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PubMed1984

Cancer mortality among immigrant populations in Ontario, 1969 through 1973.

Ontario is home to a sizeable, recently established immigrant population whose cancer mortality has until now remained unexamined. The province's six largest immigrant groups (British, Italian, German, Dutch, Polish and Soviet) were investigated to compare their cancer mortality experience with that prevailing in Ontario and in their countries of birth for the period 1969 through 1973. Standardized mortality ratios (SMRs) were computed from data from Statistics Canada and the World Health Organization (for 1971) for five sites of cancer. The rates of death from stomach cancer were significantly higher for the immigrant groups (except the Germans) than for the Canadian-born (SMRs 158.6 to 256.1) and were significantly lower for the immigrants (except the Dutch) than for the populations of their countries of birth (SMRs 26.5 to 72.9). The rates of death from colorectal cancer and cancer of the breast tended to be lower among the immigrants. Most male immigrants had high rates of death from lung cancer relative to the Canadian-born, whereas their female counterparts had relatively low rates. For most of the immigrant groups the rates of death from prostate cancer closely resembled those prevailing in the country of birth. Displacement of cancer mortality experience towards that in Ontario was most evident for Polish immigrants. It may have been too soon to see trends among the more recent immigrants (Italian, German and Dutch), who, for the most part, had not yet reached the age of highest cancer risk. Ontario should provide a valuable resource for further studies of lifestyle and environmental determinants of cancer.

Adult↗

PubMed1998

Tuberculosis among immigrants: interval from arrival in Canada to diagnosis. A 5-year study in southern Alberta.

OBJECTIVE: To examine the pattern of tuberculosis (TB) occurring among immigrants and the interval from arrival in Canada to diagnosis of the disease. DESIGN: Study of all cases of TB diagnosed in foreign-born residents of southern Alberta during the 5-year period 1990-1994. SETTING: A centre for the diagnosis, management and control of all cases of TB in the southern half of the province of Alberta. METHODS: All foreign-born patients in whom TB was newly diagnosed between January 1990 and December 1994 were included in the study. The interval from their arrival in Canada to diagnosis, their country of birth and the site of their disease were documented. RESULTS: Immigrants to Canada accounted for 248 (70.6%) of the 351 cases of TB diagnosed in southern Alberta during the 5-year period. The majority of these immigrants (182/248 [73.4%]) were of Asian origin. Extrapulmonary TB accounted for 111 (61.0%) of the 182 cases of the disease in Asian immigrants. The mean period between immigration and diagnosis was 11.2 years (standard deviation [SD] 13.9 years). Half of the patients presented within 7 years of their arrival in Canada. The time to presentation was shortest for patients with superficial lymph node disease (mean 7.6 years [SD 6.9] after arrival), intermediate among those with extrapulmonary disease, excluding superficial disease of the lymph node (10.1 years [SD 12.1]), and longest for those with pulmonary disease (14.2 years [SD 17.2]). TB developed sooner after arrival in Canada among immigrants from Asian countries (mean 9.1 years) than among those from other countries (17.2 years) (p = 0.01). CONCLUSIONS: Given the low annual incidence of TB in Canada (7.1 per 100,000), it is probable that TB occurring among immigrants reflects infection acquired before arrival in Canada. Health care professionals need to be aware that immigrants from countries with a relatively high prevalence of TB remain at risk for the disease (often at an extrapulmonary site) for many years after they immigrate to low-prevalence countries.

Adult↗

PubMed1988

Cancer mortality in Illinois Mexican and Puerto Rican immigrants, 1979-1984.

The site-specific cancer mortality in Illinois immigrant Hispanics for 1979-1984 was compared to that of US-born, non-Hispanic whites (Anglos). Using indirect methods of standardization, 22 site-specific cancer SMRs (Standard Mortality Ratios) were calculated for Mexican and Puerto Rican immigrants, using standard rates for Illinois Anglos. SMRs were also calculated for Puerto Rican immigrants using 1979-1982 mortality rates from Puerto Rico. Cancer mortality for all sites was lower in both immigrant groups than in Anglos. Colon cancer mortality risk was lower in immigrants, but had increased from home country rates in Puerto Rican male immigrants. In addition, immigrants retained their lower home country risks for cancer of the lung, prostate and female breast. Significantly higher risks were found in immigrant females only, for cancer of the stomach, cervix and gall-bladder (Mexican females). The cancer rates for immigrant Puerto Rican males were closer to those of Anglos than the rates for females and Mexicans, suggesting differences in the rates of transition to the Anglo cancer experience.

