Immigrant Minority Groups Research Articles

Healthcare costs at the end-of-life among immigrant and non-immigrant groups in Manitoba, Canada

ObjectivesIt is known that healthcare costs tend to increase during the last year of life. Recognizing the importance of efficient resource distribution for end-of-life care, this study compares healthcare costs incurred for migrants and long-term Manitobans and identifies the factors that impact healthcare costs during the last year of life. MethodsThis retrospective matched-cohort study used 15 databases linked at the individual-level, including immigration records, medical claims, hospital abstracts, drug prescriptions, emergency department visits, home care, long-term care, vital statistics mortality, housing and employment/income assistance, for those who died between January 2005 and December 2022 in Manitoba. Conditional zero-inflated gamma hurdle (ZIG) and quantile regression models were used. ResultsThe average end-of-life healthcare costs for international migrants (2469) and Long-term Manitobans (2362) were CA$44,909 and CA$16,593, respectively. According to the adjusted ZIG model, international migrants had 17% higher costs. Among international migrants, Government Assisted and Blended Visa Office-Referred Refugees (GAR/BVOR) had 36% higher costs than Long-term Manitobans. Additionally, costs were higher for those without a partner (13%), receiving employment/income assistance (30%), having higher comorbidity (309% for 4+ comorbidities vs. 0 comorbidities), death at the hospital (171%), and long-term care (169%). Adjusted Quantile regression analyses revealed that only GAR/BVOR had higher costs across all levels of the cost distribution than long-term Manitobans. ConclusionIn the last year of life, international migrants incurred greater healthcare costs than non-immigrants. However, the differences with non-immigrants varied depending on international migrants’ characteristics.

Sustainable Development of Ethnic Minority Immigrants: A Comprehensive Review of Concepts, Challenges, and Strategies

This comprehensive review explores the sustainable development of ethnic minority immigrants, a topic of increasing global importance in the context of accelerating migration trends. The study employs a systematic literature review methodology, analyzing over 30 recent articles from diverse disciplines including sociology, ethnology, economics, and geography. It investigates the conceptual framework of sustainable development for minority immigrants, encompassing economic, social, and cultural dimensions. The paper examines current challenges faced by these communities, including economic hardships, social integration difficulties, and cultural conflicts. Furthermore, it identifies key influencing factors such as economic opportunities, social and cultural dynamics, policy environments, and natural settings. The research highlights the complex interplay of these factors and their mechanisms in shaping the sustainable development of minority immigrant groups. Based on this analysis, the study proposes multifaceted strategies to promote sustainable development, emphasizing the need for cultural and educational exchange, economic support policies, and social integration initiatives. This review contributes to the growing body of literature on minority immigration and provides valuable insights for policymakers and researchers alike, underlining the importance of a holistic approach to address this critical global issue.

"We are a Generation of Slaves. We Support the Protests But do not Take to the Streets": Why Older Immigrants From the Former Soviet Union are not Part of the Protests Against the Judicial Overhaul in Israel.

Beginning in 2023, Israel has been the site of extensive protests against a proposed judicial overhaul, drawing widespread participation. However, there is a notable absence of older individuals from minority groups, particularly older immigrants from the Former Soviet Union (FSU), within these protests. This study aims to explore the perspectives of this group on the judicial overhaul and to reveal the reasons behind their non-participation in the protests. The study involved semi-structured interviews with 20 older FSU immigrants (age 65+). Through thematic content analysis, two main themes emerged: the attitudes of FSU older immigrants towards the proposed judicial overhaul and the factors contributing to their non-involvement in the protests. Participants exhibited diverse opinions on the judicial overhaul, ranging from outright disapproval to ambivalence or indecision. The lack of participation in the protests was attributed to multiple factors, including (1) older age and age-related limitations, (2) unique historical experiences and characteristics of the FSU immigrant cohort, and (3) a lack of unified stance and organization within the FSU immigrant community. The study provides insights into the challenges and barriers faced by older individuals in FSU immigrant minority groups in engaging with political processes and decision-making. These findings are of significant importance to policymakers, researchers, and professionals working with immigrant communities. Understanding these dynamics can aid in developing more inclusive and representative political processes and support engaging mechanisms for older minority immigrants.

Attitudes and perceptions toward COVID-19 virus and vaccines among a Somali population in Northern Wisconsin.

