english/Pgdb/

  3. Hyman I: Immigration and Health. Ottawa: Health Canada; 2001

    Google Scholar 

  4. Kinnon D: Canadian research on immigration and health. Ottawa: Health Canada; 1999

    Google Scholar 

  5. Wilkins K: Tuberculosis, 1994. Health Rep 1996; 8:33–39

    PubMed  Google Scholar 

  6. Gushulak BD, Williams LS: National immigration health policy: existing policy, changing needs, and future directions. Can J Public Health 2004; 95(3): I27–I29

    PubMed  Google Scholar 

  7. Citizenship and Immigration Canada: Immigration and Refugee Protection Act, Fact Sheet 20, Medical Testing and Surveillance. [Online]. 2002 [cited 2003 Aug]. Available from http://www.cic.gc.ca/english/irpa/fs-medical.html

  8. Chen J, Wilkins R, Ng E: Health expectancy by immigrant status, 1986 and 1991. Health Rep 1996; 8:29–38

    Google Scholar 

  9. Gold J, DesMeules M, Manuel D, Kazanjian A, Vissandjée B, Mao Y: Proceedings of the National Symposium on Immigrant Health in Canada. Can J Public Health 2004; 95(3): I1–I39

    Google Scholar 

  10. Parakulam G, Krishnan V, Odynak D: Health status of Canadian-born and foreign-born residents. Can J Public Health 1992; 83:311–314

    PubMed  Google Scholar 

  11. Perez CE: Health status and health behavior among immigrants. Health Rep 2002; 13:S1–S12

    Google Scholar 

  12. Sharma R, Michallowski M, Verma R: Mortality differentials among immigrant populations in Canada. Int Migration 1990; 28:443–450

    Google Scholar 

  13. Singh GK, Siahpush M: All-cause and cause-specific mortality of immigrants and native born in the United States. Am J Public Health 2001; 91:392–399

    PubMed  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

    Google Scholar 

  15. McKay L, Macintyre S, Ellaway A: Migration and Health: A Review of the International Literature. London: Medical Research Council; 2003

    Google Scholar 

  16. Vissandjee B, et al. Integrating ethnicity and migration as determinants of Canadian women’s health. Biomed Central, Women’s Health (in press)

  17. Hanley A, Choi B, Holowaty E: Cancer mortality among Chinese migrants: A review. Int J Epidemiol 1995; 24:255–265

    PubMed  Google Scholar 

  18. Miller BA, Kolonel LN, Bernstein L, Young Jr JL, Swanson GM, West D, et al. (eds): Racial/Ethnic Patterns of Cancer in the United States 1988–1992 Bethesda: National Cancer Institute; 1996

  19. Nair C, Nargundkar M, Johansen H, Strachan J: Canadian cardiovascular disease mortality: first generation immigrants versus Canadian born. Health Rep 1990; 2:203–228

    PubMed  Google Scholar 

  20. Travota F: Nativity, marital status and mortality in Canada. Sociological Abstracts 1998; 35:65–91

    Google Scholar 

  21. Sheth T, Nair C, Nargundkar M, Anand S, Yusuf S: Cardiovascular and cancer mortality among Canadians of European, South Asian and Chinese origin from 1979 to 1993: An analysis of 1.2 million deaths. CMAJ 1999; 161:132–138

    PubMed  Google Scholar 

  22. Weioft G, Gullberg A, Hjern A, Rosen M: Mortality statistics in immigrant research: Method for adjusting underestimation of mortality. Int J Epidemiol 1999; 28:756–763

    Article  PubMed  Google Scholar 

  23. Stern M, Wei M: Do Mexican Americans Really have low rates of cardiovascular disease? Prev Med 1999; 29:S90–S95

    Article  PubMed  Google Scholar 

  24. Yang X: A sensitivity analysis of repeat migration attrition in the study of migrant adjustment: the case of Bangkok. Demography 1994; 31:585–592

    PubMed  Google Scholar 

  25. Abraido-Lanza A, Dohrenwend B, Ng-Mak D, Turner J: The Latino mortality paradox: A test of the “salmon bias” and healthy migrant hypotheses. Am J Public Health 1999; 89:1543–1548

    PubMed  Google Scholar 

  26. Razum O, Zeeb H, Rohrmann S: The ‘healthy migrant effect’–-not merely a fallacy of inaccurate denominator figures (Letter). Int J Epidemiol 2000; 29:191–192

