Abstract
Objectives
The purpose of this study was to determine whether there are differences in self-rated health by immigration and generational status, and the role of health literacy in this relationship.
Methods
Data were from the Canadian component of the 2003 International Adult Literacy and Skills Survey (IALSS) undertaken by Statistics Canada. The sample comprised a total of 22,818 persons, of whom 3,861 were immigrants and 18,957 non-immigrants. The study employed logistic regression to examine the relationship between health literacy and self-rated health. The analysis separately compared: immigrants and non-immigrants; immigrant groups defined by region of origin and recency of arrival in Canada; and the local-born defined by generation.
Results
Logistic regression results indicated that immigrants compared to non-immigrants, and recent immigrants not from Europe or USA compared to established immigrants from Europe or USA, were more likely to report good self-rated health. On the other hand, compared to the third-plus generation, the second generation were less likely to report good self-rated health. Health literacy was positively associated with good self-rated health. However, its effect was largely accounted for by discordance between mother tongue and language of survey administration among immigrants, and by literacy practices at home, education, place of residence, and income among non-immigrants.
Conclusion
Health literacy is important in the health of both immigrants and non-immigrants, but with different underlying mechanisms. For nonimmigrants, engaging in literacy practices at home would benefit both health literacy and overall health, whereas for immigrants, it would be improving proficiency in either English or French.
Résumé
Objectifs
Cette étude vise à déterminer s’il existe des différences dans l’état de santé auto-évalué selon le statut d’immigrant et le statut générationnel, et le rôle que joue la littératie en santé dans cette relation.
Méthode
Les données proviennent de la composante canadienne de l’Enquête internationale sur l’alphabétisation et les compétences des adultes (EIACA) de 2003 menée par Statistique Canada. Notre échantillon comptait 22 818 personnes en tout, dont 3 861 immigrants et 18 957 non-immigrants. Par régression logistique, nous avons établi un lien entre la littératie en santé et l’état de santé auto-évalué. L’analyse comparait séparément: les immigrants et les non-immigrants; les groupes d’immigrants définis selon leur région d’origine et la récence de leur arrivée au Canada; et les gens nés au Canada définis selon leur génération.
Résultats
Les résultats de la régression logistique montrent que les immigrants sont plus susceptibles de se déclarer en bonne santé que les non-immigrants; et que les immigrants récents non originaires d’Europe ou des États-Unis sont plus susceptibles de se déclarer en bonne santé que les immigrants établis originaires d’Europe ou des États-Unis. Par ailleurs, la deuxième génération est moins susceptible que la troisième et les suivantes de se déclarer en bonne santé. La littératie en santé est positivement liée à un bon état de santé auto-évalué. Toutefois, ses effets s’expliquent en grande partie par la différence entre la langue maternelle et la langue d’administration de l’enquête (chez les immigrants) et par la pratique de la lecture à la maison, la scolarité, le lieu de résidence et le revenu (chez les non-immigrants).
Conclusion
La littératie en santé est importante pour la santé des immigrants et des non-immigrants, mais ses mécanismes sous-jacents sont différents. Pour les non-immigrants, c’est en pratiquant la lecture à la maison qu’ils peuvent améliorer leur littératie en santé et leur santé en général, tandis que pour les immigrants, c’est en perfectionnant leurs connaissances du français ou de l’anglais.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Canadian Council on Learning. Health Literacy in Canada: Initial Results from the International Adult Literacy and Skills Survey 2007. Ottawa, ON: Canadian Council on Learning, 2007.
Rootman I, Ronson B. Literacy and health research in Canada: Where have we been and where should we go? Can J Public Health 2005;96(supplement 2):S62–S77.
Von Wagner C, Semmler C, Good A, Wardle J. Health literacy and self-efficacy for participating in colorectal cancer screening: The role of information processing. Pat Educ Counsel 2009;75(3):352–57.
Sudore RL, Mehta KM, Simonsick EM, Harris TB, Newman AB, Satterfield S, et al. Limited health literacy in older people and disparities in health and healthcare access. J Am Geriatr Soc 2006;54:770–76.
Lincoln A, Paasche-Orlow MK, Cheng DM, Lloyd-Travaglini C, Caruso C, Saitz R, Samet, JH. Impact of health literacy on depressive symptoms and mental-health related quality of life among adults with addiction. J Gen Intern Med 2006;21(8):818–22.
Baker DW, Wolf MS, Feinglass J, Thompson JA, Gazmararian JA, Huang J. Health literacy and mortality among elderly persons. Arch Intern Med 2007;167(14):1503–9.
Guerra CE, Shea, JA. Health literacy and perceived health status in Latinos and African Americans. Ethn Dis 2007;17:305–12.
