IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v98y2013icp8-17.html
   My bibliography  Save this article

Immigrant health, place effect and regional disparities in Canada

Author

Listed:
  • Wang, Lu
  • Hu, Wei

Abstract

The paper addresses a critically important area in Canadian immigration and health from both a social and a spatial perspective. It employs multilevel and contextual approaches to examine the social determinants of immigrant health as well as the place effects on self-reported health at a regional and neighborhood scale. The data come from the raw microdata file of the 2005–10 Canadian Community Health Survey (a random national health survey) and the publicly available Canadian Marginalization index based on the 2006 Census. Three populations are compared: Canadian-born, overall foreign-born, and Chinese immigrants. The results suggest various degrees of association between self-reported health, individual and lifestyle behavioral characteristics, and neighborhood material deprivation and ethnic concentration in census tracts. These factors contribute differently to the reported health of Chinese immigrants, Canada's largest recent immigrant group. A healthy immigrant effect is partially evident in the overall foreign-born population, but appears to be relatively weak in Chinese immigrants. For all groups, neighborhood deprivation moderately increases the likelihood of reporting poor health. Ethnic concentration negatively affects self-rated health, with the exception of the slight protective effect of Chinese-specific ethnic density in census tracts. The multilevel models reveal significant area inequalities across Census Metropolitan Areas/Census Agglomerations in risk of reporting unhealthy status, with greater magnitude in the foreign-born population. The vast regional variations in health among Chinese immigrants should be interpreted carefully due to the group's heavy concentration in large cities. The study contributes to the literature on ethnicity and health by systematically incorporating neighborhood contextual effects in modeling the social determinants of immigrant health status. It fills a gap in the literature on neighborhoods and health by focusing on ethnically disparate groups rather than on the general population. By revealing regional disparities in health, the paper adds a spatial perspective to the work on immigrant health.

