title: Official language proficiency and self-reported health among immigrants to Canada.
abstract: BACKGROUND
  New immigrants to Canada initially report better health than does the Canadian-born population. With time, this "healthy immigrant effect" appears to diminish. Limited ability to speak English or French has been identified as a possible factor in poor health. This analysis explored the relationship between self-reported official language proficiency and transitions to poor self-reported health.
  
  
  METHODS
  Statistics Canada's Longitudinal Survey of Immigrants to Canada tracked a sample of the 2001 immigrant cohort for four years (6, 24 and 48 months after arrival). Data from each of the three survey waves were available for 7,716 respondents. Bivariate and multivariate analysis were used to examine associations between official language proficiency and self-reported health, by sex, controlling for selected pre-migration and post-migration factors. The prevalence of poor health among immigrants was compared with rates among the Canadian-born population, based on data from the Canadian Community Health Survey.
  
  
  RESULTS
  Among a representative sample of recent immigrants, the prevalence of poor self-reported health had risen substantially, especially among women, after four years in Canada. Prolonged limited official language proficiency was strongly associated with a transition to poor health among male and female immigrants who had earlier reported good health. Other factors significantly associated with an increase in the prevalence of poor self-reported health differed by sex. Refugee status, self-reported discrimination, and living in Vancouver were significant for men. Age, health care access problems, and limited friendliness of neighbours were significant for women.
authors.affiliation: Health Analysis Division at Statistics Canada, Ottawa, Ontario K1A 0T6. edward.ng@statcan.gc.ca
authors.forename: Edward
authors.initials: E
authors.lastname: Ng
authors.forename: Kevin
authors.initials: K
authors.lastname: Pottie
authors.forename: Denise
authors.initials: D
authors.lastname: Spitzer
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002170:Canada / Q000453:epidemiology; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006304:Health Status; D006306:Health Surveys / Q000706:statistics & numerical data; D006801:Humans; D007802:Language; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011287:Prejudice; D015995:Prevalence; D012036:Refugees / Q000706:statistics & numerical data; D012111:Residence Characteristics / Q000706:statistics & numerical data; D057566:Self Report; D012737:Sex Factors; D012944:Social Support; D012959:Socioeconomic Factors; D055815:Young Adult