Abstract

Background

Economic immigrants generally, and economic class principal applicants (ECPAs) specifically, tend to have better health than other immigrants. However, health outcomes vary among subcategories within this group, especially by sex.

Data and methods

This study examines hospitalization rates among ECPAs aged 25 to 74 who arrived in Canada between 1980 and 2006 as skilled workers, business immigrants, or live-in caregivers. The analysis used two linked databases to estimate age-standardized hospitalization rates (ASHRs) overall and for leading causes by sex. ASHRs of ECPA subcategories were compared with each other and with those of the Canadian-born population. Logistic regression was used to derive odds ratios for hospitalization among ECPAs, by sex.

Results

Male and female ECPAs aged 25 to 74 had significantly lower all-cause ASHRs than did the Canadian-born population in the same age range. This pattern prevailed for each ECPA subcategory and for each disease examined. Compared with skilled workers, business immigrants had lower odds of hospitalization; live-in caregivers who arrived after 1992 had higher odds. Adjustment for education, official language proficiency, and world region reduced the strength of or eliminated these associations.

Interpretation

Compared with the Canadian-born population, ECPAs generally had low hospitalization rates. Differences were apparent among ECPA subcategories.

Keywords

Business immigrants, data linkage, immigrant category, live-in caregivers, skilled workers

Findings

Health research recognizes that immigrants to Canada are not a homogeneous group and has revealed differences in outcomes by characteristics such as place of origin and period of arrival. Owing to a lack of data, few studies have focused on health outcomes by immigrant category (family class, refugees, economic class), although it is an important dimension of immigrant research. Family class immigrants and refugees are admitted for reunification and compassionate reasons. Economic class immigrants are selected based on a point system designed to assess their skills and potential contribution to the economy. [Full Text]

Authors

Edward Ng (edward.ng@canada.ca), Claudia Sanmartin, and Douglas G. Manuel are with the Health Analysis Division at Statistics Canada, Ottawa, Ontario. Douglas G. Manuel is also with the Ottawa Hospital Research Institute and the Institute of Clinical and Evaluative Sciences.

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What is already known on this subject?

  • Differences in health outcomes of immigrants to Canada vary by origin and by period of arrival.
  • Studies of variations in health by immigrant category typically focus on the three major classes—family class, refugees, and economic class.
  • Relatively little attention has been paid to economic class immigrants, although they constitute the majority of recent arrivals (55% in 2006).

What does this study add?

  • The analysis used two population-based linked databases to estimate age-standardized hospitalization rates (ASHRs) overall and for leading causes among economic class principal applicant (ECPA) subcategories, by sex, compared with their Canadian-born counterparts.
  • ECPAs of both sexes had significantly lower all-cause ASHRs than did the Canadian-born population.
  • This pattern prevailed for each ECPA subcategory and for each disease examined.
  • Differences were apparent between ECPA subcategories―compared with skilled workers, business class immigrants had lower odds of hospitalization; live-in caregivers who arrived after 1992 had higher odds.
  • Adjustment for education, official language proficiency, and world region reduced the strength of or eliminated these associations.

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