Adolescent↗

PubMed2006

Demand for psychiatric emergency services and immigration. Findings in a Spanish hospital during the year 2003.

BACKGROUND: The aim of this study is to investigate differences among immigrants and natives regarding access and pathways to psychiatric care, psychiatric admission rates, length of stay, continuity of care, and main diagnoses. METHODS: Psychiatric emergency visits (1511) and hospitalizations (410) were registered in a Spanish Hospital with a catchment area of 280 000 people (19.3% immigrants) during the year 2003. Motives for demanding emergency psychiatric care, pathways to care, admission rates, length of stay, continuity of care, and main diagnoses were compared among natives and immigrants. RESULTS: Immigrants accounted for 13.0% of consultations to the psychiatric emergency room (15.9% of patients) and 11.0% of admissions to the psychiatric hospitalization unit (13.5% of patients). The pathways to care were different for immigrants and natives. Immigrants had a lower rate of readmission to the psychiatric emergency room. Motives for consultation and hospitalization were also different among immigrants and natives. Immigrants showed more self-aggressive behaviours and neuroses, and lower rates of affective disorders and psychoses. CONCLUSIONS: Immigrants under-used psychiatric emergency and hospitalization services in comparison with natives. They did not consult because of psychoses or affective disorders, but mainly because of reactive conditions related to the stress of migration.

Adult↗

PubMed2006

Cardiovascular disease risk factors among five major ethnic groups in Oslo, Norway: the Oslo Immigrant Health Study.

BACKGROUND: The levels of cardiovascular risk factors vary in different segments of a population. Our aim was to investigate ethnic differences in cardiovascular risk factors among five major immigrant groups in Oslo, Norway. DESIGN: A population-based, cross-sectional study. METHODS: The Oslo Immigrant Health study was conducted in 2002. All first-generation immigrants aged 31-60 years living in Oslo from Sri Lanka, Turkey, Iran, Vietnam, and a random sample of 30% of those from Pakistan, were invited. A total of 3019 individuals provided written consent and met the inclusion criteria. Participants had a clinical examination, blood test, and were asked to complete the study questionnaire. RESULTS: Immigrants from Vietnam had the highest high-density lipoprotein (HDL) cholesterol, whereas immigrants from Sri Lanka and Pakistan, and men from Turkey, had the lowest HDL-cholesterol and highest triglycerides. Immigrants from Sri Lanka, Pakistan and Turkey had the highest blood pressure. Smoking was least prevalent among Sri Lankan immigrants and most common among Turkish immigrants. Ethnic differences in blood pressure and HDL-cholesterol, and triglycerides among women, were attenuated after adjusting for obesity measures. A moderate and higher (> or =10%) Framingham risk score was most common among Turkish and Pakistani immigrants. CONCLUSIONS: We found ethnic differences in triglycerides, HDL-cholesterol and blood pressure; however, the differences in blood pressure were surprisingly small. Ethnic differences were partly explained by obesity. The prevalence of smoking also varied greatly between the different ethnic groups.

Adult↗

PubMedDate not supplied

[Infectious disease and sociodemographic characteristics of foreign immigrants in the Central Penitentiary for Men in Barcelona].

