Abstract

Background

Few studies of the healthy immigrant effect (HIE) have examined the mental health outcomes of Canadian-born individuals on a national scale compared with immigrants by admission category. This study fills this gap by examining the self-reported mental health (SRMH) of immigrants by admission category and other immigration dimensions (e.g., source world region and duration since landing) and making comparisons with Canadian-born respondents to a population-based survey.

Data and methods

Based on four cycles (2011 to 2014) of the Canadian Community Health Survey (CCHS) linked to the Longitudinal Immigration Database (IMDB), odds ratios of high (i.e., excellent or very good) SRMH among Canadian-born respondents and IMDB-linked immigrants are compared using logistic regression. Among the IMDB immigrant population, high SRMH was also examined according to the above-mentioned immigration dimensions. Adjusted results were hierarchically controlled for age, sex, social and economic factors, and sense of belonging.

Results

Age–sex adjusted results show that immigrants, especially refugees, are less likely than the Canadian-born population to report high mental health levels, but these differences disappeared after full adjustment. The odds of immigrants having high SRMH differed more by source world region and duration since landing. For example, fully adjusted results show support for the HIE, with recent immigrants (interviewed within 10 years of landing) more likely to report high SRMH than either the Canadian-born population or established immigrants. Greater odds of high SRMH among recent immigrants also holds across admission classes and for selected world regions.

Interpretation

This study provides new evidence on differences in mental health between Canadian-born individuals and immigrants by various characteristics. Results support a deterioration of the HIE in SRMH and identify factors significantly associated with SRMH. This study can also serve as a baseline for further studies on the impact of COVID-19 on immigrants’ mental health by immigrant category.

Keywords

immigrant category, refugee, mental health, linked data, healthy immigrant effect

DOI: https://www.doi.org/10.25318/82-003-x202000800001-eng

Findings

Overall, immigrants are found to be healthier upon their arrival to Canada than the Canadian-born population—a phenomenon referred to as the healthy immigrant effect (HIE). However, this initial health advantage seems to disappear over time, partly because of stress and other integration challenges.1-3 Whether this HIE and its deterioration also apply to mental health is an area of ongoing research.4-10 The Canadian government’s Immigration Levels Plan stipulates that almost 1 million immigrants will be admitted to Canada between 2018 and 2020, and immigrants to Canada will increase from 7.5 million to more than 12 million by 2036 (almost 30% of the Canadian population).11-12 Because of the growth in Canada’s immigrant population, it is important to monitor the health—including mental health—of immigrants. In light of the COVID-19 pandemic and its impact on mental health, this study can provide a baseline for future studies on the longer-term impact of COVID-19 on immigrants’ mental health by immigrant category. [Full article]

Authors

Edward Ng (edward.ng@canada.ca) is with the Health Analysis Division at Statistics Canada and Haozhen Zhang is with the Research and Evaluation Branch at Immigration, Refugees and Citizenship Canada in Ottawa, Ontario.

 

What is already known on this subject?

  • Most major immigrant-receiving countries reported a healthy immigrant effect, both in terms of self-reported perceived health and chronic conditions.
  • Little research has been done on the mental health of immigrants by admission category, source world region or duration since landing. This is attributable in part to a lack of data.

What does this study add?

  • Based on a newly linked national health-oriented dataset, immigrants—especially refugees—are less likely than the Canadian-born population to have high self-reported mental health (SRMH), but these differences largely disappeared after full model adjustments.
  • The variations of high SRMH among immigrants are more noticeable by duration since landing and source world region, even after controlling for confounding factors.
  • Data linkage provides a great opportunity to add value to existing datasets by producing policy-relevant insights for the health outcomes of immigrants, especially for mental health and by admission category.

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