Suggested Citation

  • Wang, Lu & Hu, Wei, 2013. "Immigrant health, place effect and regional disparities in Canada," Social Science & Medicine, Elsevier, vol. 98(C), pages 8-17.
  • Handle: RePEc:eee:socmed:v:98:y:2013:i:c:p:8-17
    DOI: 10.1016/j.socscimed.2013.08.040
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953613005054
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.socscimed.2013.08.040?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Langford, Ian H. & Bentham, Graham, 1996. "Regional variations in mortality rates in England and Wales: An analysis using multi-level modelling," Social Science & Medicine, Elsevier, vol. 42(6), pages 897-908, March.
    2. Curtis, Sarah & Setia, Maninder S. & Quesnel-Vallee, Amelie, 2009. "Socio-geographic mobility and health status: A longitudinal analysis using the National Population Health Survey of Canada," Social Science & Medicine, Elsevier, vol. 69(12), pages 1845-1853, December.
    3. Dunn, James R. & Dyck, Isabel, 2000. "Social determinants of health in Canada's immigrant population: results from the National Population Health Survey," Social Science & Medicine, Elsevier, vol. 51(11), pages 1573-1593, December.
    4. A S Fotheringham & D W S Wong, 1991. "The Modifiable Areal Unit Problem in Multivariate Statistical Analysis," Environment and Planning A, , vol. 23(7), pages 1025-1044, July.
    5. McDonald, James Ted & Kennedy, Steven, 2005. "Is migration to Canada associated with unhealthy weight gain? Overweight and obesity among Canada's immigrants," Social Science & Medicine, Elsevier, vol. 61(12), pages 2469-2481, December.
    6. Zhang, Jinjin & Verhoef, Marja J., 2002. "Illness management strategies among Chinese immigrants living with arthritis," Social Science & Medicine, Elsevier, vol. 55(10), pages 1795-1802, November.
    7. Duncan, Craig & Jones, Kelvyn & Moon, Graham, 1998. "Context, composition and heterogeneity: Using multilevel models in health research," Social Science & Medicine, Elsevier, vol. 46(1), pages 97-117, January.
    8. Wang, Lu & Rosenberg, Mark & Lo, Lucia, 2008. "Ethnicity and utilization of family physicians: A case study of Mainland Chinese immigrants in Toronto, Canada," Social Science & Medicine, Elsevier, vol. 67(9), pages 1410-1422, November.
    9. Hou, Feng & Picot, Garnett, 2003. "The Rise in Low-income Rates Among Immigrants in Canada," Analytical Studies Branch Research Paper Series 2003198e, Statistics Canada, Analytical Studies Branch.
    10. Bruce Newbold, K. & Danforth, Jeff, 2003. "Health status and Canada's immigrant population," Social Science & Medicine, Elsevier, vol. 57(10), pages 1981-1995, November.
    11. Nicholas Biddle & Steven Kennedy & James Ted Mcdonald, 2007. "Health Assimilation Patterns Amongst Australian Immigrants," The Economic Record, The Economic Society of Australia, vol. 83(260), pages 16-30, March.
    12. Eschbach, K. & Stimpson, J.P. & Kuo, Y.-F. & Goodwin, J.S., 2007. "Mortality of foreign-born and US-born Hispanic adults at younger ages: A reexamination of recent patterns," American Journal of Public Health, American Public Health Association, vol. 97(7), pages 1297-1304.
    13. Peter Kitchen & Allison Williams & James Chowhan, 2012. "Sense of Community Belonging and Health in Canada: A Regional Analysis," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 107(1), pages 103-126, May.
    14. Matheson, Flora I. & Moineddin, Rahim & Glazier, Richard H., 2008. "The weight of place: A multilevel analysis of gender, neighborhood material deprivation, and body mass index among Canadian adults," Social Science & Medicine, Elsevier, vol. 66(3), pages 675-690, February.
    15. Karlsen, Saffron & Nazroo, James Y. & Stephenson, Rob, 2002. "Ethnicity, environment and health: putting ethnic inequalities in health in their place," Social Science & Medicine, Elsevier, vol. 55(9), pages 1647-1661, November.
    16. Heide Glaesmer & Ulla Wittig & Elmar Braehler & Alexandra Martin & Ricarda Mewes & Winfried Rief, 2011. "Health care utilization among first and second generation immigrants and native-born Germans: a population-based study in Germany," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 56(5), pages 541-548, October.
    17. Laurence S. Moss, 2003. "Editor's Introduction," American Journal of Economics and Sociology, Wiley Blackwell, vol. 62(2), pages 315-318, April.
    18. Ross, N.A. & Tremblay, S. & Khan, S. & Crouse, D. & Tremblay, M. & Berthelot, J.-M., 2007. "Body mass index in urban Canada: Neighborhood and metropolitan area effects," American Journal of Public Health, American Public Health Association, vol. 97(3), pages 500-508.