Canadian Council on Learning. Health Literacy in Canada: A Healthy Understanding. Ottawa, ON: Canadian Council on Learning, 2008.
Chui T, Tran K, Maheux H. Immigration in Canada: A Portrait of the Foreignborn Population, 2006 Census. Catalogue, No. 97-557-XIE. Ottawa, ON: Statistics Canada, 2007.
Acevedo-Garcia D, Pan J, Jun H-J, Osypuk TL, Emmons, KM. The effect of immigrant generation on smoking. Soc Sci Med 2005;61:1223–42.
Ng E, Wilkins R, Gendron F, Berthelot J-M. Dynamics of immigrants’ health in Canada: Evidence from the National Population Health Survey. In: Healthy Today, Healthy Tomorrow? Findings from the National Population Health Survey (Statistics Canada, Catalogue 82-618). Ottawa, ON: Statistics Canada, 2005.
Newbold, KB. Self-rated health within the Canadian immigrant population: Risk and the healthy immigrant effect. Soc Sci Med 2005;60:1359–70.
Hyman I. Immigration and Health: Reviewing Evidence of the Healthy Immigrant Effect in Canada. Joint Centre of Excellence for Research on Immigration and Settlement (CERIS) Working Paper, No. 55. Toronto, ON: CERIS, 2007.
Newbold KB, Danforth J. Health status and Canada’s immigrant population. Soc Sci Med 2003;57:1981–95.
McDonald JT, Kennedy S. Insights into the ‘healthy immigrant effect’: Health status and health service use of immigrants to Canada. Soc Sci Med 2004;59:1613–27.
Chen J, Ng E, Wilkins R. The health of Canada’s immigrants in 1994–95. Health Rep 1996;7(4):33–45.
Ali J. Mental health of Canada’s immigrants. Health Rep 2002;13 (Supplement):101–13.
Wilkins R, Tjepkema M, Mustard C, Choinière R. The Canadian census mortality follow-up study, 1991 through 2001. Health Rep 2008;19(3):25–43.
Beiser M. The health of immigrants and refugees in Canada. Can J Public Health 2005;96(supplement 2):S30–S44.
Vissandjée B, Weinfeld M, Dupéré S, Abdool S. Sex, gender, ethnicity, and access to health care services: Research and policy challenges for immigrant women in Canada. J Int Migration Integration 2001;2(1):55–75.
Steele LS, Lemieux-Charles L, Clark JP, Glazier, RH. The impact of policy changes on the health of recent immigrants and refugees in the inner city: A qualitative study of service providers’ perspectives. Can J Public Health 2002;93(2):118–22.
Dunn JR, Dyck I. Social determinants of health in Canada’s immigrant population: Results from the National Population Health Survey. Soc Sci Med 2000;51:1573–93.
Stewart M, Anderson J, Beiser M, Mwakarimba E, Neufeld A, Simich L, et al. Multicultural meanings of social support among immigrants and refugees. International Migration 2008;46(3):123–59.
Zanchetta MS, Poureslami, IM. Health literacy within the reality of immigrants’ culture and language. Can J Public Health 2006;97(supplement 2):S26–S30.
Pottie K, Ng E, Spitzer D, Mohammed A, Glazier R. Language proficiency, gender and self-reported health: An analysis of the first two waves of the Longitudinal Survey of Immigrants to Canada. Can J Public Health 2008;99(6):505–10.
Ng E, Pottie K, Spitzer D, Glazier R. Language proficiency, gender and self-reported health: A dynamic view from the Longitudinal Survey of Immigrants to Canada. Poster presented at the National Metropolis Conference, Halifax, NS, April 4–5, 2008.
Statistics Canada and Human Resources and Social Development Canada. Building Our Competencies: Canadian Results of the International Adult Literacy and Skills Survey 2003. Catalogue, No. 89-617-XIE. Ottawa, ON: Statistics Canada, 2005.
Rudd R, Kirsch I, Yamamoto K. Literacy and Health in America. Princeton, NJ: Policy Information Center, Education Testing Service, 2004.
Desjardins R. Determinants of literacy proficiency: A lifelong-life-wide learning perspective. Int J Educ Res 2003;39:205–45.
Author information
Authors and Affiliations
Corresponding author
Additional information
Acknowledgement: This study was supported by funding from the Canadian Council on Learning.
Conflict of Interest: None to declare.
Rights and permissions
About this article
Cite this article
Omariba, D.W.R., Ng, E. Immigration, Generation and Self-rated Health in Canada: On the Role of Health Literacy. Can J Public Health 102, 281–285 (2011). https://doi.org/10.1007/BF03404049
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03404049