BACKGROUND: Immigration from socioeconomically under-developed countries is relatively recent in our country. Analyzing the impact of diseases such as HIV/AIDS and tuberculosis among these populations is of particular interest with regard to public health. METHODS: Case study and tests conducted at the Male Prison Facility in Barcelona from January 1, 1996 to September 30, 1996, the cases being the foreign immigrants from socioeconomically underdeveloped countries, and the checks of the native prisoners paired by age (+/- 5 years). A description is provided of the epidemiological and sociodemographic characteristics of the immigrants, and a comparison is drawn between the two populations. RESULTS: 450 prisoners, 300 native and 150 immigrants. Sixty-three percent (63%) of the immigrants were from the Maghreb, 72% being in this country illegally, 55% having resided in our country for over 5 years and 53% not living with any family members. The immigrants used less injected drugs that the native prisoners (OR: 0.2; IC95% 0.09-0.41), had less HIV infection (OR: 0.2; IC95% 0.05-0.49) and lived to a lesser extent with family (OR: 0.2; IC95% 1.011-0.36). No differences were found to exist with regard to infection by Mycobacterium tuberculosis nor tubercular disease. The legal immigrants were older (OR: 1.07; IC95% 1.01-1.13) lived to a greater extent with family (OR: 2.7; IC95% 1.23-5.80) and drank more alcohol (OR: 1.7; IC95% 1.07-2.59) than the illegal residents. CONCLUSIONS: The native prisoners had HIV to a greater extent than the immigrants, the use of injected drugs, more common among the natives, bearing an influence on this aspect. As regards the immigrants, the high degree of illegal residence and the absence of a stable core family comprise indicators of a situation of being socially disadvantaged.

Communicable Diseases↗

PubMed1997

Geographically indirect immigration to Canada: description and analysis.

"This article is concerned with geographically indirect immigration to Canada over the period 1968-1988. A geographically indirect immigrant is an individual legally admitted to Canada whose country of last permanent residence differs from country of birth. Records maintained by Employment and Immigration Canada on every immigrant legally admitted over the period were used in the study. Relative to geographically direct immigrants, geographically indirect immigrants tend to be older, more educated, and more highly skilled. Moreover, if they were not born in an English or French speaking country, indirect immigrants are more likely to speak English and/or French capably than direct migrants born in such countries. The study also contains bivariate logit estimates of a model of geographically indirect Canadian immigration. This model suggests that indirect migrants tend to be influenced by personal characteristics (age, sex, marital status, occupation, language ability), as well as by various characteristics of the country of birth (distance from Canada, income level, political conditions)."

Americas↗

PubMed2006

New York City's immigrant minorities. Reducing cancer health disparities.

One million newcomers arrive in the United States every year; 11.7% of the total U.S. population is foreign-born. Immigrants face cancer care and research access barriers, including economic, immigration status, cultural, and linguistic. In 2000, the Center for Immigrant Health, NYU School of Medicine, launched the Cancer Awareness Network for Immigrant Minority Populations (CANIMP), a network comprising community- and faith-based organizations, local and national government health institutions, clinical service providers, researchers, and immigrant-service and advocacy organizations. This community-based participatory program chose as its priorities high- incidence cancer sites in the overall immigrant community (colorectal, lung, breast, cervical, prostate), as well as sites with strikingly high incidence in specific immigrant groups (gastric, liver, oral). CANIMP has developed successful outreach, education, screening, survivorship, training, and research programs to decrease cancer disparities. Over 2500 at-risk community members have been reached, 25 junior minority researchers trained, 60 minority interns mentored, numerous cancer disparities research projects funded and conducted, and vital partnerships to improve cancer data developed. These initiatives serve as models to address community, systems, physician, and cancer research gaps in immigrant communities. Cancer 2006. (c) 2006 American Cancer Society.

Community Networks↗

PubMed2007

Cultural correlates of eating attitudes: a comparison between native-born and immigrant university students in Israel.

OBJECTIVE: This study explores the association between gender and exposure to Western culture and attitudes toward eating. METHOD: Four hundred and ninety-nine university students participated in the study: 216 Israeli natives, 153 new immigrants (3 years or less since immigration) from the Former Soviet Union (FSU), and 130 veteran immigrants from FSU (4-15 years since immigration). Attitudes toward eating were measured using the Eating Attitude Test - EAT-26. RESULTS: Israeli born women had higher weight and body mass index (BMI) than did new immigrant women. Higher scores on the EAT-26 were found among women than among men. Among women only, native-born Israelis and veteran immigrants were more likely to have positive EAT-26 scores (19.6%, 18.8%) than were new immigrant women (7.9%), indicating disordered eating attitudes. Part of the differences in EAT-26 scores was explained by differences between the groups on age and BMI; however, even after adjustment the differences remained significant on the bulimia subscale. CONCLUSION: The results suggest a rapid cultural effect in attitudes toward eating that may reflect a tendency toward eating disorders as well as a difference in the proportion of obesity. It seems that the veteran immigrants have adopted Western cultural norms and eating patterns in a way that has erased the differences in tendency toward eating disorders between them and the Israeli born women.