The study's aim was to gain a qualitative understanding of vaccine beliefs and attitudes toward COVID-19 among Somali residents living in Northern Wisconsin (WI). While vaccination rates are significantly lower among Black and Hispanic populations, those with lower educational levels, and in rural areas, minimal is known about Somali population perspectives of COVID-19 vaccination rates. Through qualitative methodology employing focus groups for data collection and the inclusion of Somali interpreters, we explored Somali community viewpoints regarding these topics. Focus group interviews were transcribed verbatim with subsequent transcripts reviewed and analyzed by the research team to identify themes. The overarching theme was Protecting self, others, and community. Most participants accepted vaccinations, and the COVID-19 vaccine specifically, to protect themselves, others, and their community. Factors contributing to vaccine update included trusting local messengers, including public health nurses; valuing collective memory associated with previous communicable disease outbreaks; believing religion supported vaccine protective actions; and following recommended government and media advice. Study results suggest strategies for increasing community outreach to newly resettled refugee and immigrant minority groups, establishing trust between community members, nurses, and other public health personnel, and facilitators for connecting health messaging to Somali cultural and religious beliefs to promote public health and safety.

Postpartum contraception usage in immigrants compared with non-immigrants in Buffalo, NY

ObjectivesThe purpose of this study was to compare rates of postpartum contraception use in immigrant populations in Buffalo, NY compared with non-immigrant populations. The study also explores rates of specific birth control selection amongst those who did choose to employ postpartum contraception. Study designA retrospective chart review was conducted comparing the rate of postpartum contraceptive use in 132 immigrant individuals with that of 134 non-immigrant individuals, as measured by the documented intent or refusal to initiate any contraceptive method within the first three months postpartum. Patients were from clinics affiliated with the Women and Children’s Hospital of Buffalo (WCHOB) who delivered during the years 2015–2016. The immigrant patients were chosen from the top ten immigrant countries of origin who delivered at WCHOB at the time. ResultsAfter controlling for factors of maternal age, gestational age at time of delivery, and gravidity and parity, the immigrant group was more likely to decline postpartum contraception in the first three months postpartum compared with the non-immigrant group (25.8% vs 6.7%, p < 0.001). Immigrants were more likely to select a barrier method (p = 0.036) and decided to employ contraception more remotely from delivery when compared with non-immigrant individuals (p < 0.001). Amongst the immigrant cohort, there was no statistically significant difference in methods chosen based on broad geographic areas of origin. ConclusionsImmigrant obstetric populations in Buffalo are less likely to employ postpartum contraception compared with non-immigrant populations. The factors influencing this are multifactorial; however, this information can inform care for both immigrant and non-immigrant patients.

Common mental disorders in Peruvian immigrant in Chile: a comparison with the host population

BackgroundThe Inner Santiago Health Study (ISHS) aimed to (i) estimate the prevalence of common mental disorders (CMD; i.e. depressive and anxiety disorders) among immigrants of Peruvian origin in Chile; (ii) determine whether such immigrants are at higher risk of CMD when compared with the native-born geographically matched population (i.e. non-immigrants); and (iii) identify factors associated with higher risk of any CMD among this immigrant group. A secondary aim was to describe access to mental health services by Peruvian immigrants meeting criteria for any CMD.MethodsFindings are based on a population-based cross-sectional household mental health survey of 608 immigrant and 656 non-immigrant adults (18-64 years) residing in Santiago de Chile. Diagnoses of ICD-10 depressive and anxiety disorders and of any CMD were obtained using the Revised Clinical Interview Schedule. The relationships between demographic, economic, psychosocial, and migration-specific predictor variables, and risk of any CMD were analyzed with a series of stepwise multivariate logistic regression models.ResultsThe one-week prevalence of any CMD was 29.1% (95% CI: 25.2-33.1) among immigrants and 34.7% (95% CI: 30.7-38.7) among non-immigrants. Depending on the statistical model used in the pooled sample, we found the prevalence of any CMD among non-immigrants to be higher (OR=1.53; 95% CI: 1.05-2.25) or similar (OR=1.34; 95% CI: 0.94-19.2) when compared with immigrants. In the multivariate stepwise regression of any CMD in immigrants only, the prevalence was higher for females, those with primary compared to higher education, in debt and exposed to discrimination. Conversely, higher levels of functional social support, sense of comprehensibility, and manageability were associated with a lower risk of any CMD in immigrants. In addition, no differences were observed between immigrants and non-immigrants reporting any CMD in mental health service utilization.ConclusionOur results evidence high levels of current CMD in this immigrant group, particularly amongst women. However, lower adjusted prevalence of any CMD in immigrants compared to non-immigrants was limited to preliminary statistical models, thus failing to provide clear support for a “healthy immigrant effect”. The study sheds new light on differences in CMD prevalence by immigrant status in Latin America by examining differential exposure to risk factors in immigrant versus non-immigrant groups.

