title: Language proficiency, gender and self-reported health: an analysis of the first two waves of the longitudinal survey of immigrants to Canada.
abstract: BACKGROUND
  Most immigrants to Canada now come from Asia, the Middle East, the Caribbean and Africa, where cultures and languages often differ significantly from the Canadian context. Subgroups of immigrants experience disparities in health. Inability to communicate in an official language in Canada may be a marker of risk for poor health due to both pre- and post-migration factors. We aimed to study the relationship between language proficiency and self-reported health.
  
  
  METHODS
  We conducted a cross-sectional analysis of the first two surveys of the Longitudinal Survey of Immigrants to Canada (2001, 2003), a population-based cohort study of new immigrants to Canada. Specifically, we used logistic regression analyses to examine the relationship between self-reported health and language proficiency by sex, controlling for a range of health determinants at 6 months (wave 1) and 2 years (wave 2) after arrival.
  
  
  RESULTS
  After controlling for covariates (age, sex, education, region of birth, immigrant class, job satisfaction, access to health care), analysis of the wave 1 survey showed that poor proficiency in English or French is significantly related to the self-reported poor health (OR=2.0, p<0.01). And this relationship was consistent in the wave 2 survey (OR=1.9, p<0.01). We also found that this statistically significant association between poor language proficiency and self-reported health holds only for women (wave 1 survey OR=2.6, p <0.01, wave 2 survey OR=2.2, p<0.01), not for men.
  
  
  CONCLUSIONS
  The association between poor language proficiency and poor self-reported health, and particularly its significantly greater impact on women, has implications for language training, health care and social services, and health information.
authors.affiliation: Institute of Population Health, University of Ottawa, Ottawa, ON. kpottie@uottawa.ca
authors.forename: Kevin
authors.initials: K
authors.lastname: Pottie
authors.forename: Edward
authors.initials: E
authors.lastname: Ng
authors.forename: Denise
authors.initials: D
authors.lastname: Spitzer
authors.forename: Alia
authors.initials: A
authors.lastname: Mohammed
authors.forename: Richard
authors.initials: R
authors.lastname: Glazier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002170:Canada; D003144:Communication Barriers; D003430:Cross-Sectional Studies; D004522:Educational Status; D054242:Emigrants and Immigrants / Q000145:classification / Q000193:education*; D005260:Female; D006297:Health Services Accessibility; D006305:Health Status Indicators; D006801:Humans; D007588:Job Satisfaction; D007802:Language; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012036:Refugees / Q000145:classification / Q000193:education*; D012649:Self Concept; D012737:Sex Factors; D012959:Socioeconomic Factors; D055815:Young Adult