Journal of Epidemiology and Community Health
Volume 71, Issue 7, 2017, Pages 625-632

Socioeconomic gradients in all-cause, premature and avoidable mortality among immigrants and long-term residents using linked death records in Ontario, Canada (Article) (Open Access)

Khan A.M. , Urquia M. , Kornas K. , Henry D. , Cheng S.Y. , Bornbaum C. , Rosella L.C.*
  • a Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada, Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
  • b Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada, Institute for Clinical Evaluative Sciences, Toronto, ON, Canada, Centre for Inner City Health, Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
  • c Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
  • d Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada, Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
  • e Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
  • f Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada, Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada
  • g Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada, Institute for Clinical Evaluative Sciences, Toronto, ON, Canada, Public Health Ontario, Toronto, ON, Canada

Abstract

Background Immigrants have been shown to possess a health advantage, yet are also more likely to reside in arduous economic conditions. Little is known about if and how the socioeconomic gradient for all-cause, premature and avoidable mortality differs according to immigration status. Methods Using several linked population-based vital and demographic databases from Ontario, we examined a cohort of all deaths in the province between 2002 and 2012. We constructed count models, adjusted for relevant covariates, to attain age-adjusted mortality rates and rate ratios for all-cause, premature and avoidable mortality across income quintile in immigrants and longterm residents, stratified by sex. Results A downward gradient in age-adjusted all-cause mortality was observed with increasing income quintile, in immigrants (males: Q5: 13.32, Q1: 20.18; females: Q5: 9.88, Q1: 12.51) and long-term residents (males: Q5: 33.25, Q1: 57.67; females: Q5: 22.31, Q1: 36.76). Comparing the lowest and highest income quintiles, male and female immigrants had a 56% and 28% lower all-cause mortality rate, respectively. Similar trends were observed for premature and avoidable mortality. Although immigrants had consistently lower mortality rates compared with long-term residents, trends only differed statistically across immigration status for females ( p<0.05). Conclusions This study illustrated the presence of income disparities as it pertains to all-cause, premature, and avoidable mortality, irrespective of immigration status. Additionally, the immigrant health advantage was observed and income disparities were less pronounced in immigrants compared with long-term residents. These findings support the need to examine the factors that drive inequalities in mortality within and across immigration status.

Author Keywords

[No Keywords available]

Index Keywords

information processing immigrant Death Certificates death certificate demography health disparity Health Status Disparities human epidemiology immigration trends Ethnic Groups statistics and numerical data ethnic group data base controlled study participant observation economic conditions clinical study resident Humans migrant male Canada Emigrants and Immigrants female Socioeconomic Factors risk factor Risk Factors spatiotemporal analysis socioeconomics Ontario mortality rate sex factor premature mortality Sex Factors Mortality, Premature Ontario [Canada] cause of death highest income group mortality public health
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85020650825&doi=10.1136%2fjech-2016-208525&partnerID=40&md5=72488829519160ea894f03a251ebaf28
DOI: 10.1136/jech-2016-208525
ISSN: 0143005X
Cited by: 8
Original Language: English