Risk of Subsequent Preeclampsia by Maternal Country of Birth: A Norwegian Population-Based Study

In this nationwide population-based study, we investigated the associations of preeclampsia in the first pregnancy with the risk of preeclampsia in the second pregnancy, by maternal country of birth using data from the Medical Birth Registry of Norway and Statistics Norway (1990-2016). The study population included 101,066 immigrant and 544,071 non-immigrant women. Maternal country of birth was categorized according to the seven super-regions of the Global Burden of Disease study (GBD). The associations between preeclampsia in the first pregnancy with preeclampsia in the second pregnancy were estimated using log-binomial regression models, using no preeclampsia in the first pregnancy as the reference. The associations were reported as adjusted risk ratios (RR) with 95% confidence intervals (CI), adjusted for chronic hypertension, year of first childbirth, and maternal age at first birth. Compared to those without preeclampsia in the first pregnancy, women with preeclampsia in the first pregnancy were associated with a considerably increased risk of preeclampsia in the second pregnancy in both immigrant (n = 250; 13.4% vs. 1.0%; adjusted RR 12.9 [95% CI: 11.2, 14.9]) and non-immigrant women (n = 2876; 14.6% vs. 1.5%; adjusted RR 9.5 [95% CI: 9.1, 10.0]). Immigrant women from Latin America and the Caribbean appeared to have the highest adjusted RR, followed by immigrant women from North Africa and the Middle East. A likelihood ratio test showed that the variation in adjusted RR across all immigrant and non-immigrant groups was statistically significant (p = 0.006). Our results suggest that the association between preeclampsia in the first pregnancy and preeclampsia in the second pregnancy might be increased in some groups of immigrant women compared with non-immigrant women in Norway.

Employment Probability of Visible Minority Immigrants in Canada by Generational Status, Circa 2016

Using 2016 Census data, we compare the odds of employment (full time or self-employment) for visible minority immigrants in Canada with those of non–visible minority immigrants. Intergenerational comparisons of employment outcomes are made because one would expect second- and third-generation immigrants to be less prone to labour market barriers than first-generation immigrants. Estimates based on a logistic regression of employment probability reveal lower employment odds for four out of 10 identified visible minority immigrant groups in comparison with non–visible minority immigrants for all three generations. For first- and second-generation immigrants, the results were mixed, but third-generation immigrants faced significantly lower employment probabilities in all groups of visible minorities with the exception of Chinese and Japanese. A lack of proficiency in official languages (English or French) lowers the employment probability for all groups. It is estimated that post-secondary education (PSE) acquired outside of Canada has a weaker positive association with employment than PSE acquired within Canada. Pre- and post-immigration labour market experience have a weak association with employment.

Stage-Specific Risk of Breast Cancer among Canadian Immigrant and Non-Immigrant Women.

Breast cancer screening utilization varies across immigrant and non-immigrant populations. Recent studies have also suggested that some immigrant populations in Canada present with a higher frequency of later-stage breast cancer compared to non-immigrants. Our study aimed to augment prior research by presenting breast cancer stage distributions and stage-specific breast cancer incidence rates for immigrant and non-immigrants in British Columbia, Canada. We utilized a population-based cohort of more than 1.3million women built from linked administrative health and immigration data sets. Age-standardized incidence rate ratios were generated to compare immigrant and non-immigrant groups. Poisson regression was used to assess the relative frequency of later stage diagnosis among immigrant groups compared to non-immigrants. Indian and Chinese immigrants both showed significantly lower stage I and stage II-IV incidence rates compared to non-immigrants. However, Indian immigrants showed a higher frequency of later stage tumours at diagnosis compared to non-immigrants, while in contrast Chinese immigrants showed a lower frequency of later stage tumours. Filipino immigrants showed similar stage-specific rates and stage at diagnosis compared to non-immigrants. Our findings highlight a need for continued surveillance of cancer among immigrant and non-immigrant populations and inquiry into reasons for differences in stage at diagnosis across groups.