    19. Editors, 2003. "Editor's Introduction," American Journal of Economics and Sociology, Wiley Blackwell, vol. 62(4), pages 645-648, October.
    20. Hou, Feng & Myles, John, 2005. "Neighbourhood inequality, neighbourhood affluence and population health," Social Science & Medicine, Elsevier, vol. 60(7), pages 1557-1569, April.
    21. Bruce Newbold, K., 2005. "Self-rated health within the Canadian immigrant population: risk and the healthy immigrant effect," Social Science & Medicine, Elsevier, vol. 60(6), pages 1359-1370, March.
    22. Diez Roux, A.V., 2001. "Investigating neighborhood and area effects on health," American Journal of Public Health, American Public Health Association, vol. 91(11), pages 1783-1789.
    23. Kim, Daniel & Baum, Christopher F. & Ganz, Michael L. & Subramanian, S.V. & Kawachi, Ichiro, 2011. "The contextual effects of social capital on health: A cross-national instrumental variable analysis," Social Science & Medicine, Elsevier, vol. 73(12), pages 1689-1697.
    24. Zsembik, Barbara A. & Fennell, Dana, 2005. "Ethnic variation in health and the determinants of health among Latinos," Social Science & Medicine, Elsevier, vol. 61(1), pages 53-63, July.
    25. Cummins, Steven & Curtis, Sarah & Diez-Roux, Ana V. & Macintyre, Sally, 2007. "Understanding and representing 'place' in health research: A relational approach," Social Science & Medicine, Elsevier, vol. 65(9), pages 1825-1838, November.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Frank Trovato, 2020. "The Immigrant Mortality Advantage in Canada, 2001 and 2011," Journal of International Migration and Integration, Springer, vol. 21(2), pages 351-379, June.
    2. Eric Vaz & Richard Ross Shaker & Michael D. Cusimano & Luis Loures & Jamal Jokar Arsanjani, 2020. "Does Land Use and Landscape Contribute to Self-Harm? A Sustainability Cities Framework," Data, MDPI, vol. 5(1), pages 1-18, January.
    3. Scott Daniel Emerson & Anita Minh & Martin Guhn, 2018. "Ethnic density of regions and psychiatric disorders among ethnic minority individuals," International Journal of Social Psychiatry, , vol. 64(2), pages 130-144, March.
    4. Yao Yi & Yu Liao & Lingling Zheng & Mengjie Li & Jing Gu & Chun Hao & Yuantao Hao, 2019. "Health Selectivity and Rural-Urban Migration in China: A Nationwide Multiple Cross-Sectional Study in 2012, 2014, 2016," IJERPH, MDPI, vol. 16(9), pages 1-14, May.
    5. Choon-Lee Chai, 2022. "Picturing Settlement Experiences: Immigrant Women’s Senses of Comfortable and Uncomfortable Places in a Small Urban Center in Canada," Journal of International Migration and Integration, Springer, vol. 23(3), pages 1567-1598, September.
    6. Manka Nkimbeng & Alvine Akumbom & Marianne Granbom & Sarah L. Szanton & Tetyana P. Shippee & Roland J. Thorpe & Joseph E. Gaugler, 2022. "Where to Retire? Experiences of Older African Immigrants in the United States," IJERPH, MDPI, vol. 19(3), pages 1-17, January.
    7. Ljunge, Martin, 2016. "Migrants, health, and happiness: Evidence that health assessments travel with migrants and predict well-being," Economics & Human Biology, Elsevier, vol. 22(C), pages 35-46.
    8. 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.
    9. Wang, Lu & Kwak, Min-Jung, 2015. "Immigration, barriers to healthcare and transnational ties: A case study of South Korean immigrants in Toronto, Canada," Social Science & Medicine, Elsevier, vol. 133(C), pages 340-348.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Wang, Lu & Rosenberg, Mark & Lo, Lucia, 2008. "Ethnicity and utilization of family physicians: A case study of Mainland Chinese immigrants in Toronto, Canada," Social Science & Medicine, Elsevier, vol. 67(9), pages 1410-1422, November.
    2. Santosh Jatrana & Ken Richardson & Samba Siva Rao Pasupuleti, 2018. "Investigating the Dynamics of Migration and Health in Australia: A Longitudinal Study," European Journal of Population, Springer;European Association for Population Studies, vol. 34(4), pages 519-565, October.
    3. Bécares, Laia & Nazroo, James & Albor, Christo & Chandola, Tarani & Stafford, Mai, 2012. "Examining the differential association between self-rated health and area deprivation among white British and ethnic minority people in England," Social Science & Medicine, Elsevier, vol. 74(4), pages 616-624.
