All-cause and circulatory disease-related hospitalization, by generation status: Evidence from linked data
Ottawa - Immigrants tend to have better health than the Canadian-born. However, the "healthy immigrant" effect diminishes over time and varies by source country. Over successive generations, immigrants' rates of hospitalization overall, and for circulatory diseases in particular, tended to rise and converge with those of the third-plus generation, according to an analysis of census data linked to hospital administrative records.
During the 2006/2007 to 2008/2009 period, all-cause hospitalization rates, standardized to account for differences in age distributions, were 609 per 10,000 population among first-generation immigrants. Among the second generation, the rate was 792 hospitalizations per 10,000, and for the third-plus generation, 839 hospitalizations per 10,000. The corresponding hospitalization rates for circulatory diseases were 119, 142 and 152, respectively, per 10,000.
Convergence in hospitalization rates over immigrant generations was apparent for both men and women. Recent (arrived 1996 to 2006) first-generation immigrants were the least likely to have had at least one hospitalization during the 2006/2007 to 2008/2009 period, followed by long-term (arrived before 1996) first-generation immigrants, and then, second-generation Canadians. All three groups were less likely to have been hospitalized compared with the third-plus generation.
Results varied by origin, with higher odds of circulatory disease-related hospitalization among people of South Asian descent, and lower odds among those of Chinese descent.
Adjustments for education and income reduced differences, especially between the second and third-plus generations. Based on age-standardized hospitalization rates, South Asian immigrants' health advantage in circulatory diseases was lost by the second generation. Among the Chinese, all-cause and circulatory disease-related hospitalization rates generally increased across generations, but remained significantly lower than for the third-plus generation.