Horizontalism and Wisdom Dialogues to Build Trust: A Case Study of Collaborations With Immigrant Farmers in Minnesota

Collaboration between farmers and other farm support professionals is a critical tool for food systems transformation. Collaborative research and outreach can address structural inequalities that limit the success of immigrant and minority growers and uplift farmer knowledge, which has been systemically valued below that of academic knowledge. Agroecologists who work at the synthesis of science, movement, and practice propose wisdom dialogues and horizontalism as principles by which to develop collaborations that avoid reinforcing structural inequalities due to race, gender, and traditions of valuing academic knowledge above that of farmers. Public entities, such as land grant universities and state agencies, have a particular responsibility to address structural inequalities and serve the diversity of farmers in their region. This study examines the use of collaborative learning processes, such as wisdom dialogues and horizontalism, by public and non-profit professionals in their collaborations with a group of immigrant farmers in the Upper Midwest. We used a qualitative interview approach with two farmers, two of their advisers, and eight of their collaborators at the University of Minnesota Extension, Department of Agriculture, and a local agricultural non-profit. Through the interviews we examined each of their perspectives on current and potential collaborations by discussing the motivations, resources, and effects for and of collaboration between immigrant farmers and farm support professionals. Farmer interviewees emphasized that collaborations between immigrant and non-immigrant individuals and groups must develop with non-exploitative motivations and preparation undertaken by non-immigrant individuals to better understand the experience of immigrant farmer prior to engaging in collaboration. Emergent themes from interviews with non-farmers included a strong commitment to providing access to knowledge and resources, and recognition that collaboration improved the ability to accomplish institutional goals, indicating use of wisdom dialogues and horizontal learning at varying levels within current work. Interviewees emphasized that institutional support was an important determinant for how much they could prioritize relationships and collaboration in their work. Based on interviewees' experiences, support and continued opportunities for learning are critical to facilitate continued use of wisdom dialogues and horizontalism to address different conceptions of equity and equality, and for developing intentional and mutually beneficial collaborations.

Citizens-in-waiting: strategic naturalization delays in the USA and UAE

ABSTRACT This article contributes to the study of conditional inclusion by examining the strategic postponement of naturalization cases in the UAE and USA. In both cases, the naturalization cases of specific minority immigrant groups are delayed (potentially indefinitely) by one branch of the federal government in the name of national security. Drawing upon ostensibly opposite cases, I identify delays as an important but largely overlooked strategy of boundary-policing found across regime-types. The pattern of delays reveals whose attempts to become one of “us” is met with greater obstacles. The prolonged questioning of the moral character of certain minorities makes their access to rights contingent upon their behaviour, rather than a statutorily enacted and secure right. Instead of being fully included or excluded, the targets of these deferrals are conditionally included in the host state – suspended in limbo without indication of whether they will receive citizenship or how long they must wait.

Depression and anxiety symptoms in Russian-speaking skilled immigrants living in Australia: A comparison with Anglo-Australians and Russian-speaking non-immigrants

Data and systematic research on Australia’s diverse immigrant population have been sparse. This study is the first empirical analysis of anxiety and depression symptoms in Russian-speaking skilled immigrants living in Australia. We compared levels of depression and anxiety symptoms in Russian-speaking skilled immigrants to Australia, Russian-speaking non-immigrants residing in one of the countries of the Former Soviet Union (FSU) and Anglo-Australians. 65 Russian-speaking immigrants from the FSU, 65 Russian-speaking non-immigrants residing in Russia, Ukraine, or Belarus, and 63 Anglo-Australians were recruited through social clubs, community web forums, churches, schools and universities. Participants completed online versions of the Centre for Epidemiologic Studies Depression Scale, the State-Trait Anxiety Inventory, the Interpersonal Support Evaluation List, the Perceived Stress Scale and socio-demographic questionnaires. Results indicated that levels of anxiety and depression were higher in Anglo-Australians compared to the Russian-speaking immigrant and the Russian-speaking non-immigrant groups after controlling for age, gender, relationship status, highest educational level, employment and health status. The outcomes of this study provide valuable insight into the mental health status of this under investigated group and can serve as the first step towards culturally informed mental health service delivery. Future research should address the limitations of the current study such as employing better sampling methods and using more culturally relevant scales to measure depression and anxiety.