Acculturation↗

PubMed1995

Mastectomy as the preferred treatment for breast cancer among new immigrants from the former USSR.

Sixty-four new immigrant patients with primary breast cancer who arrived in Israel since 1990 were compared to 322 Israeli women with primary breast cancer. New immigrant patients had a more advanced stage at diagnosis (stage III+IV 28% vs. 13% respectively, P = 0.00005); larger mean tumor size (3.08 +/- 1.7 cm vs. 2.25 +/- 1.4 cm respectively, P = 0.00002); and more involved lymph nodes (3.8 +/- 5.3 vs. 1.8 +/- 3.3 P = 0.0002). Forty-seven percent of new immigrants had breast-conserving surgery compared to 69% of the Israelis (P = 0.0004). In stage II 51% of the new immigrants had conservative surgery compared to 74% in the Israeli group (P = 0.03). Mastectomy was recommended to 39 Israeli patients and to six immigrants. Only 19% of the Israeli group requested mastectomy compared to 44% in the new immigrant group. Most of the new immigrant patients chose mastectomy although breast-conserving surgery was an equal alternative. The reasons for choosing mastectomy as the preferred mode of treatment were related to economic problems, different life concepts, and other priorities. Constant surveillance and considerable enlightenment are needed in the new immigrant population, so that they will be able to separate the disease and its treatment from their paramedical problems.

Breast Neoplasms↗

PubMed1998

Friendship expectations among immigrant adolescents and their host peers.

This study investigated differences in friendship expectations between immigrants in early and middle adolescence and their Israeli-born peers. Israeli newcomers from the former Soviet Union and their non-immigrant classmates were asked to rate behavioural characteristics of peers according to the extent of their importance for friendship, and also to assess the importance of these characteristics as friendship expectations of members of the other group. Results indicate that immigrants assign greater importance than their host counterparts to all aspects of friendship expectations (help and assistance, status, similarity, and avoidance of harm). Immigrants also tend to view their host peers as expecting more of their friendship in terms of status and similarity, whereas host adolescents perceive the help and avoidance functions of friendship to be a strong factor in the friendship expectations of their immigrant counterparts. Immigrants' friendship expectations were found to be correlated with social distress, especially among early adolescent girls. The results are discussed in terms of the functions of friendships and friendship expectations in the immigrants' adaptation process, and of institutional differences in allocation of immigrants to integrated or segregated classrooms.

Adolescent↗

PubMedDate not supplied

Psychopathology of white mentally ill immigrants to Jamaica.

OBJECT: To test the hypothesis that white immigrants to a predominantly black country have a different pattern of psychopathology from the native population. METHOD: The psychopathology (DSM III-R) of white immigrants to Jamaica seen in the author's private practice between 1979 and 1990 was compared with the psychopathology of a control sample of native Jamaicans matched with the immigrant sample for age, sex, and social class. RESULTS: There was no statistical difference in the major diagnoses mood disorder (35%), anxiety states (27%), and schizophrenia (20%) between the immigrant and control groups. White immigrants to this black country did not develop schizophrenia at higher rates than the native born. White mentally ill immigrants to Jamaica move into social class positions at a significantly higher level (p < 0.005) than those of their parents with whom they grew up in their home country. This was significantly different (p < 0.005) from their Jamaican controls. Two case studies are presented to illustrate these findings. CONCLUSIONS: The political/economic situation which exists in black postcolonial countries like Jamaica provides a protective social environment for white immigrants, which buffers them from the etiological conditions that engender schizophrenia in immigrants to other countries with predominantly white populations.

Adaptation, Psychological↗

PubMed2006

Tobacco use among immigrant and nonimmigrant adolescents: individual and family level influences.

