Abstract:
New immigrants to Canada typically have a more favourable health profile than
the non-immigrant population. This phenomenon, known as the 'healthy immigrant
effect', has been attributed to both the socioeconomic advantage (ie. educational
attainment, occupational opportunity) of non-refugee immigrants and existing screening
protocols that admit only the healthiest of persons to Canada. It has been suggested that
this health advantage diminishes as the time of residence in Canada increases, due in part
to the adoption of health-risk behaviours such as alcohol and cigarette use, an increase in
excess body weight, and declining rates of physical activity. However, the majority of
health research concerning immigrants to Canada has been limited to cross-sectional
studies (Dunn & Dyck, 2000; Newbold & Danforth, 2003), which may mask an
immigrant-specific cohort effect. Furthermore, the practice of aggregating foreign-bom
persons by geographical regions or treating all immigrants as a homogeneous group may
also obfuscate intra-immigrant differences in health. Accordingly, this study uses the
Canadian National Population Health Surveys (NPHS) and data from the United Nations
Development Program (UNDP) to prospectively evaluate factors that predict health status
among immigrants to Canada. Each immigrant in the NPHS was linked to the UNDP
Human Development Index of their country of birth, which uses a combined measure of
health, education, and per capita income of the populace. The six-year change in health
function, psychological distress, and self-rated health were considered from a population
health perspective (Evans, 1994), using generalized-estimating equations (GEE) to
examine the compounding effect of past and recent predictors of health. Demographic
