Health and health service utilization among Canada’s immigrant population: A linkage follow-up study


Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

3090.0: Monday, December 12, 2005 - 10:50 AM

Abstract #107320

Sarah L. McDermott, MHSc¹, Marie DesMeules, MSc¹, Arminée Kazanjian, Dr Soc², Erich Kliewer, PhD³, Doug Manuel, MD, MSc⁴, Bilkis Vissandjée, PhD⁵, Elizabeth Ruddick⁶, and Yang Mao, PhD¹. (1) Surveillance and Risk Assessment Division, Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, 120 Colonnade Road, A.L. 6702A, Ottawa, ON K1A 0K9, Canada, (613) 941-8421, sarah_mcdermott@phac-aspc.gc.ca, (2) Health Care and Epidemiology, University of British Columbia, 5804 Fairview Avenue, Vancouver, BC V6T 1Z3, Canada, (3) Epidemiology and Cancer Registry, CancerCare Manitoba, 675 McDermot Avenue, Room ON-2114, Winnipeg, MB R3E 0V9, Canada, (4) Institute for Clinical Evaluative Sciences, G1 06, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada, (5) School of Nursing, Université de Montréal, succursale Centre-Ville, PO Box 6128, Montreal, QC H3C 3J7, Canada, (6) Strategic Research and Statistics, Citizenship and Immigration Canada, 365 Laurier Avenue West, 18th Floor, Ottawa, ON K1A 1L1, Canada

Canada's immigrant population comprises a diverse group, within which health disparities may exist. This study investigates health service utilization (HSU) of Canadian immigrants and their subgroups. Standardized rates of HSU between 1998-2000 were calculated using linked health and immigration data for immigrants in Quebec (QC), Ontario (ON) and British Columbia (BC) landing between 1985 – 2000 (n=2,713,676). Rates were compared, using rate ratios (RRs), to a matched comparison group. Overall, immigrants' HSU was lower than the comparison group, however differences across subgroups were observed. Immigrants granted refugee status in Canada used physician services more frequently than the comparison group (RR range 1.02 - 1.26, all significantly greater than 1, p<0.05). Visits for some diagnoses were higher among immigrants, including diabetes mellitus (DM) and hepatitis among women. Immigrant men granted refugee status in Canada had significantly greater rates of visits for DM than the comparison group (RR range 1.26 - 2.43, all significantly greater than 1, p<0.05). BC and ON immigrants made proportionately fewer visits to specialists than the comparison group. In ON, use of annual check-ups and immunizations (preventive services) was higher among immigrants than the comparison group (RR range 1.07 – 2.00, all significantly greater than 1, p<0.05). However, in BC, Pap smear use was lower among immigrant women than their comparison counterparts (RR 0.63 (95% CI 0.62 – 0.64)). This research method optimizes use of available surveillance data on immigrant health. Results provide a basis for development and evaluation of targeted policies and programs addressing the health needs of immigrants.

Learning Objectives:

At the conclusion of the session, the participants in this session will be able to

1. Describe a new population health surveillance method involving linkage of health service and immigration data.
2. Define the “healthy immigrant effect” and recognize discrepancies from this effect for certain immigrant subgroups where health service use is concerned (i.e. by immigration category, country of origin, length of residence in host country).
3. List specific diseases for which health service use is greater among the immigrant population or its subgroups.

Keywords: Immigrants, Health Care Utilization

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Identifying Health Risks that Impact Immigrants and Refugees

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA