Ryerson University, Ontario, Canada.
Ryerson University, Ontario, Canada.
Soc Sci Med. 2013 Dec;98:8-17. doi: 10.1016/j.socscimed.2013.08.040. Epub 2013 Sep 8.
The paper addresses a critically important area in Canadian immigration and health from both a social and a spatial perspective. It employs multilevel and contextual approaches to examine the social determinants of immigrant health as well as the place effects on self-reported health at a regional and neighborhood scale. The data come from the raw microdata file of the 2005-10 Canadian Community Health Survey (a random national health survey) and the publicly available Canadian Marginalization index based on the 2006 Census. Three populations are compared: Canadian-born, overall foreign-born, and Chinese immigrants. The results suggest various degrees of association between self-reported health, individual and lifestyle behavioral characteristics, and neighborhood material deprivation and ethnic concentration in census tracts. These factors contribute differently to the reported health of Chinese immigrants, Canada's largest recent immigrant group. A healthy immigrant effect is partially evident in the overall foreign-born population, but appears to be relatively weak in Chinese immigrants. For all groups, neighborhood deprivation moderately increases the likelihood of reporting poor health. Ethnic concentration negatively affects self-rated health, with the exception of the slight protective effect of Chinese-specific ethnic density in census tracts. The multilevel models reveal significant area inequalities across Census Metropolitan Areas/Census Agglomerations in risk of reporting unhealthy status, with greater magnitude in the foreign-born population. The vast regional variations in health among Chinese immigrants should be interpreted carefully due to the group's heavy concentration in large cities. The study contributes to the literature on ethnicity and health by systematically incorporating neighborhood contextual effects in modeling the social determinants of immigrant health status. It fills a gap in the literature on neighborhoods and health by focusing on ethnically disparate groups rather than on the general population. By revealing regional disparities in health, the paper adds a spatial perspective to the work on immigrant health.
本文从社会和空间角度探讨了加拿大移民和健康领域的一个至关重要的问题。它采用多层次和背景方法，研究了移民健康的社会决定因素以及在区域和邻里尺度上对自我报告健康的地点影响。数据来自 2005-10 年加拿大社区健康调查（一项随机全国健康调查）的原始微观数据文件和基于 2006 年人口普查的公开可用的加拿大边缘化指数。比较了三个群体：加拿大出生、整体外国出生和中国移民。结果表明，自我报告的健康状况、个人和生活方式行为特征以及邻里物质贫困和族裔聚居程度与族裔聚居程度之间存在不同程度的关联。这些因素对中国移民的报告健康状况产生了不同的影响，中国是加拿大最近最大的移民群体。整体外国出生人口中部分存在健康移民效应，但在华裔移民中似乎相对较弱。对于所有群体，邻里贫困程度都会适度增加报告健康状况不佳的可能性。族裔聚居程度对自我评估健康状况产生负面影响，但在族裔聚居程度方面除外，族裔聚居程度在普查区内对特定族裔密度有轻微的保护作用。多层次模型揭示了不同的人口普查都会区/普查聚集区之间在报告不健康状态的风险方面存在显著的区域不平等，其中外国出生人口的不平等程度更大。由于该群体主要集中在大城市，因此应该谨慎解释中国移民之间巨大的区域健康差异。该研究通过系统地将邻里背景影响纳入移民健康状况的社会决定因素模型，为种族和健康文献做出了贡献。它通过关注种族不同的群体而不是一般人口，填补了邻里与健康文献之间的空白。通过揭示健康方面的区域差异，本文为移民健康工作增加了空间视角。
