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Population Health Metrics
Published in: Population Health Metrics 1/2016

Open Access 01-12-2016 | Research

Infant mortality among the Canadian-born offspring of immigrants and non-immigrants in Canada: a population-based study

Author: Zoua M. Vang

Published in: Population Health Metrics | Issue 1/2016

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Abstract

Background

Adult immigrants in Canada have a survival advantage over their Canadian-born counterparts. It is unknown whether migrants are able to transmit their survival advantage to their Canadian-born children.

Methods

Neonatal and postneonatal mortality between the Canadian-born population and 12 immigrant subgroups were compared using 1990–2005 linked birth-infant death records. Age-at-death specific mortality rates and rate differences were calculated by nativity status and maternal birthplace. A chi-square statistic was used to compare group differences in maternal sociodemographic characteristics. Multivariate survival analysis was used to estimate the effect of maternal birthplace on neonatal and postneonatal mortality, net of maternal sociodemographic and infant characteristics.

Results

Overall, immigrants had lower rates of neonatal and postneonatal mortality than the Canadian-born population. But the adjusted risk of neonatal mortality was higher for Sub-Saharan African (hazard ratio [HR] = 1.32; 95 % confidence interval [CI] = 1.05, 1.66), Haitian (HR = 2.29, 95 % CI = 1.90, 2.76), non-Spanish Caribbean (HR = 1.38; 95 % CI = 1.01, 1.89), and Pakistani (HR = 1.87; 95 % CI = 1.31, 2.68) migrants relative to Canadian-born women. There were fewer significant disparities in postneonatal death, with higher adjusted risks of mortality observed for Pakistani (HR = 2.67, 95 % CI = 1.77, 4.02) and Haitian (HR = 1.41, 95 % CI = 1.02, 1.97) migrants only.

Conclusion

Inequalities in infant mortality are more concentrated in the neonatal period. Contingent on surviving the first 27 days after birth, the infants of most immigrants (except those from Haiti and Pakistan) have the same chances of survival as the infants of Canadian-born women. Improvements in prenatal care and access to postpartum care may reduce disparities in infant mortality.
Appendix
Available only for authorised users
Footnotes
1
Reliable estimates of infant mortality rates for Aboriginal peoples in Canada are currently not available at the national level [4].
 
2
The non-Spanish Caribbean includes countries that were formerly English, French, and Dutch colonies. These countries are typically distinguished from the two Spanish-speaking Caribbean countries, Cuba and the Dominican Republic, in part because of the different languages and cultures but also because of different histories of colonization in the former Spanish colonies [58, 60].
 
3
In Québec, the Collège d’enseignement général et professionnel (or CEGEP) is a network of colleges that provide pre-university and technical programs to high school graduates. Pre-university programs are shorter in duration (2 years) and are meant to prepare students for matriculation into universities. Technical programs (lasting three years) train students for employment but students who take this stream can also matriculate into bachelor programs at universities [61].
 
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Metadata
Title
Infant mortality among the Canadian-born offspring of immigrants and non-immigrants in Canada: a population-based study
Author
Zoua M. Vang
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Population Health Metrics / Issue 1/2016
Electronic ISSN: 1478-7954
DOI
https://doi.org/10.1186/s12963-016-0101-5

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