Inequity in location and quality of death of advanced cancer patients by immigrant status.

12036 Background: Most cancer patients prefer to die at home, a location associated with better quality of death (QoD) and caregiver outcomes. A number of studies demonstrate disparities in end-of-life (EoL) care among immigrant vs non-immigrant populations in the U.S. This study aims to evaluate how immigrant status affects location and QoD among patients with advanced cancer in the U.S. Methods: Data were derived from Coping with Cancer, a federally funded multi-site prospective study of advanced cancer patients and caregivers. The analytic sample of patients who died during the study observation period was weighted (Nw=308) to reduce statistically significant sociodemographic differences between immigrant (Nw=49) and non-immigrant (Nw=259) groups. Immigrant status was determined by patient self-report. Primary outcomes were location of death (intensive care unit, hospital, nursing home, inpatient hospice, home), death at preferred location (yes/no, as per caregiver report in post-mortem interview), and poor QoD (composite score of post-mortem caregiver ratings for patient psychological distress, physical distress, and quality of life in the last week of life). Results: As compared to non-immigrants, immigrants were more likely to die in a hospital as opposed to home [AOR 3.33; 95% CI (1.65-6.71); p=0.001] and less likely to die where they preferred [AOR 0.42, 95% CI (0.20-0.90); p=0.026]. As shown in Table, values-inconsistent aggressive EoL care mediated the effect of immigrant status on death at the patient s preferred location. Further, immigrants were more likely to have poor QoD [AOR 5.47; 95% CI (2.70-11.08); p&lt;0.001]. In particular, among patients who preferred symptom-directed, comfort EoL care, immigrants as opposed to non-immigrants were more likely to have poor QoD [AOR 9.53, 95%CI (4.05-22.40); p&lt;0.001]. Conclusions: Immigrants, as compared to non-immigrants, are more likely to die in hospital settings, less likely to die at their preferred location, and more likely to have poor QoD. These findings are consistent with previously described inequities in EoL care of immigrants and highlight the importance of determining the potential causes and solutions to ensure immigrants receive values-congruent care.[Table: see text]

Everybody needs somebody: Specificity and commonality in perceived social support trajectories of immigrant and non‐immigrant youth

Perceived social support can help immigrant youth to deal with developmental acculturation: the simultaneous resolution of developmental and acculturative tasks. This person-oriented three-wave comparative study investigated perceived social support trajectories in two immigrant and one non-immigrant group. We investigated whether similar social support trajectory classes can be found across groups, whether developmental and/or acculturation-related processes predict class membership, and whether social support trajectory classes associate with changes in self-efficacy. The sample comprised 1326 ethnic German immigrant and 830 non-immigrant adolescents in Germany, and 1593 Russian Jewish adolescents in Israel (N = 3749; Mage = 15.45; SD = 2.01; 50% female). Results revealed two social support trajectory classes across all and within each group: a stable well-supported class and a low but increasingly-supported class. Respective to the increasingly-supported class, membership in the well-supported class was associated with commonality in developmental predictors (female gender, high involvement with family and peers) in all groups and specificity in acculturation-related predictors (higher heritage and host culture orientation) in immigrant groups. Patterns of self-efficacy over time matched social support trajectories of both classes in all groups. Findings indicate that stakeholders looking to support immigrant adolescents should be aware of the nuanced coaction of development and migration.

Comparison of syphilis seropositivity between non-immigrant and immigrant populations in the Anatolian side of Istanbul, Turkiye: Results of five-years retrospective study.

