Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

ACC 2024 Congress

Catch up on all the top stories and latest evidence in cardiology research with our ACC 2024 Congress hub page.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Research article

The shrinking health advantage: unintentional injuries among children and youth from immigrant families

Authors: Natasha Ruth Saunders, Alison Macpherson, Jun Guan, Lisa Sheng, Astrid Guttmann

Published in: BMC Public Health | Issue 1/2018

Login to get access

Abstract

Background

Immigrants typically arrive in good health. This health benefit can decline as immigrants adopt behaviours similar to native-born populations. Risk of injury is low in immigrants but it is not known whether this changes with increasing time since migration. We sought to examine the association between duration of residence in Canada and risk of unintentional injury.

Methods

Population-based cross-sectional study of children and youth 0 to 24 years in Ontario, Canada (2011-2012), using linked health and administrative databases. The main exposure was duration of Canadian residence (recent: 0–5 years, intermediate: 6–10 years, long-term: >10 years). The main outcome measure was unintentional injuries. Cause-specific injury risk by duration of residence was also evaluated. Poisson regression models estimated rate ratios (RR) for injuries.

Results

999951 immigrants were included with 24.2% recent and 26.4% intermediate immigrants. The annual crude injury rates per 100000 immigrants were 6831 emergency department visits, 151 hospitalizations, and 4 deaths. In adjusted models, recent immigrants had the lowest risk of injury and risk increased over time (RR 0.79; 95% CI 0.77, 0.81 recent immigrants, RR 0.90; 95% CI 0.88, 0.92 intermediate immigrants, versus long-term immigrants). Factors associated with injury included young age (0-4 years, RR 1.30; 95% CI 1.26, 1.34), male sex (RR 1.52; 95% CI 1.49, 1.55), and high income (RR 0.93; 95% CI 0.89, 0.96 quintile 1 versus 5). Longer duration of residence was associated with a higher risk of unintentional injuries for most causes except hot object/scald burns, machinery-related injuries, non-motor vehicle bicycle and pedestrian injuries. The risk of these latter injuries did not change significantly with increasing duration of residence in Canada. Risk of drowning was highest in recent immigrants.

