Abstract

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Background
Keywords
Findings
Authors
Why is this study important?
What is already known on this subject?
What does this study add?

Background

Hospital records lack information about country of birth.  This study describes a method for calculating hospitalization rates by the percentage of foreign-born in Census Dissemination Areas (DAs).

Data and methods

Data from the 2006 Census were used to classify DAs by the percentage of the foreign-born population who lived in them.  Quintile and tercile thresholds were created to classify DAs as having low to high percentages of foreign-born residents.  This information was appended to the 2005/2006 Hospital Morbidity Database via postal codes.  Age-sex standardized hospitalization rates were calculated for low to high foreign-born concentration DAs, nationally and subnationally.

Results

Nationally, quintile thresholds had better discriminatory power to detect variations in hospitalization rates by foreign-born concentration, but tercile thresholds produced reliable results at subnational levels.  All-cause hospitalization rates were lowest among residents of the high foreign-born concentration terciles.  Similar gradients emerged in hospitalization rates for heart disease, diseases of the circulatory system, and mental health conditions.  The pattern varied more at the subnational level.

Interpretation

With this approach, administrative data can be used to calculate hospitalization rates by foreign-born concentration. 

Keywords

Administrative data, ecological studies, hospital records, immigration, public health surveillance

Findings

By 2031, it is projected that 28% of Canada's population could be foreign-born, up from about 20% in 2006. Understanding patterns of health care use among this growing segment of the population is important for the planning and delivery of services. While evidence suggests better health among the foreign-born compared with people born in Canada, much of that research is based on survey data. Those studies are typically constrained by small sample sizes that limit area-level comparisons. Furthermore, analysis based on survey data may be subject to recall bias or affected by linguistic and cultural barriers. [Full Text]

Authors

Gisèle Carrière (1-604-666-5907; gisele.carriere@statcan.gc.ca) is with the Health Analysis Division at  Statistics Canada, Vancouver, British Columbia, V6B 6C7. Paul A. Peters and Claudia Sanmartin are with the Health Analysis Division at Statistics Canada, Ottawa, Ontario, K1A 0T6.