Our study aimed to evaluate the seropositivity for syphilis in non- immigrant and immigrant populations and compare the results regarding demographic data. In accordance with the reverse algorithm, syphilis tests were performed between May 2014 and December 2018 in hospitals in our service zone for syphilis screening or symptomatic disease. A total of 135.328 non- immigrant and 6.641 immigrant were screened for syphilis. Seropositivity rates were 1.3% in the non- immigrant and 3.8% in immigrant groups (p=0.0001). There was a statistically significant difference in terms of seropositivity rates between the various age groups in the local group and immigrant groups (except 18 25 age group) (p<0.05). Syphilis seropositivity rates were found to be lower in indigenous population than immigrant groups according to the years tested (p=0.0001). The seropositivity rates were 2.4% and 3.2% among the males (p=0.025) and 0.6% and 4.0% among females (p=0.0001) in non-immigrantand immigrant groups, respectively. Whereas, 0.6% of pregnant women in the local group and 3.7% of pregnant women in immigrant groups were seropositive for syphilis (p=0.0001). Among the HIV positive group, syphilis seropositivity was only observed in the non-immigrant group with a rate of 23.0% (p=0.0001). The antibodies against syphilis were found more frequently in immigrants than non-immigrant. Among the HIV positive individuals syphilis seropositivity was only observed in the non-immigrant group.

Clearing the Smoke Screen: Smoking, Alcohol Consumption, and Stress Management Techniques among Canadian Long-Term Care Workers.

Background: Currently, there is abundant research indicating that smoking and alcohol consumption have significant impacts on morbidity and mortality, though little is known about these behaviors among Canadian health care workers. The objective of this study was to examine health and coping behaviors, such as smoking and alcohol consumption as well as stress management techniques, among health care workers consisting of gendered, racialized, and immigrant employees. Methods: Drawing on a single-case, mixed-methods study in Ontario, Canada, this paper presents under-researched data about smoking practices, alcohol consumption, and stress management techniques among health care workers in labor-intensive, high-stress, high-turnover environments. In particular, it identifies the various mechanisms for maintaining health and well-being. Results: The findings suggest that 7.7% of survey respondents reported smoking while 43.4% reported alcohol consumption, which were reported more frequently among immigrants than among non-immigrants. Participants also reported health-promoting activities in face-to-face interviews, such as mindful breathing techniques and drawing upon social support, while a few respondents reported alcohol consumption to specifically cope with sleep disturbances and job stress. Conclusions: Although smoking and alcohol consumption were both connected with coping strategies and leisure, they were predominant in immigrant groups compared to non-immigrant groups.

Visualising Immigrant Fertility -- Profiles of Childbearing and their Implications for Migration Research

Different measures of fertility have strengths and limitations when used to describe the fertility of immigrants, and no single measure captures every aspect of this complex phenomenon. This paper introduces a novel visual framework that shows life course profiles of immigrant childbearing in a multifaceted way. It develops the well-known cohort fertility curve—showing the average number of children ever born over the life course—and adds lines for immigrant women arriving at different ages, using their average number of children born on arrival as a starting point. These immigrant fertility profiles can illustrate a number of important aspects of childbearing simultaneously, including children born before arrival, fertility after arrival and completed fertility at the end of childbearing. In addition to showing numbers of children born (i.e. fertility quantum), the slopes of each profile indicate the tempo of fertility and how this changes by age and duration of residence. The fertility profiles of different immigrant groups can be plotted in the same graph, and can be compared and contrasted with non-immigrant groups—at origin as well as destination—through the augmentation of each visualisation. Using Nordic register data, we illustrate how these fertility profiles can be used to expand our knowledge of immigrant childbearing and to investigate various hypotheses of migrant fertility, giving a novel overview of the relationships between fertility measures such as period and quantum, before and after arrival.

Nutrition Factors Are Associated with Post-Traumatic Stress Disorder in Immigrant and Canadian-Born Adults: Findings from the Canadian Longitudinal Study on Aging

