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Effects of length of stay and language proficiency on health care experiences among Immigrants in Canada and the United States


  • Lebrun, Lydie A.


This study sought to examine the influence of length of stay and language proficiency on immigrants’ access to and utilization of care in Canada and the United States (US). Data came from the 2007–2008 Canadian Community Health Survey and the National Health Interview Survey. Analyses were limited to foreign-born, non-elderly adults in each country (n = 12,870 in Canada and n = 7440 in the US). Health care indicators included having a usual source of care; annual consultation with a health professional, dentist, and eye doctor; flu shot in the past year; and Pap test in the past 3 years. Logistic regression models were employed to estimate the relative odds of access or use of care, adjusting for need, demographic factors, socioeconomic status, and insurance coverage. In general, rates of health care access and utilization were higher in Canada than the US among all immigrant groups. In both countries, adjusted analyses indicated that immigrants with shorter length of stay (less than 10 years) and limited language proficiency generally had lower rates of access/use compared with those with longer length of stay (10 years or more) and proficiency in each country’s official language(s), respectively. There was one exception to this pattern in the US: immigrants with limited English had higher odds of having a recent Pap test relative to English-proficient immigrants. The persistence of disparities in health care experiences based on length of stay and language proficiency in Canada suggests that universal health insurance coverage may not be sufficient for ensuring access to and utilization of primary and preventive care for this population.

Suggested Citation

  • Lebrun, Lydie A., 2012. "Effects of length of stay and language proficiency on health care experiences among Immigrants in Canada and the United States," Social Science & Medicine, Elsevier, vol. 74(7), pages 1062-1072.
  • Handle: RePEc:eee:socmed:v:74:y:2012:i:7:p:1062-1072
    DOI: 10.1016/j.socscimed.2011.11.031

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    References listed on IDEAS

    1. Hunt, L.M.Linda M. & Schneider, Suzanne & Comer, Brendon, 2004. "Should "acculturation" be a variable in health research? A critical review of research on US Hispanics," Social Science & Medicine, Elsevier, vol. 59(5), pages 973-986, September.
    2. Salant, Talya & Lauderdale, Diane S., 2003. "Measuring culture: a critical review of acculturation and health in Asian immigrant populations," Social Science & Medicine, Elsevier, vol. 57(1), pages 71-90, July.
    3. Thomson, Maria D. & Hoffman-Goetz, Laurie, 2009. "Defining and measuring acculturation: A systematic review of public health studies with Hispanic populations in the United States," Social Science & Medicine, Elsevier, vol. 69(7), pages 983-991, October.
    4. repec:aph:ajpbhl:10.2105/ajph.2004.041418_7 is not listed on IDEAS
    5. Grove, Natalie J. & Zwi, Anthony B., 2006. "Our health and theirs: Forced migration, othering, and public health," Social Science & Medicine, Elsevier, vol. 62(8), pages 1931-1942, April.
    6. Bentham, Graham, 1988. "Migration and morbidity: Implications for geographical studies of disease," Social Science & Medicine, Elsevier, vol. 26(1), pages 49-54, January.
    7. Abraído-Lanza, Ana F. & Chao, Maria T. & Flórez, Karen R., 2005. "Do healthy behaviors decline with greater acculturation?: Implications for the Latino mortality paradox," Social Science & Medicine, Elsevier, vol. 61(6), pages 1243-1255, September.
    8. Asanin, Jennifer & Wilson, Kathi, 2008. ""I spent nine years looking for a doctor": Exploring access to health care among immigrants in Mississauga, Ontario, Canada," Social Science & Medicine, Elsevier, vol. 66(6), pages 1271-1283, March.
    9. Viruell-Fuentes, Edna A., 2007. "Beyond acculturation: Immigration, discrimination, and health research among Mexicans in the United States," Social Science & Medicine, Elsevier, vol. 65(7), pages 1524-1535, October.
    10. Arcia, E. & Skinner, M. & Bailey, D. & Correa, V., 2001. "Models of acculturation and health behaviors among Latino immigrants to the US," Social Science & Medicine, Elsevier, vol. 53(1), pages 41-53, July.
    11. McDonald, James Ted & Kennedy, Steven, 2004. "Insights into the 'healthy immigrant effect': health status and health service use of immigrants to Canada," Social Science & Medicine, Elsevier, vol. 59(8), pages 1613-1627, October.
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    13. Yuriy Pylypchuk & Julie Hudson, 2009. "Immigrants and the use of preventive care in the United States," Health Economics, John Wiley & Sons, Ltd., vol. 18(7), pages 783-806.
    14. Parminder Raina & Vicki Torrance-Rynard & Micheline Wong & Christel Woodward, 2002. "Agreement between Self-Reported and Routinely Collected Health Care Utilisation Data among Seniors," Social and Economic Dimensions of an Aging Population Research Papers 81, McMaster University.
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    Cited by:

    1. R. S. Oropesa & Nancy S. Landale & Marianne M. Hillemeier, 2016. "Legal Status and Health Care: Mexican-Origin Children in California, 2001–2014," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 35(5), pages 651-684, October.
    2. Haining Wang & Zhiming Cheng & Russell Smyth, 2016. "Language, Health Outcomes and Health Inequality," Monash Economics Working Papers 43-16, Monash University, Department of Economics.
    3. Lum, Irene D. & Swartz, Rebecca H. & Kwan, Matthew Y.W., 2016. "Accessibility and use of primary healthcare for immigrants living in the Niagara Region," Social Science & Medicine, Elsevier, vol. 156(C), pages 73-79.


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