Immigrant Health and Adaptation in Canada:

Adults vs. Adolescents

Kyunghwa Kwak & Floyd RudminWellbeing & Public Policy Conference; Hamilton, NY, June 12, 2014

Traditional Views on Immigrant Health

Immigrant Experiences

Acculturation Difficulties & Stress

Maladaptation & Health Problems

Some Limitations with Immigrant Studiesthe small sample size the data collection from the areas where immigrant

populations are concentratedconfounding effects (e.g., visible minority status,

socioeconomic status, family affluence)

a large nationally representative data set which had been collected across all regions of the society

avoiding the possibility of yielding skewed outcomes

New Directions in Empirical Findings

Health Outcome

Immigrant Paradox

Healthy Immigrant Effect

Epidemiological Paradox

Definition: Healthy Immigrant Effect

Healthy Immigrant Effect (De Maio, 2010):

(1) an initial advantage in new immigrants’ health conditions in comparison to the native-born population

(2) loss of this advantage and deterioration in health status over time (2 to 10 years)

The health transitions of immigrants

>> explain the social patterning and provide the ground for policy implications of the social determinants of health

Framework of the Study

National Population Data in Canada

Adults

Immigrants >

Non-Immigrants?

Adolescents

Immigrants >

Non-Immigrants?

Subjective Well-being

(Health & Adaptation)

Data SourceCanadian Community Health Survey

(CCHS 2007: aged 12 - 69)

PopulationParticipant Ns

Immigrants Non-Immigrants

Adults(20-69 years)

N = 3676 N = 92,982

Adolescents(12-19 years) N = 920 N = 13,572

Sampling Participants (Statistics Canada)

Who: individuals from regional health units and from lists of household telephone numbers with a target number proportional to the general population size of each region

How: voluntary; choice of language; 78% overall national response rate

Where: all provinces and territories When: January to December 2007

DemographicsAdults Adolescents

Age: RI (36) < NI (45 years old)

Demographic

Information

Age: RI (15.6) > NI (15.4)

Gender: RI ≈ NI (Female 53%) Gender: RI ≈ NI (Female 48%)

Visible Minority Status: RI (71%) > NI (9%)

Visible Minority Status: RI (71%) > NI (18%)

Household Income: NI > RI Household Income: NI > RI

Education: RI > NI Household Size: RI > NI

Age

Controlled

Covariates

Age

Gender Visible Minority Status

Visible Minority Status Household Income

Education Household Size

Household Income Presence of Parents / Interview

Measures:Self-PerceptionHealth:

General Health Mental Health Psychological Illnesses Chronic Illnesses with Somatic Symptoms

Adaptation: Life Satisfaction Daily Life Stress Sense of Belonging

Questions

Health Adaptation

In general, would you say your health is.....?

In general, would you say your mental health is.....?

asthma, migraine, back problems, ulcer, & bowel disorders

How satisfied are you with your life in general?

About the amount of stress in your life, would you say that most days are....?

How would you describe your sense of belonging to your local community?

Key Findings: Health

PopulationsHealth

General Health

Mental Health

Chronic-Somatic

Mood & Anxiety

Adult

Recent Immigrants RI > NI RI > NI

NI > RI NI > RINon-Immigrants

Adolescent

Recent Immigrants

RI > NIF ≈ M

RI > NIF ≈ M NI > RI

F > M NI > RIF ≈ M

Non-Immigrants

Key Findings: Adaptation

PopulationsAdaptation

Daily Stress Belonging Satisfaction

AdultRecent Immigrants RI ≈ NI

NI > RI NI > RINon-Immigrants

Adolescent

RecentImmigrants RI ≈ NI

F > M RI ≈ NIF > M

RI ≈ NI F ≈ M Non-Immigrants

Adults ComparisonImmigrants vs. Non-Immigrants

General HealthMental Health Daily StressLife Satisfaction Belonging1

1.5

2

2.5

R-Immi Non-Immi

Ass

essm

ent

Adolescents Comparison Immigrants vs. Non-Immigrants

General Health Mental Health Daily Stress Life Satisfaction Belonging1

1.5

2

2.5

R-Immi Non-Immi

Ass

essm

ent

Healthy Resilient Immigrants

Disadvantaged Adults: Yes [ R-Immigrants > Non-Immigrants ] Adolescents: Yes [ R-Immigrants > Non-Immigrants ]

Health Adults: Yes [ R-Immigrants > Non-Immigrants ] Adolescents: Yes [ R-Immigrants > Non-Immigrants ]

Adaptation Adults: NO [ R-Immigrants > Non-Immigrants ] Adolescents: Yes [ Immigrants ≈ Non-Immigrants ]

Conclusions

Healthy & Well-Adapted Immigrants

Sustainability of Immigrant Health

Differential Focuses

Adults: Quality of Life

Adolescents: Gender Specific Guidance

Characteristics of Social and Societal Support

Adults: HealthRecent Immigrants vs. Non-Immigrants

Rec-ImmiNon-Immi

1

1.5

2

2.5

Mental Health

General Health

Ass

essm

ent

Adults: AdaptationRecent Immigrants vs. Non-Immigrants

Rec-ImmiNon-Immi

1

1.5

2

2.5

Satisfaction

Belonging

Daily Stress

Ass

essm

ent

Adolescent HealthImmigrants vs. Non-Immigrants

ImmigrantNon-Immi

1

1.5

2

2.5

Mental Health

General Health

Ass

essm

ent

Adolescent AdaptationImmigrants vs. Non-Immigrants

ImmigrantNon-Immi

1

1.5

2

2.5

Satisfaction

Belonging

Daily StressAss

essm

ent

Adolescent Health No Gender Differences

General HealthMental Health

1

1.5

2

2.5I-Female

I-Male

N-Female

N-Male

Ass

essm

ent

Adolescents: Adaptation & Gender

Equally Good Adaptation

Immigrants ≈ Non-Immigrants

But

Girls – more Stress and Psychosomatization

Boys – weaker sense of Belonging

Daily StressGender Difference

Daily Stress2

2.5

3

F-Immi M-Immi F-Nonimmi M-Nonimmi

Ass

essm

ent

Psychosomatic SymptomsGender Differences

Psychosomatic Symptoms0

0.1

0.2

0.3

0.4

F-Immi M-Immi F-Nonimmi M-Nonimmi

Ass

essm

ent