Abstract Objectives To examine associations between post-traumatic stress disorder (PTSD) and nutrition factors among Canadian-born and immigrant adults. Methods The sample included participants of the Canadian Longitudinal Study on Aging (CLSA) (n = 27,211; 45–85 years) categorized by ethnicity (native white, native minority, immigrant white, and immigrant minority). PTSD was measured using the Primary Care PTSD tool. Nutrition factors included nutrition status indicators (anthropometrics, body fat %, handgrip strength, nutrition risk, sarcopenia, bone mineral density, and iron deficiency anemia) and dietary intakes (fiber, pulses and nuts, fat, omega-3 fatty acids, fruits and vegetables, fruit juice, calcium/vitamin D, salty snacks, pastries, and chocolate bars). Covariates included socioeconomic and health-related variables. Binary logistic regression analysis was conducted. Results Compared to white Canadians born in Canada, immigrant minority groups had a higher likelihood of PTSD (OR = 1.47, 95% CI 1.14–1.90, P &amp;lt; 0.001). Nutrition factors associated with PTSD included high nutrition risk (OR = 1.60, CI 1.41–1.80, P &amp;lt; 0.001), intakes of pulses and nuts (≥ one source; ORs 1.50–1.16, P's-&amp;lt; 0.05), pastries or chocolate (≥ 2/3 of a standard bar) (ORs = 1.35–1.37, P's &amp;lt; 0.05), and fiber (2–3 sources daily; OR = 0.83, CI 0.69–1.00, P &amp;lt; 0.05), as well as high waist-to-height ratio (OR = 0.91, CI 0.69–0.97, P &amp;lt; 0.05). Other factors included income (&amp;lt;C$100,000/yr; ORs 1.39–2.58, P's &amp;lt; 0.001), being widowed, divorced, or separated (OR = 1.35, CI 1.10–1.65, P &amp;lt; 0.05), having multiple chronic conditions (ORs = 1.76–3.34, P's &amp;lt; 0.001), experiencing chronic pain (OR = 1.64, P &amp;lt; 0.001), and smoking (OR = 1.22, P &amp;lt; 0.001). Conclusions Many nutrition-related factors contribute to PTSD in mid-age and older adults suggesting that targeted nutrition interventions within comprehensive programming will likely help prevent or manage PTSD. Funding Sources MITACS and Fulbright Canada.

Trust in the Israeli Healthcare System Among Arabs, Jewish Immigrants, and Non-immigrants.

Previous studies have shown that minorities and immigrants have low levels of trust in healthcare systems (HCSys), which might present a barrier in access to and utilization of healthcare services. We compared the levels of trust in Israel's HCSys among the Arab minority, immigrant Jews, and non-immigrant Jew sand draw on the integrative model of organizational trust to explore factors that can explain differences in the trust level within and between the study groups. We obtained cross-sectional census data from the 2017 Social Survey of the Israel Central Bureau of Statistics. We studied levels of trust based on a survey question: "Do you have trust in the HCSys?" We used logistic regression models to compare levels of trust in HCSys among the study groups, adjusting for components of the integrative model: characteristics (sex, age, education, religiosity, and healthcare service use), abilities (private health insurance ownership), integrity (discrimination, trusting the justice system and government), and perceived risk (self-reported health). Our findings revealed that Arabs (odds ratio (OR) = 4.20, 95% confidence intervals (CI) = 4.17, 4.23) and immigrant Jews (OR = 2.54, 95% CI = 2.51, 2.58) had more trust in the HCSys compared to non-immigrant Jews, even after adjusting for all the component variables. Different components of the integrative model explained trust in each population group. Minority and immigrant groups had greater trust in the HCSys compared to the non-immigrant group. These findings may indicate different expectations with respect to patient-caregiver relations and HCSys utilization and raise questions regarding access to HCS and quality of care among minority and immigrant groups.

Depression risk and body mass index among immigrants and non-immigrants in Canada: results from the Canadian Community Health Surveys, 2010-2014.

Obesity has been associated with an increased risk of the depression in the general population, but it is unknown whether this relationship applies equally to immigrants as well as non-immigrants. Furthermore, the nature of the relationship is uncertain, is it direct or curvilinear? The aim of this study is to examine the relationship between body mass index and major depressive episode among immigrants and non-immigrants. To provide more statistically robust data, a series of cross-sectional health surveys of the Canadian population for the 5 years 2010-2014 were pooled to increase the number of immigrants in the study. Restricted cubic splines analysis was used to examine the nature of the association. Immigrants had lower 12-month depression and obesity prevalence rates than non-immigrants. In addition, it was found that non-immigrants were more likely to develop depression than immigrants, OR = 1.40 (95% CI, 1.16-1.67). Obese respondents were more likely to develop depression than normal weight respondents in both immigrant (OR = 1.55; 95% CI, 1.03-2.32) and non-immigrant groups (OR = 1.23; 95% CI, 1.15-1.32). A significant nonlinear elongated J-shaped association between obesity and depression was found for both immigrants and non-immigrants with increased risk of depression in obese individuals. Culture-specific, clinical-based interventions should be developed to improve the early identification, treatment and recovery of individuals with a high BMI particularly among those with BMIs in the obese range.