    Article  PubMed  Google Scholar 

  27. Razum O, Zeeb H, Akgun H, Yilmaz S: Low overall mortality of Turkish residents in Germany persists and extends into a second generation: Merely a healthy migrant effect? Trop Med Int Health 1998; 3:297–303

    Article  PubMed  Google Scholar 

  28. Reijneveld SA: The cross-cultural validity of self-reported use of health care: A comparison of survey and registration data. J Clin Epidemiol 2000; 53:267–72

    Article  PubMed  Google Scholar 

  29. Langlois C, Doherty C: The Longitudinal Immigrant Database (IMDB): An Introduction. IMDB Technical Paper, 1997 [cited 2003 Aug 5]. Citizenship and Immigration Canada Ottawa, ON: Canada Online. Available from URL:http://www.cic.gc.ca/english/srr/pdf/res4bi.pdf

  30. Probert A, Semenciw R, Mao Y: Analysis of immigration data: 1980-1994, Chapter 9. In: Record Linkage Techniques, Proceedings of an International Workshop and Exposition. Arlington, VA; March 20–21, 1997

  31. Kobayahse A, Moore E, Rosenberg M: Healthy Immigrant Children: A Demographic and Geographical Analysis. Ottawa: Human Resources Development Canada; 1998

    Google Scholar 

  32. Yusuf S, Reddy S, Ounpuu S, Anand S: Global burden of cardiovascular disease, part II: variations in cardiovascular disease by specific ethnic groups and geographical regions and prevention strategies. Circulation 2001; 104:2855– 2864

    PubMed  Google Scholar 

  33. Sheth T, Nair C, Nargundkar M, Anand S, Yusuf S: Cardiovascular and cancer mortality among Canadians of European, south Asian and Chinese origin from 1979 to 1993: An analysis of 1.2 million deaths. CMAJ 1999; 161:132–138

    PubMed  Google Scholar 

  34. Whincup PH, Gilg JA, Papacosta O, Seymour C, Miller GJ, Alberti KGMM, Cook DG: Early evidence of ethnic differences in cardiovascular risk: Cross sectional comparison of British South Asian and white children. BMJ 2002; 324:635–641

    Article  PubMed  Google Scholar 

  35. Khattar RS, Swales JD, Senior R, Lahiri A: Racial variation in cardiovascular morbidity and mortality in essential hypertension. Heart 2000; 83: 267–71

    Article  PubMed  Google Scholar 

  36. Hennis A, Wu SY, Nemesure B, Li X, Leske MC: Diabetes in a Caribbean population: epidemiological profile and implications. Int J Epidemiol 2002; 31: 234–239

    Article  PubMed  Google Scholar 

  37. Lee J, Parsons GF, Gentleman JF: Falling short of Pap test guidelines. Health Rep 1998; 10:9–19.

    Google Scholar 

  38. Her C: Nasopharyngeal cancer and the Southeast Asian patient. Am Fam Physician 2001; 63:1776–1782

    PubMed  Google Scholar 

  39. Rosenblatt KA, Weiss NS, Schwartz SM: Liver cancer in Asian migrants to the United States and their descendants. Cancer Causes Control 1996; 7:345–350

    Article  PubMed  Google Scholar 

  40. Haworth EA, Soni Raleigh V, Balarajan R: Cirrhosis and primary liver cancer amongst first generation migrants in England and Wales. Ethn Health 1999; 4:93–99

    Article  PubMed  Google Scholar 

  41. Montalto G, Cervello M, Giannitrapani L, Dantona F, Terranova A, Castagnetta LA: Epidemiology, risk factors, and natural history of hepatocellular carcinoma. Ann N Y Acad Sci 2002; 963:13–20

    PubMed  Google Scholar 

  42. Decosas J, Pedneault V: Women and AIDS in Africa: demographic implications for health promotion. Health Policy Plan 1992; 7:227–233

    Google Scholar 

  43. Singer SM, Willms DG, Adrien A, Baxter J, Brabazon C, Leaune V, Godin G, Maticka-Tyndale E, Cappon P: Many voices–-sociocultural results of the ethnocultural communities facing AIDS study in Canada. Can J Public Health 1996; 87:S26–32, S28–35

    Google Scholar 

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Correspondence to Marie DesMeules.

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DesMeules, M., Gold, J., McDermott, S. et al. Disparities in Mortality Patterns Among Canadian Immigrants and Refugees, 1980–1998: Results of a National Cohort Study. J Immigrant Health 7, 221–232 (2005). https://doi.org/10.1007/s10903-005-5118-y

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  • DOI: https://doi.org/10.1007/s10903-005-5118-y

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