Insights into the healthy immigrant effect: Mortality by period of immigration and birthplace

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by Edward Ng and the Longitudinal Health and Administrative Data Research Team

Executive summary

• According to the 2006 Census, almost 20% of the Canadian population were foreign-born.
• By 2031, the percentage is projected to reach at least 25%.
• The origins of the immigrant population are increasingly diverse.
• Studies based on age-standardized mortality rates (ASMR) have found a healthy immigrant effect, with lower overall rates among immigrants.
• A duration effect has also been observed—immigrants' mortality advantage lessened as their time in Canada increased.
• ASMRs based on the 1991 to 2001 census mortality follow-up study indicate a healthy immigrant effect and a duration effect at the national level for all-cause mortality and for circulatory diseases and cancer.
• These generalizations mask considerable heterogeneity among immigrant groups.
• ASMRs differed by world region of birth and by sex.
• At the national level, a healthy immigrant effect was observed by world region for men, but depending on the cause of death, not for women from the United States, Sub-Saharan Africa or South Asia .
• In Toronto, Montreal and Vancouver, lack of an overall healthy immigrant effect for all-cause mortality was observed for women from the United States and Sub-Saharan Africa, and for some men from these regions.
• ASMRs for people from the United Kingdom, India and China supported an overall healthy immigrant effect at the national level, however, women from India living in Toronto and Montreal and women from the United Kindom living in Vancouver had ASMRs more similar to those of Canadian-born women. ASMR levels among women from India reflected higher circulatory disease rates. In Montreal, cancer ASMRs were higher for women from China.