title: Language Barriers Among the Foreign-Born in Canada: Agreement of Self-Reported Measures and Persistence Over Time.
abstract: Persistent language barriers are associated with poor health outcomes. The agreement between reporting a language barrier at time of immigration and in the 2007-2008 Canadian Community Health Survey (CCHS) was calculated using kappa scores among foreign-born individuals who arrived to Ontario, Canada between 1985 and 2005. A total of 2323 immigrants were included, with a mean (± SD) time of 10.2 ± 6.4 years between immigration and completing the CCHS. Only 6 % of immigrants reported a persistent language barrier, resulting in a low agreement between the two sources (kappa = 0.06, 95 % CI 0.042-0.086). Though immigrants were less likely to report a persistent language barrier the longer they had been in Canada, only 13 % of immigrants who had arrived <2 years ago reported one. Self-reported language barriers at time of immigration are poor indicators of persistent language barriers. There is a need for a better measure of language barriers among Canadian immigrants.
authors.affiliation: Toronto Western Hospital, University Health Network, 399 Bathurst Street, 8EW-432E, Toronto, ON, M5T 2S8, Canada. Karen.okrainec@uhn.ca.|Samuel Lunenfeld Research Institute of Mount Sinai Hospital, Toronto, ON, Canada. Karen.okrainec@uhn.ca.
authors.forename: Karen
authors.initials: K
authors.lastname: Okrainec
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.|Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada.|Department of Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: Gillian L
authors.initials: GL
authors.lastname: Booth
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
authors.forename: Simon
authors.initials: S
authors.lastname: Hollands
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.|Department of Medicine, University of Toronto, Toronto, ON, Canada.|Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.|Samuel Lunenfeld Research Institute of Mount Sinai Hospital, Toronto, ON, Canada.
authors.forename: Chaim M
authors.initials: CM
authors.lastname: Bell
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003144:Communication Barriers; D054242:Emigrants and Immigrants; D005260:Female; D006304:Health Status; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D057566:Self Report; D012737:Sex Factors; D012959:Socioeconomic Factors; D013997:Time Factors
keywords: Agreement; Immigrants; Language barriers