School of Geography and Earth Sciences, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada.
Soc Sci Med. 2010 Apr;70(8):1219-28. doi: 10.1016/j.socscimed.2010.01.009. Epub 2010 Feb 12.
Immigrants in Canada constitute approximately 20% of the total population and will continue to account for a significant portion of the country's population in the future. Accordingly, a growing body of research has focused on examining the disparity in health status between the increasing foreign-born and the Canadian-born populations. The healthy immigrant effect, in particular, acknowledges that immigrants have better health status than their Canadian-born counterparts upon arrival in the country. However, studies have shown that over time the health of immigrants declines to a level on par with the Canadian-born population. There is much speculation as to the reasons for this decline including acculturation (i.e., uptake of unhealthy lifestyles) and a lack of access to health care. Yet, there have been few studies to examine possible reasons for potential declines in health, especially from the perspective of immigrants themselves. This study is one of the first to qualitatively examine perceived changes in health status and reasons for health status change among immigrants. The paper presents the results of 23 in-depth interviews with adults with recent (less than 3 years of residency), mid-term (3-10 years), and long-term (more than 10 years) immigrants living in the Greater Toronto Area. The results reveal that the majority of the participants believed their health had remained stable or even improved over time due to improved living standards and lifestyle behaviours in Canada. Those who perceived their health to have worsened over time attributed the change to the stress associated with migration, and the aging process rather than the adoption of an unhealthy lifestyle. Additionally, while the vast majority of participants reported improved access to resources upon migration, there were mixed reviews in terms of how beneficial these resources were or could be for health. The findings highlight the need for research to incorporate mental health into studies on changing immigrant health status and to focus on those factors contributing to high levels of stress among more recent immigrants.
加拿大的移民约占总人口的 20%，未来仍将占该国人口的很大一部分。因此，越来越多的研究集中在研究不断增加的外国出生人口和加拿大出生人口之间健康状况的差异上。特别是，“健康移民效应”承认，移民抵达该国时的健康状况优于其在加拿大出生的同龄人。然而，研究表明，随着时间的推移，移民的健康状况会下降到与加拿大出生人口相当的水平。对于这种下降的原因有很多猜测，包括文化适应（即采用不健康的生活方式）和缺乏获得医疗保健的机会。然而，很少有研究来检查健康状况下降的可能原因，尤其是从移民自身的角度来看。这项研究是首批定性检查移民健康状况变化感知和健康状况变化原因的研究之一。本文介绍了对最近（少于 3 年居住）、中期（3-10 年）和长期（超过 10 年）居住在大多伦多地区的成年人进行的 23 次深入访谈的结果。结果表明，大多数参与者认为他们的健康状况随着时间的推移保持稳定，甚至有所改善，这是由于在加拿大生活水平和生活方式的改善。那些认为自己的健康状况随着时间的推移而恶化的人将这种变化归因于与移民相关的压力和衰老过程，而不是采用不健康的生活方式。此外，尽管绝大多数参与者报告在移民后获得了更多的资源，但对于这些资源对健康的有益程度或可能的有益程度存在不同的看法。研究结果强调需要研究将心理健康纳入移民健康状况变化的研究，并关注导致最近移民压力水平较高的因素。
