Disparities in mortality patterns among Canadian immigrants and refugees, 1980-1998: results of a national cohort study.
This study examines mortality patterns among Canadian immigrants, including both refugees and non-refugees, 1980-1998. Records of a stratified random sample of Canadian immigrants landing between 1980-1990 (N = 369,936) were probabilistically linked to mortality data (1980-1998). Mortality rates among immigrants were compared to those of the general Canadian population, stratifying by age, sex, immigration category, region of birth and time in Canada. Multivariate analysis examined mortality risks for various immigrant subgroups. Although immigrants presented lower all-cause mortality than the general Canadian population (SMR between 0.34 and 0.58), some cause-specific mortality rates were elevated among immigrants, including mortality from stroke, diabetes, infectious diseases (AIDS and hepatitis among certain subgroups), and certain cancers (liver and nasopharynx). Mortality rates differed by region of birth, and were higher among refugees than other immigrants. These results support the need to consider the heterogeneity of immigrant populations and vulnerable subgroups when developing targeted interventions.
DesMeules
Marie
M
Surveillance and Risk Assessment Division, Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, 120 Colonnade Road, AL 6702A, Ottawa, ON, Canada K1A 0K9. Marie_DesMeules@phac-aspc.gc.ca
Gold
Jenny
J
McDermott
Sarah
S
Cao
Zhenyuan
Z
Payne
Jennifer
J
Lafrance
Bryan
B
Vissandjée
Bilkis
B
Kliewer
Erich
E
Mao
Yang
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D002170:Canada; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016001:Confidence Intervals; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality; D015999:Multivariate Analysis; D016012:Poisson Distribution; D012036:Refugees / Q000706:statistics & numerical data*; D012306:Risk; D012307:Risk Factors; D055815:Young Adult