2. Traditional Views on Immigrant Health Immigrant Experiences Acculturation Difficulties & Stress Maladaptation & Health Problems

3. Some Limitations with Immigrant Studies the small sample size the data collection from the areas where immigrant populations are concentrated confounding effects (e.g., visible minority status, socioeconomic status, family affluence) a large nationally representative data set which had been collected across all regions of the society avoiding the possibility of yielding skewed outcomes

4. New Directions in Empirical Findings Immigrant Paradox Healthy Immigrant Effect Epidemiological Paradox

5. Definition: Healthy Immigrant Effect Healthy Immigrant Effect (De Maio, 2010): (1) an initial advantage in new immigrants’ health conditions in comparison to the native-born population (2) loss of this advantage and deterioration in health status over time (2 to 10 years) The health transitions of immigrants >> explain the social patterning and provide the ground for policy implications of the social determinants of health

6. Framework of the Study National Population Data in Canada  Adults Immigrants > Non-Immigrants ?  Adolescents Immigrants > Non-Immigrants ? Subjective Well-being (Health & Adaptation)

7. Data Source Canadian Community Health Survey (CCHS 2007: aged 12 - 69) Population Participant Ns ImmigrantsNon-Immigrants Adults (20-69 years) N = 3676N = 92,982 Adolescents (12-19 years) N = 920N = 13,572

8. Sampling Participants (Statistics Canada) Who Who: individuals from regional health units and from lists of household telephone numbers with a target number proportional to the general population size of each region How How: voluntary; choice of language; 78% overall national response rate Where Where: all provinces and territories When When: January to December 2007

9. Demographics Adolescents Age: RI (36) < NI (45 years old) Demographic Information Age: RI (15.6) > NI (15.4) Gender: RI ≈ NI (Female 53%)Gender: RI ≈ NI (Female 48%) Visible Minority Status: RI (71%) > NI (9%) Visible Minority Status: RI (71%) > NI (18%) Household Income: NI > RI Education: RI > NIHousehold Size: RI > NI Age Controlled Covariates Age GenderVisible Minority Status Household Income EducationHousehold Size Household IncomePresence of Parents / Interview

10. Measures: Self-Perception  Health :  General Health  Mental Health  Psychological Illnesses  Chronic Illnesses with Somatic Symptoms  Adaptation :  Life Satisfaction  Daily Life Stress  Sense of Belonging

11. Questions Health Health Adaptation Adaptation In general, would you say your health is.....? In general, would you say your mental health is.....? asthma, migraine, back problems, ulcer, & bowel disorders How satisfied are you with your life in general? About the amount of stress in your life, would you say that most days are....? How would you describe your sense of belonging to your local community?

12. Key Findings: Health Populations Health General Health Mental Health Chronic- Somatic Mood & Anxiety Adult Recent Immigrants RI > NI NI > RI Non- Immigrants Adolescent Recent Immigrants RI > NI F ≈ M RI > NI F ≈ MNI > RI F > M NI > RI F ≈ M Non- Immigrants

13. Key Findings: Adaptation Populations Adaptation Daily StressBelongingSatisfaction Adult Recent Immigrants RI ≈ NI NI > RI Non-Immigrants Adolescent Recent Immigrants RI ≈ NI F > M RI ≈ NI F > M RI ≈ NI F ≈ M Non-Immigrants

14. Adults Comparison Immigrants vs. Non-Immigrants

15. Adolescents Comparison Immigrants vs. Non-Immigrants

16. Healthy Resilient Immigrants Disadvantaged  Adults: Yes [ R-Immigrants > Non-Immigrants ]  Adolescents: Yes [ R-Immigrants > Non-Immigrants ] Health  Adults: Yes [ R-Immigrants > Non-Immigrants ]  Adolescents: Yes [ R-Immigrants > Non-Immigrants ] Adaptation  Adults: NO [ R-Immigrants > Non-Immigrants ]  Adolescents: Yes [ Immigrants ≈ Non-Immigrants ]

17. Conclusions

18. Adults: Health Recent Immigrants vs. Non-Immigrants

19. Adults: Adaptation Recent Immigrants vs. Non-Immigrants

20. Adolescent Health Immigrants vs. Non-Immigrants

21. Adolescent Adaptation Immigrants vs. Non-Immigrants

22. Adolescent Health No Gender Differences

23. Adolescents: Adaptation & Gender

24. Daily Stress Gender Difference

25. Psychosomatic Symptoms Gender Differences