Dataset Information

Association of immigrant generational status with asthma.

ABSTRACT: OBJECTIVE:We sought to examine whether asthma risk is lower in second-generation immigrants (i.e., Canadian-born children with at least one foreign-born parent) and first-generation immigrants (i.e., foreign-born children) compared with non-immigrants (i.e., Canadian-born children to Canadian-born parents). METHODS:Data were obtained from the Canadian National Longitudinal Survey of Children and Youth from 1994 to 2008, which measured child health and developmental factors from birth to early adulthood. The sample included 15,799 participants aged 2-26 years. Asthma was defined as diagnosis by a health professional as having asthma, having wheezing or whistling in the chest, or use of medication for asthma. RESULTS:Prevalence of asthma (defined as a combination of any three factors) was lower in first-generation (32%) and second-generation (34%) immigrants compared with non-immigrants (46%). After controlling for covariates, first- and second-generation immigrants had 0.21 (AOR?=?0.21; 95% CI?=?0.07-0.67) and 0.19 (AOR?=?0.19; 95% CI?=?0.09-0.39) lower odds of reporting asthma compared with non-immigrants, respectively. For every year the parent(s) of second-generation immigrants resided in Canada, the odds for asthma increased by 5% (AOR?=?1.05; 95% CI?=?1.02-1.06). CONCLUSION:Immigrant children and youth in Canada, regardless of whether they are first- or second-generation, have lower odds for asthma compared with non-immigrants.

SUBMITTER: Philipneri A

PROVIDER: S-EPMC6964630 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Publications

Association of immigrant generational status with asthma.

Philipneri Anne A Hanna Steven S Mandhane Piush J PJ Georgiades Katholiki K

Canadian journal of public health = Revue canadienne de sante publique 20190408 4

<h4>Objective</h4>We sought to examine whether asthma risk is lower in second-generation immigrants (i.e., Canadian-born children with at least one foreign-born parent) and first-generation immigrants (i.e., foreign-born children) compared with non-immigrants (i.e., Canadian-born children to Canadian-born parents).<h4>Methods</h4>Data were obtained from the Canadian National Longitudinal Survey of Children and Youth from 1994 to 2008, which measured child health and developmental factors from bi ...[more]

PMID: 30963505

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Project description:ImportancePeople who immigrate face unique health literacy, communication, and system navigation challenges, and they may have diverse preferences that influence end-of-life care.ObjectiveTo examine end-of-life care provided to immigrants to Canada in the last 6 months of their life.Design, setting, and participantsThis population-based cohort study (April 1, 2004, to March 31, 2015) included 967 013 decedents in Ontario, Canada, using validated linkages between health and immigration databases to identify immigrant (since 1985) and long-standing resident cohorts.ExposuresAll decedents who immigrated to Canada between 1985 and 2015 were classified as recent immigrants, with subgroup analyses assessing the association of time since immigration, and region of birth, with end-of-life care.Main outcomes and measuresLocation of death and intensity of care received in the last 6 months of life. Analysis included modified Poisson regression with generalized estimating equations, adjusting for age, sex, socioeconomic position, causes of death, urban and rural residence, and preexisting comorbidities.ResultsAmong 967 013 decedents of whom 47 514 (5%) immigrated since 1985, sex, socioeconomic status, urban (vs rural) residence, and causes of death were similar, while long-standing residents were older than immigrant decedents (median [interquartile range] age, 75 [58-84] vs 80 [68-87] years). Recent immigrant decedents were overall more likely to die in intensive care (15.6% vs 10.0%; difference, 5.6%; 95% CI, 5.2%-5.9%) after adjusting for differences in age, sex, income, geography, and cause of death (relative risk, 1.30; 95% CI, 1.27-1.32). In their last 6 months of life, recent immigrant decedents experienced more intensive care admissions (24.9% vs 19.2%; difference, 5.7%; 95% CI, 5.3%-6.1%), hospital admissions (72.1% vs 68.2%; difference, 3.9%; 95% CI, 3.5%-4.3%), mechanical ventilation (21.5% vs 13.6%; difference, 7.9%; 95% CI, 7.5%-8.3%), dialysis (5.5% vs 3.4%; difference, 2.1%; 95% CI, 1.9%-2.3%), percutaneous feeding tube placement (5.5% vs 3.0%; difference, 2.5%; 95% CI, 2.3%-2.8%), and tracheostomy (2.3% vs 1.1%; difference, 1.2%; 95% CI, 1.1%-1.4%). Relative risk of dying in intensive care for recent immigrants compared with long-standing residents varied according to recent immigrant region of birth from 0.84 (95% CI, 0.74-0.95) among those born in Northern and Western Europe to 1.96 (95% CI, 1.89-2.05) among those born in South Asia.Conclusions and relevanceAmong decedents in Ontario, Canada, recent immigrants were significantly more likely to receive aggressive care and to die in an intensive care unit compared with other residents. Further research is needed to understand the mechanisms behind this association.

Project description:ObjectiveTo compare recent immigrants and long-term residents in Ontario, Canada, on established health service quality indicators of end-of-life cancer care.DesignRetrospective, population-based cohort study of cancer decedents between 2004 and 2015.SettingOntario, Canada.ParticipantsWe grouped 13 085 immigrants who arrived in Ontario in 1985 or later into eight major ethnic groups based on birth country, mother tongue and surname, and compared them to 229 471 long-term residents who were ≥18 years at the time of death.Primary and secondary outcome measuresAggressive care, defined as a composite of ≥2 emergency department visits, ≥2 new hospitalisations or an intensive care unit admission within 30 days of death; and supportive care, defined as a physician house call within 2 weeks, or palliative nursing or personal support worker home visit within 6 months of death. Multivariable logistic regression was used to examine the association between immigration status and the odds of each main outcome.ResultsCompared with long-term residents, immigrants overall and by ethnic group had higher rates of aggressive care (13.7% vs 17.5%, respectively; p<0.001). Among immigrants, Southeast Asians had the highest use while White-Eastern and Western Europeans had the lowest. Supportive care use was similar between long-term residents and immigrants (50.0% vs 50.5%, respectively; p=0.36), though lower among Southeast Asians (46.6%) and higher among White-Western Europeans (55.6%). After adjusting for sociodemographic characteristics and comorbidities, immigrants remained more likely than long-term residents to receive aggressive care (OR: 1.15, 95% CI 1.09 to 1.21), yet were less likely to receive supportive care (OR: 0.95, 95% CI 0.91 to 0.98).ConclusionsAmong cancer decedents in Ontario, immigrants are more likely to use aggressive healthcare services at the end of life than long-term residents, while supportive care varies by ethnicity. Contributors to variation in end-of-life care require further study.

Dataset Information

Association of immigrant generational status with asthma.

Publications

Association of immigrant generational status with asthma.

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