Immigrant health, place effect and regional disparities in Canada
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.
Volume (Year): 98 (2013)
Issue (Month): C ()
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- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- Bruce Newbold, K. & Danforth, Jeff, 2003. "Health status and Canada's immigrant population," Social Science & Medicine, Elsevier, vol. 57(10), pages 1981-1995, November.
- 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.
- 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.
- 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.
- 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.
- Editors, 2003. "Editor's Introduction," American Journal of Economics and Sociology, Wiley Blackwell, vol. 62(2), pages 315-318, April.
- Editors, 2003. "Editor's Introduction," American Journal of Economics and Sociology, Wiley Blackwell, vol. 62(4), pages 645-648, October.
- Hou, Feng & Myles, John, 2005. "Neighbourhood inequality, neighbourhood affluence and population health," Social Science & Medicine, Elsevier, vol. 60(7), pages 1557-1569, April.
- 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.
- 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.
- Daniel Kim & Christopher F Baum & Michael Ganz & S.V. Subramanian & Ichiro Kawachi, 2011. "The contextual effects of social capital on health: a cross-national instrumental variable analysis," Boston College Working Papers in Economics 786, Boston College Department of Economics.
- A S Fotheringham & D W S Wong, 1991. "The modifiable areal unit problem in multivariate statistical analysis," Environment and Planning A, Pion Ltd, London, vol. 23(7), pages 1025-1044, July.
- 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.
- 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)