title: Health and growth status of immigrant and refugee children in Toronto, Ontario: A retrospective chart review.
abstract: OBJECTIVE
  To describe selected anthropometric and health status variables among immigrant and refugee children ≤6 years of age within an inner city clinic in Toronto, Ontario.
  
  
  METHODS
  A retrospective chart review of patients born between January 1, 1998 and December 31, 2008, was conducted at a Toronto community health centre serving a primarily immigrant and refugee population. Outcome measures included calculated age-specific percentiles for height and weight, and the prevalence of anemia, iron deficiency, enteric parasites, elevated lead levels, HIV and hepatitis B. Postal codes were collected and used to determine the patient's neighbourhood income quintile.
  
  
  RESULTS
  A total of 331 patients, born between January 1, 1998 and December 31, 2008, were identified. Of these, a total of 210 charts were manually reviewed. The prevalence of height-for-age and weight-for-age under the third percentile on the Centers for Disease Control and Prevention Growth Charts were 7.2% and 11.6%, respectively, and 8.4% and 5.0%, respectively, on the WHO Growth Standards Chart. Prevalence rates were also calculated for anemia (22.8%), iron deficiency (53.3%), hepatitis B (2.5%), parasitic infections (33.6%), elevated blood lead levels (4.9%) and HIV (0%). Neighbourhood income quintiles revealed that 46.7% of patients were residing in the lowest (ie, poorest) income quintile neighbourhoods.
  
  
  CONCLUSIONS
  These findings reveal a high burden of illness within the population presenting to an immigrant/refugee health clinic, and illustrate the need for further research in this area, as well as increased efforts to ensure appropriate screening within clinics serving a high volume of newcomer patients.
authors.affiliation: St Michael's Hospital Department of Family and Community Medicine, University of Toronto, Toronto, Ontario;; Columbia University Mailman School of Public Health, New York City, New York, USA;
authors.forename: Leila
authors.initials: L
authors.lastname: Salehi
authors.affiliation: St Michael's Hospital Department of Family and Community Medicine, University of Toronto, Toronto, Ontario;; Centre for Research on Inner City Health, St Michael's Hospital;; Institute for Clinical Evaluative Sciences;
authors.forename: Aisha K
authors.initials: AK
authors.lastname: Lofters
authors.affiliation: East End Community Health Centre, Toronto, Ontario.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Hoffmann
authors.affiliation: Dalla Lana School of Public Health, University of Toronto;; Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute of St Michael's Hospital;
authors.forename: Jane Y
authors.initials: JY
authors.lastname: Polsky
authors.affiliation: St Michael's Hospital Department of Family and Community Medicine, University of Toronto, Toronto, Ontario;
authors.forename: Katherine D
authors.initials: KD
authors.lastname: Rouleau
keywords: Canada; Child; Emigrants; Health; Immigrants; Refugees