Conclusions

Risk of all-cause and most cause-specific unintentional injuries in immigrants rises with increasing time since migration. This indicates the need to develop strategies for maintaining the immigrant health advantage over time while balancing the desire to support integration, active living, and healthy child development.
Appendix
Available only for authorised users
Literature
1.
Mendoza FS. Health disparities and children in immigrant families: a research agenda. Pediatrics. 2009;124(Suppl 3):S187–95.CrossRefPubMed
2.
Miller LS, Robinson JA, Cibula DA. Healthy Immigrant Effect: Preterm Births Among Immigrants and Refugees in Syracuse, NY. Matern Child Health J. 2016;20(2):484–93.
3.
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(8):1613–27.CrossRefPubMed
4.
Vandenheede H, Willaert D, De Grande H, Simoens S, Vanroelen C. Mortality in adult immigrants in the 2000s in Belgium: a test of the 'healthy-migrant' and the 'migration-as-rapid-health-transition' hypotheses. Trop Med Int Health. 2015;20(12):1832–45.CrossRefPubMed
5.
Norredam M, Olsbjerg M, Petersen JH, Laursen B, Krasnik A. Are there differences in injury mortality among refugees and immigrants compared with native-born? Inj Prev. 2013;19(2):100–5.CrossRefPubMed
6.
Newbold KB. Health care use and the Canadian immigrant population. Int J Health Serv. 2009;39(3):545–65.CrossRefPubMed
7.
Javier JR, Wise PH, Mendoza FS. The relationship of immigrant status with access, utilization, and health status for children with asthma. Ambul Pediatr. 2007;7(6):421–30.CrossRefPubMed
8.
Setia MS, Quesnel-Vallee A, Abrahamowicz M, Tousignant P, Lynch J. Convergence of body mass index of immigrants to the Canadian-born population: evidence from the National Population Health Survey (1994-2006). Eur J Epidemiol. 2009;24(10):611–23.CrossRefPubMed
9.
Sordo L, Indave BI, Vallejo F, Belza MJ, Sanz-Barbero B, Rosales-Statkus M, Fernandez-Balbuena S, Barrio G. Effect of country-of-origin contextual factors and length of stay on immigrants' substance use in Spain. Eur J Public Health. 2015;25(6):930–6.CrossRefPubMed
10.
Guttmann A, Manuel D, Stukel TA, Desmeules M, Cernat G, Glazier RH. Immunization coverage among young children of urban immigrant mothers: findings from a universal health care system. Ambul Pediatr. 2008;8(3):205–9.CrossRefPubMed
11.
Kwak K, Rudmin F. Adolescent health and adaptation in Canada: examination of gender and age aspects of the healthy immigrant effect. International journal for equity in health. 2014;13(1):103.CrossRefPubMedPubMedCentral
12.
Chan BTB, Schull MJ, Schultz SE. Emergency Department Services in Ontario. Toronto: Institute for Clinical Evaluative Sciences; 2001.
13.
Peden M, Oyegbite K, Ozanne-Smith J. World Report on Child Injury Prevention. Geneva: World Health Organization, UNICEF; 2008.
14.
Macpherson A, Spinks A. Bicycle helmet legislation for the uptake of helmet use and prevention of head injuries. Cochrane Database Syst Rev. 2007;2:CD005401.
15.
16.
Howard AW, MacArthur C, Willan A, Rothman L, Moses-McKeag A, MacPherson AK. The effect of safer play equipment on playground injury rates among school children. CMAJ. 2005;172(11):1443–6.CrossRefPubMedPubMedCentral
17.
18.
Saunders NR, To T, Parkin PC, Guttmann A. Emergency Department Revisits by Urban Immigrant Children in Canada: A Population-Based Cohort Study. J Pediatr. 2016;170:218–26.CrossRefPubMed
19.
Saunders NR, Macpherson A, Guan J, Sheng L, Guttmann A. Unintentional injuries in children and youth from immigrant families in Ontario, Canada: a population-based cross-sectional study. CMAJ Open. 2017;5(1):E90–6.CrossRefPubMedPubMedCentral
20.
21.
22.
23.
Laursen B, Moller H. Unintentional injuries in children of Danish and foreign-born mothers. Scand J Public Health. 2009;37(6):577–83.CrossRefPubMed
24.
Annest JL, Hedegaard H, Chen LH, Warner M, Smalls E. In: Control CfDCNCfIPa, editor. Proposed framework for presenting injury data using ICD-10-CM external cause of injury codes. Atlanta, GA: Centers for Disease Control and Prevention; 2014.
25.
Fridman L, Fraser-Thomas JL, McFaull SR, Macpherson AK. Epidemiology of sports-related injuries in children and youth presenting to Canadian emergency departments from 2007-2010. BMC Sports Sci Med Rehabil. 2013;5(1):30.CrossRefPubMedPubMedCentral
26.
Macpherson AK, Macarthur C, To TM, Chipman ML, Wright JG, Parkin PC. Economic disparity in bicycle helmet use by children six years after the introduction of legislation. Inj Prev. 2006;12(4):231–5.CrossRefPubMedPubMedCentral
27.
Durbin A, Moineddin R, Lin E, Steele LS, Glazier RH. Mental health service use by recent immigrants from different world regions and by non-immigrants in Ontario, Canada: a cross-sectional study. BMC Health Serv Res. 2015;15:336.CrossRefPubMedPubMedCentral
28.
Kim SY, Benner AD, Takushi RM, Ongbongan K, Dennerlein D, Spencer DK. “It's like we’re just renting over here”: The Pervasive Experiences of Discrimination of Filipino Immigrant Youth Gang Members in Hawai’i. AAPI Nexus. 2009;6(1):11–30.PubMedPubMedCentral
29.
Muggah E, Dahrouge S, Hogg W. Access to primary health care for immigrants: results of a patient survey conducted in 137 primary care practices in Ontario, Canada. BMC family practice. 2012;13:128.CrossRefPubMedPubMedCentral
30.
Xiang H, Yu S, Zhang X, Scurlock C, Smith GA, Stallones L. Behavioral risk factors and unintentional injuries among U.S. immigrant adults. Ann Epidemiol. 2007;17(11):889–98.CrossRefPubMed
31.
Dudani A, Macpherson A, Tamim H. Childhood behavior problems and unintentional injury: a longitudinal, population-based study. J Dev Behav Pediatr. 2010;31(4):276–85.CrossRefPubMed
32.
Kahl H, Dortschy R, Ellsasser G. Injuries among children and adolescents (1-17 years) and implementation of safety measures. Results of the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2007;50(5-6):718–27.CrossRefPubMed
33.
White HL, Macpherson AK. Capturing paediatric injury in Ontario: differences in injury incidence using self-reported survey and health service utilisation data. Inj Prev. 2012;18(1):33–7.CrossRefPubMed
Metadata
Title
The shrinking health advantage: unintentional injuries among children and youth from immigrant families
Authors
Natasha Ruth Saunders
Alison Macpherson
Jun Guan
Lisa Sheng
Astrid Guttmann
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-017-4612-1

Other articles of this Issue 1/2018

BMC Public Health 1/2018 Go to the issue

Research article

How public health nurses’ deal with sexting among young people: a qualitative inquiry using the critical incident technique

Research article

Attitude and subjective wellbeing of non-compliant mothers to childhood oral polio vaccine supplemental immunization in Northern Nigeria

Research article

Reproductive health knowledge among college students in Kenya

Research article

Impact of financial burden, resulting from prescription co-payments, on antihypertensive medication adherence in an older publically insured population

Research article

Effectiveness of active school transport interventions: a systematic review and update

Research article

Feasibility study of the SWITCH implementation process for enhancing school wellness