    4. James Ted McDonald, 2005. "The Health Behaviors of Immigrants and Native-born People in Canada," Social and Economic Dimensions of an Aging Population Research Papers 144, McMaster University.
    5. Dean, Jennifer Asanin & Wilson, Kathi, 2010. ""My health has improved because I always have everything I need here...": A qualitative exploration of health improvement and decline among immigrants," Social Science & Medicine, Elsevier, vol. 70(8), pages 1219-1228, April.
    6. Wang, Lu & Kwak, Min-Jung, 2015. "Immigration, barriers to healthcare and transnational ties: A case study of South Korean immigrants in Toronto, Canada," Social Science & Medicine, Elsevier, vol. 133(C), pages 340-348.
    7. Hamilton, Tod G. & Kawachi, Ichiro, 2013. "Changes in income inequality and the health of immigrants," Social Science & Medicine, Elsevier, vol. 80(C), pages 57-66.
    8. Shahin Shooshtari & Carol Harvey & Evelyn Ferguson & Tuula Heinonen & Syeed Khan, 2014. "Effects of Remittance Behavior on the Lives of Recent Immigrants to Canada from the Philippines: A Population-Based Longitudinal Study," Journal of Family and Economic Issues, Springer, vol. 35(1), pages 95-105, March.
    9. Amoyaw, Jonathan Anim & Abada, Teresa, 2016. "Does helping them benefit me? Examining the emotional cost and benefit of immigrants' pecuniary remittance behaviour in Canada," Social Science & Medicine, Elsevier, vol. 153(C), pages 182-192.
    10. Wen, Ming & Hawkley, Louise C. & Cacioppo, John T., 2006. "Objective and perceived neighborhood environment, individual SES and psychosocial factors, and self-rated health: An analysis of older adults in Cook County, Illinois," Social Science & Medicine, Elsevier, vol. 63(10), pages 2575-2590, November.
    11. Monika Sander, 2008. "Changes in Immigrants' Body Mass Index with Their Duration of Residence in Germany," SOEPpapers on Multidisciplinary Panel Data Research 122, DIW Berlin, The German Socio-Economic Panel (SOEP).
    12. Ade Kearns & Elise Whitley & Matt Egan & Catherine Tabbner & Carol Tannahill, 2017. "Healthy Migrants in an Unhealthy City? The Effects of Time on the Health of Migrants Living in Deprived Areas of Glasgow," Journal of International Migration and Integration, Springer, vol. 18(3), pages 675-698, August.
    13. Alexandre Lebel & Yan Kestens & Christelle Clary & Sherri Bisset & S V Subramanian, 2014. "Geographic Variability in the Association between Socioeconomic Status and BMI in the USA and Canada," PLOS ONE, Public Library of Science, vol. 9(6), pages 1-11, June.
    14. Rivera, Berta & Casal, Bruno & Currais, Luis, 2013. "Healthy Immigrant Effect: Trayectoria de salud de la población inmigrante a partir de la ENSE 2011-2012/Healthy Immigrant Effect: An Empirical Approach to the Health Trajectory of Immigrant Population," Estudios de Economia Aplicada, Estudios de Economia Aplicada, vol. 31, pages 339-358, Septiembr.
    15. Flowerdew, Robin & Manley, David J. & Sabel, Clive E., 2008. "Neighbourhood effects on health: Does it matter where you draw the boundaries?," Social Science & Medicine, Elsevier, vol. 66(6), pages 1241-1255, March.
    16. Ana Maria Osorio & Catalina Bolancé & Nyovani Madise, 2012. "Intermediary and structural determinants of early childhood health in Colombia: exploring the role of communities," Working Papers XREAP2012-13, Xarxa de Referència en Economia Aplicada (XREAP), revised Jun 2012.
    17. Weden, Margaret M. & Carpiano, Richard M. & Robert, Stephanie A., 2008. "Subjective and objective neighborhood characteristics and adult health," Social Science & Medicine, Elsevier, vol. 66(6), pages 1256-1270, March.
    18. Acevedo-Garcia, Dolores & Bates, Lisa M. & Osypuk, Theresa L. & McArdle, Nancy, 2010. "The effect of immigrant generation and duration on self-rated health among US adults 2003-2007," Social Science & Medicine, Elsevier, vol. 71(6), pages 1161-1172, September.
    19. Thompson, Tess & Rodebaugh, Thomas L. & Pérez, Maria & Struthers, James & Sefko, Julianne A. & Lian, Min & Schootman, Mario & Jeffe, Donna B., 2016. "Influence of neighborhood-level factors on social support in early-stage breast cancer patients and controls," Social Science & Medicine, Elsevier, vol. 156(C), pages 55-63.
    20. Eric Vaz & Richard Ross Shaker & Michael D. Cusimano & Luis Loures & Jamal Jokar Arsanjani, 2020. "Does Land Use and Landscape Contribute to Self-Harm? A Sustainability Cities Framework," Data, MDPI, vol. 5(1), pages 1-18, January.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:98:y:2013:i:c:p:8-17. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.