title: An evaluation of the healthy immigrant effect with adolescents in Canada: Examinations of gender and length of residence.
abstract: The healthy immigrant effect, HIE, is the finding that immigrants initially arrive in the settlement society in the same or better health than their native-born counterparts, yet this advantage is lost as their length of residence increases. This phenomenon has been found among adult populations.
  
  
  
  The present study sought to extend the premise of HIE to adolescents in Canada.
  
  
  
  Utilizing national data sets of three years (Canadian Community Health Survey 2007, 2009, 2011; Statistics Canada), adolescents (aged 12-19), foreign-born immigrants (N = 2919) and native-born non-immigrants (N = 39,083), were compared for their perceived general health and mental health as well as diagnosed chronic illnesses and psychological illnesses. Multiple imputations were first carried out for the degrees of missing values, and multivariate analyses were conducted to find differences between non-immigrants and immigrants, and between recent and long-term immigrants to verify (1) whether immigrant adolescents show better health than their non-immigrant peers, (2) whether the health of immigrant adolescents vary with length of residence and gender, and (3) whether persistent trends would be shown across the three survey years.
  
  
  
  After adjusting for age, visible minority status, household income and household size as covariates, immigrant adolescents indeed reported better health in all four measures in each survey year. Girls experienced more health problems regardless of immigrant status, especially for chronic and psychological illnesses. However, only in 2009 the long-term immigrant adolescents reported less favorite health than recent immigrants, and length of residence influenced boys' and girls' mental health in different directions.
  
  
  
  The HIE was confirmed with national community population samples of adolescents in Canada: foreign-born immigrant adolescents experience better health than their native-born peers. However, understanding of the HIE needs to be further extended to encompass the influence of societal contexts and their impact on various segments of populations.
authors.affiliation: Centre for Research on Migration, Refugees, and Belonging, School of Law and Social Sciences, University of East London, London E15 1NF, United Kingdom. Electronic address: K_Kyunghwa@yahoo.ca.
authors.forename: Kyunghwa
authors.initials: K
authors.lastname: Kwak
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D002170:Canada / Q000453:epidemiology; D002648:Child; D002908:Chronic Disease / Q000453:epidemiology; D054242:Emigrants and Immigrants / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D044382:Population Groups / Q000523:psychology / Q000706:statistics & numerical data; D057566:Self Report; D012737:Sex Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Adolescents; Canada; Gender; Healthy immigrant effect; Length of residence