PURPOSE: To identify individual and family level characteristics that might explain differences in rates of tobacco use among immigrant and nonimmigrant adolescents. METHODS: Data for analysis come from a probability sample of 5401 adolescents aged 12-18 years participating in the Ontario Health Survey (OHS). Three groups were compared: (a) adolescents born in Canada to Canadian-born parents (n = 3886), (b) adolescents born in Canada to immigrant parents (n = 1233), and (c) adolescents born outside of Canada (n = 282). Discrete, multilevel logistic regression was used in the analysis. RESULTS: Adolescents born outside of Canada report the lowest rates of tobacco use, despite greater economic hardship. A negative association emerges between family socioeconomic status and tobacco use among adolescents born in Canada but not among adolescents born outside of Canada. Immigrant youth are less likely to affiliate with peers who smoke and are more likely to come from families where parents do not smoke: these differences partially explain the decreased rates of tobacco use among immigrant adolescents. CONCLUSIONS: Although subject to greater economic hardship, immigrant youth are less likely to engage in tobacco use. Protective factors associated with immigrant family life, such as lower rates of parental tobacco use and less exposure among immigrant adolescents to peers who smoke, may counteract some of the negative effects of poverty and social hardship. Future research should begin to address the processes that lead to adaptive outcomes among adolescents from immigrant families, despite greater exposure to social disadvantage.

Adolescent↗

PubMed2004

The role of health insurance on Pap smear and mammography utilization by immigrants living in the United States.

BACKGROUND: Nearly half of recent immigrants to the United States lack health insurance. Access to cancer screening services for this group is problematic. We examine the role of health insurance and having a usual source of care (USC) on Pap smear and mammography utilization by immigrant women using a nationally representative sample. METHODS: We used a telephone survey that oversampled racial and ethnic minorities. We analyzed data on 3,622 women age 18-70. We classified the 822 foreign-born women as recent immigrants if they had resided in the United States for under 10 years; LT immigrants were those with a longer tenure. RESULTS: Among recent immigrants, 73% and 78% (SE 4%) reported a Pap smear or mammogram, respectively, in the previous 2 years versus 89% and 89% of U.S.-born women (P < 0.05 for both comparisons). Among those with insurance or a USC, differences in screening between recent immigrants and U.S.-born women were four percentage points or less and not statistically significant. However, uninsured recent immigrants were less likely than uninsured U.S.-born women to have Pap smears [60% (SE 7%) versus 71%, P < 0.05]. Adjusting for differences in sociodemographics, health attitudes or beliefs, patient or provider communication, and the medical care environment, insurance remained the strongest predictor of screening. CONCLUSION: Disparities in screening were greatly attenuated among the insured population. Increasing awareness of available safety net sources of care may also improve cancer screening among uninsured recent immigrants.

Adolescent↗

PubMedDate not supplied

Effects of immigration on the mentally ill--does it produce psychological distress?

This report explores psychological distress among immigrants seeking help from psychiatric outpatient clinics as compared with control nonpatient immigrants. Our hypothesis is that nonpsychotic mentally ill immigrants will react to acculturation by psychological distress similarly to healthy individuals. Three questionnaires were used in this survey: Demographic Psychosocial Inventory, Brief Symptom Inventory (BSI), and Psychiatric Epidemiology Research Interview-Demoralization Scale (PERI-D). They were completed by patient and control groups consisting of recent adult immigrants to Israel from the former Soviet Union. The patient group included 158 subjects seeking psychiatric help from outpatient clinics. Among them, 51 met ICD-10 criteria for neurotic, stress-related, and somatoform disorders; 41 for schizophrenia; 32 for mood disorders; 18 for organic illnesses; and 16 for personality disorders. The control group consisted of 222 immigrants with no previous psychiatric history, matched by gender and age to the patient group. Although all distress symptoms were significantly more severe in the patient group than in the control group, the BSI profile, showing a high level of depression, anxiety, interpersonal sensitivity, and obsessive-compulsive dimensions, was similar in both groups. The psychological distress level as measured by the PERI-D was 1.4 times higher in patients than in the control group. Within the patient group, the lowest distress level was found in patients suffering from organic disorders. No significant differences in the level of psychological distress were found among other diagnostic subgroups. The results suggest that mentally ill immigrants react to acculturation by a psychological distress syndrome similarly to nonpatient immigrants but more severely than nonpatient immigrants.

