Refugees arrive in Canada with settlement challenges different from those faced by other immigrants, including a higher risk of poor health. This study reports hospitalization rates for the three fiscal years from 2006/2007 through 2008/2009 for immigrants who arrived during the 1980-to-2006 period, with a focus on three refugee groups.


Information from two linked databases was used to estimate age-standardized hospitalization rates (ASHRs) per 10,000 population aged 30 or older for all causes (excluding pregnancy) and for leading causes, by immigrant category and by refugee subcategory. The analysis focused on refugees from Poland, Vietnam and the Middle East, whose hospitalization rates were compared with those of the Canadian-born population and/or economic class immigrants from the same areas.


Immigrants aged 30 or older, including refugees, had significantly lower all-cause ASHRs than did the Canadian-born population. All-cause ASHRs were 470 per 10,000 for immigrants overall and 494 for refugees, compared with 891 for the Canadian-born. Of the three source areas, immigrants and refugees from Vietnam had lower ASHRs. The circulatory disease-specific ASHR for government-assisted refugees from the Middle East was similar to that of the Canadian-born population (142 and 158, respectively). Except for those from Poland, refugees typically had higher ASHRs than did their economic class counterparts.


Refugees, like other immigrants, generally had lower hospitalization rates than did the Canadian-born population, but some subgroups were particularly susceptible to hospitalization for specific chronic diseases.


Data linkage, health care utilization, immigrant category, migration


Relatively little information is available at the national level about the health of refugees in Canada. Evidence from the Longitudinal Survey of Immigrants to Canada showed that refugees were more likely than other immigrants to report poor health. Possible explanations include hardships associated with the involuntary nature of their migration and post-migration difficulty obtaining support and health care. [Full Text]


Edward Ng (edward.ng@canada.ca), Claudia Sanmartin and Douglas G. Manuel are with the Health Analysis Division at Statistics Canada, Ottawa, Ontario. Douglas G. Manuel is also with the Ottawa Health Research Institute and the Institute of Clinical and Evaluative Sciences.

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What is already known on this subject?

  • While previous work on refugee health research often focused on infectious disease or on mental health issues, a recent review identified data gaps for non-communicable diseases and chronic conditions.
  • In Canada, provincial research found an elevated risk of chronic diseases among refugees, but comparisons with the total Canadian-born population have been presented only in mortality studies.
  • No quantitative examination of the health of refugees, compared with other immigrant categories from the same areas, has been conducted.

What does this study add?

  • Information from two linked databases was used to estimate age-standardized hospitalization rates, by immigrant category and by refugee subcategory during the 2006/2007-to-2008/2009 period.
  • The analysis focused on refugees from Poland, Vietnam and the Middle East.
  • Hospitalization rates among immigrants overall and for those in the economic, refugee and family categories were substantially below that of the Canadian-born.
  • Refugees tended to have higher hospitalization rates than did economic immigrants.

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