Background: Economic immigrants generally, and economic class principal applicants (ECPAs) specifically, tend to have better health than other immigrants, as well as the Canadian-born population. However, health outcomes vary among subcategories within this group, especially by sex. Methods: This study examines hospitalization rates among ECPAs aged 25 to 74 who arrived in Canada between 1980 and 2006 as skilled workers, business immigrants, or live-in caregivers. The analysis used two linked databases to estimate age-standardized hospitalization rates (ASHRs) overall and for leading causes by sex. ASHRs of ECPA subcategories were compared with each other and with those of the Canadian-born population. Logistic regression was used to derive odds ratios for hospitalization among ECPAs, by sex. Results: Male and female ECPAs aged 25 to 74 had significantly lower all-cause ASHRs than did the Canadian-born population in the same age range. This pattern prevailed for each ECPA subcategory and for each disease examined. Compared with skilled workers, business immigrants had lower odds of hospitalization; live-in caregivers who arrived after 1992 had higher odds. Adjustment for education, official language proficiency, and world region reduced the strength of or eliminated these associations. Interpretation: Compared with the Canadian-born population, ECPAs generally had lower hospitalization rates. Differences were apparent among ECPA subcategories. © Minister of Industry, 2017.

Live-in caregivers Immigrant category Business immigrants Data linkage Skilled workers

hospitalization human epidemiology middle aged Cohort Studies statistics and numerical data Aged Humans migrant male Canada Emigrants and Immigrants female Socioeconomic Factors socioeconomics population research adult age sex factor Sex Factors Age Factors Censuses cohort analysis