ARCHIVED – Health Status and Social Capital of Recent Immigrants in Canada: Evidence from the Longitudinal Survey of Immigrants to Canada

Descriptive analysis

Evidence from the LSIC and CCHS indicates that in the initial period after arrival, the self-reported health status of immigrants is better than that of their Canadian born counterparts. This reflects the “healthy immigrant effect,” which is possibly due to the health standards required by the immigrant selection program and verified by a pre-migration medical examination. According to section 38 of Canada’s Immigration and Refugee Protection Act (IRPA) issued in 2002, “a foreign national is inadmissible on health grounds if their health condition (a) is likely to be a danger to public health; (b) is likely to be a danger to public safety; or (c) might reasonably be expected to cause excessive demand on health or social services.” However, this “healthy immigrant effect” is found to diminish gradually with time spent in Canada.

Figure 1: Share of Immigrants and Canadian-Born Self-Reporting as Healthy

See table below
  LSIC immigrants CCHS non-immigrants
2001 97 88.2
2003 95 88.9
2005 92 89

Note: The plots in Figure 1 are age standardized to represent a person of mean age in the Canadian population as measured by the CCHS

Source: LSIC (2005), CCHS (2000-2005).

The gap of incidence of a healthy population between immigrants and Canadians narrows at four years after landing, as shown in Figure 1. Our results are consistent with existing studies on health status of immigrants (e.g., McDonald and Kennedy 2004; Newbold and Danforth 2003; and Zhao 2007a).

Table 2:   Immigrants’ Health Status at Wave 1 Cross-Tabulated with Each of Waves 2 and 3 (Unweighted Sample Size N=7716)

Health status, wave 1 Health status, wave 2 Health status,  wave 3
Not healthy Healthy Not healthy Healthy
Not healthy (number) 4,706 1,590 3,116 1,533 3,174
(%) 100 34 66 33 67
Healthy (number) 152,908 6,959 145,927 11,121 141,787
(%) 100 5 95 7 93
Total (number) 157,615 8,550 149,043 12,654 144,961
(%) 100 5 95 8 92

Source: LSIC (2005).

Table 3:   Immigrants’ Health Status at Wave 2 Cross-Tabulated with Wave 3 (Unweighted Sample Size N=7714)

Health status, wave 2 Health status, wave 3
Not healthy Healthy
Not healthy (number) 8,550 3,644 4,906
(%) 100 43 57
Healthy (number) 149,043 9,010 140,033
(%) 100 6 94
Total (number) 157,593 12,654 144,939
(%) 100 8 92

Source: LSIC (2005).

The dynamic changes in health status of immigrants over the initial period after landing can be found in Tables 2 and 3. At the wave 1 interview, 97 percent of immigrants (152,908) report their health as good, very good, or excellent. Among these healthy immigrants, 5 percent and 7 percent report their health as fair or poor at waves 2 and 3, respectively, while 93 percent remain healthy at wave 3. In contrast, among the unhealthy immigrants at wave 1, 67 percent report their health as good, very good, or excellent at four years after landing. As shown in Table 3, 95 percent of immigrants (149,043) report their health as good, very good, or excellent at wave 2, while 6 percent of these healthy immigrants report their health as fair or poor at wave 3. Among the unhealthy immigrants at wave 2, 57 percent report their health as healthy at wave 3. Given all these changes, after four years in Canada 92 percent of the LSIC immigrants deem their health status as good, very good, or excellent.

Figure 2: Share of Immigrants Self-Reporting as “Healthy” by Immigration Category

See table below
  Family class Skilled workers Refugees
Wave 1 95 98 94
Wave 2 92 96 92
Wave 3 89 94 87

Source: LSIC (2005).

As shown in Figure 2, when looking at the health status of immigrants by immigrant category, there are obvious disparities among immigrant sub-groups. In each wave, skilled workers have the largest share of healthy immigrants, followed by family class immigrants and refugees. Refugees are more likely to report their health as fair or poor initially because they often come from areas of conflict with poor public health infrastructure and are more likely to be at risk for malnutrition and infectious diseases.

Many refugees may have suffered physical or emotional trauma and unhealthy living conditions prior to migration. After arrival in Canada, most refugees are eligible for income support and other immediate and essential services from the Resettlement Assistance Program (RAP), which are offered for up to one year. Particularly under the Interim Federal Health Program (IFHP), resettled refugees are eligible for health benefits until their provincial health care coverage begins. Those with provincial/territorial health coverage are provided with supplemental coverage for one year. The IFHP coverage can be extended up to 24 months for recipients identified with special needs. With the income support from the RAP along with other assistance, the LSIC refugees were able by the second wave of the LSIC to narrow the gap between proportions reporting being healthy as compared to other categories. However, after this initial period, refugees may have experienced more financial and cultural barriers, which had negative effects on their health outcomes, implied by the widened gap at four years after landing. 

Friendship networks of recent immigrants in Canada represent an extremely important source of support and assistance (van Kemenade et al. 2006). Figure 3 presents the health status of recent immigrants by the presence of new friends. Immigrants who have made friends after their arrival in Canada are more likely to report a better health status in all three waves. This may be largely related to the ability of friendships to promote a sense of belonging and reduce loneliness. Sense of belonging can be considered a possible emotional outcome (Ueno 2004). Friendship networks also have potential impacts on immigrants’ settlement outcomes and integration to Canadian society, such as housing, employment, education, and health care services usage (Xue 2008; Zhao 2007a; van Kemenade et al. 2006), which may affect both emotional and physical health as well.

Figure 3:  Share of Immigrants Self-Reporting as “Healthy” by Having Made New Friends

See table below
  No new friend Having made new friends
Wave 1 94 97
Wave 2 89 95
Wave 3 86 93

Source: LSIC (2005).

Organizational networks such as community organizations, religious groups, and ethnic and immigration associations are important sources of assistance for recent immigrants. Findings from the LSIC indicate that the percentage of immigrants involved in group or organizational activities increases with time spent in Canada (Zhao 2007a). Good social integration generally makes for good social support (Franke 2006); this social support may also be beneficial for immigrant health outcomes. As shown in Figure 4, at six months after landing, there are almost no differences in the health status between immigrants involved in organizational or group activities and immigrants who are not involved in such activities. In contrast, two years after landing, the proportion of healthy immigrants among the immigrants involved in group or organizational activities is larger than those who are not involved. At for years after landing, the gap widens to 3 percentage points.

Figure 4:  Share of Immigrants Self-Reporting as “Healthy” by Participation in Organizations

See table below
  Participation in organizations No participation in any organization
Wave 1 97 97
Wave 2 95 94
Wave 3 94 91

Source: LSIC (2005).

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