Abstract
Health IssueThis chapter investigates (1) the association between ethnicity and migration, as measured by length of residence in Canada, and two specific self-reported outcomes: (a) self-perceived health and (b) self-reports of chronic conditions; and (2) the extent to which these selected determinants provide an adequate portrait of the differential outcomes on Canadian women's self-perceived health and self-reports of chronic conditions. The 2000 Canadian Community Health Survey was used to assess these associations while controlling for selected determinants such as age, sex, family structure, highest level of education attained and household income.Key Findings• Recent immigrant women (2 years or less in Canada) are more likely to report poor health than Canadian-born women (OR = 0.48 CI: 0.30–0.77). Immigrant women who have been in Canada 10 years and over are more likely to report poor health than Canadian-born women (OR = 1.31 CI: 1.18–1.45).• Although immigrant women are less likely to report chronic conditions than Canadian-born women, this health advantage decreased over time in Canada (OR from 0.35 to 0.87 for 0–2 years to 10 years and above compared with Canadian born women).Data Gaps and Recommendations• Migration experience needs to be conceptualized according to the results of past studies and included as a social determinant of health above and beyond ethnicity and culture. It is expected that the upcoming longitudinal survey of immigrants will help enhance surveillance capacity in this area.• Variables need to be constructed to allow women and men to best identify themselves appropriately according to ethnic identity and number of years in the host country; some of the proposed categories used as a cultural group may simply refer to skin colour without capturing associated elements of culture, ethnicity and life experiences.
Highlights
Given the increasing diversity of Canadian society, ethnicity and migration experiences are both important issues to consider when examining the social determinants of women's health. [1,2,3,4,5,6,7] Immigrants represent a large and increasing segment of the Canadian population
According to the data from Canadian Community Health Survey (CCHS) (2000), 20% of women and men reported that they had been in Canada between 3 and 9 years, and 72% of women and men indicated 10 years or more of residence in Canada, leaving 8% of women and men who would be categorized as recent immigrants, that is, 0 to 2 years of residence in Canada since migration (Figure 1)
One limitation of our analysis is that the use of cross-sectional data makes it difficult to disentangle the direction of causality and limits the ability to exclude the potential for reverse causation.[8,10,11,12,13]
Summary
Given the increasing diversity of Canadian society, ethnicity and migration experiences are both important issues to consider when examining the social determinants of women's health. [1,2,3,4,5,6,7] Immigrants represent a large and increasing segment of the Canadian population. [1016] after 10 years of residence in Canada, the prevalence of a number of chronic conditions and longterm disability approaches the levels found in the Canadian-born population.[12,13] Explanations for this "healthy migrant effect" among recent immigrants may include selection bias and healthy behaviours, such as low rates of tobacco use, as well as spurious research findings due to methodological limitations.[1,2,14,15] comprehensive information that includes sex and gender differences in how migrants and ethnic groups experience health is still lacking. A number of studies have shown that it is timely to assess the health of women and men with respect to ethnicity and migration experiences, in order to contribute to the understanding of the complexity attached to these concepts.[10,13,14,15]
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