The impact of considering birthplace in analyses of immigrant health.

BACKGROUND: Despite the heterogeneity of Canada's immigrant population, small sample sizes often prevent health researchers from studying specific subgroups. This report demonstrates how combining cycles of the Canadian Community Health Survey (CCHS) makes it possible to move beyond the Canadian-born/immigrant dichotomy to more refined analyses of immigrant health. DATA AND METHODS: Based on combined data from the 2003, 2005, and 2007/2008 CCHS, this analysis compares the age-standardized prevalence of fair/poor self-perceived health, diabetes and arthritis among immigrants and the Canadian-born population at three progressively more precise breakdowns of immigrants by birthplace.
RESULTS: Overall, immigrants were more likely than the Canadian-born to report poor health and diabetes, but less likely to report arthritis. This association changed when the immigrant group was disaggregated. This report demonstrates the importance of analyzing immigrants' health outcomes by birthplace and duration of residence in Canada.
INTERPRETATION: Studies based on the immigrant/non-immigrant dichotomy combine immigrants with different risk factors, settlement experiences and health behaviours, and can yield findings that appear contradictory. Analysis of more specific immigrant subgroups improves understanding of immigrants' health relative to that of the Canadian-born population.