Acculturation↗

PubMed2001

Increased rates of psychosis among immigrants to Sweden: is migration a risk factor for psychosis?

BACKGROUND: Previous studies have shown high rates of psychosis among Afro-Caribbean immigrants to the UK and immigrants to the Netherlands. Rates of schizophrenia-like psychoses (SLP), i.e. schizophrenia or other non-affective psychosis, among the native-born and immigrant populations were assessed in Malmö, the city in Sweden with the highest proportion of immigrants. METHODS: All adult patients admitted for in-patient psychiatric treatment in Malmö during the course of a 1-year period (N = 1162) were studied with regard to ethnicity and SLP diagnosis. A smaller sample consisting only of first-onset SLP cases (regardless of in- or out-patient status) was also studied (N = 56). Risks for admission and first-onset were calculated on the basis of current background population figures for Malmö. RESULTS: Compared with those who were native-born, immigrants had increased risk for admission for SLP, with a similar tendency for increased risk for first-onset of SLP. Relative risk for SLP admission was most markedly increased in immigrants from East-Africa. Background factors specifically associated with migration (e.g. extreme duress) did not appear to contribute strongly to SLP in immigrants. CONCLUSION: While the current results add to the growing body of evidence showing increased risk for psychosis in immigrants, vulnerability to psychosis may have been determined by factors other than the migration process.

Adult↗

PubMed2004

Cancer incidence patterns among Chinese immigrant populations in Alberta.

This study examines the incidence of cancer among Chinese immigrants to Alberta in comparison to the incidence in Canadian-born Alberta residents and in people of Chinese origin still living in China. Cancer cases among Chinese immigrants and Canadian-born Alberta residents were identified from the Alberta Cancer Registry (1974-1993). Incidence rates for Shanghai (1975-1992) were obtained from the International Agency for Research on Cancer (IARC) publications. Direct age-standardized incidence rates (ASIRs) were calculated using the "world standard population." Descriptive analysis and Poisson regression modelling were employed to obtain the rate ratios for certain cancer sites among the three populations. For males, the overall incidence of cancer (excluding non-melanoma skin cancer) was lowest in Chinese immigrants while being similar in Canadian-born Alberta residents and Chinese living in Shanghai (197 vs. 224 and 232/100,000). For females, the overall incidence in Chinese immigrants was lower than Canadian-born Alberta residents but similar to that in Chinese living in Shanghai (154 vs 200 and 150/100,000). For cancers that are common in China (stomach and esophagus), the incidence rates for Chinese immigrants were more similar to those for Canadian-born residents than to rates for Shanghai. However, the incidence of liver cancer was very high in the immigrants, suggesting the possible presence of an initiating event during childhood or early adulthood. For cancers that are traditionally uncommon in China (breast and prostate), rates for immigrants were mid-way between those of the two comparison groups. This study supports observations that the risk of cancer in immigrants tends towards the risk of people in the new host country.

Alberta↗

PubMed2002

Nutrient intake of first generation Gujarati Asian Indian immigrants in the U.S.

OBJECTIVE: To examine the nutrient intake of Gujarati Asian Indian immigrants in the U.S. and the influence of length of residence in the U.S. and socioeconomic status (SES) on their macronutrient intake. METHODS: Subjects were male (n = 90) and female (n = 99) Gujarati Asian Indian immigrants over the age of 45. Each participant completed a 24-hour dietary recall. Dietary recalls were analyzed using Food Processor nutrient analysis software. Participants were classified into recent immigrants (<10 years length of residence in the U.S.) and long-term immigrants (>10 years length of residence in the U.S.) and into low, medium and high education groups, based on highest level of education achieved, to examine the influence of these variables on their macronutrient intake. RESULTS: The macronutrient contributions to the total energy intake of these Gujarati Asian Indian immigrants were as follows: carbohydrate 57%, protein 12% and total fat 33%. The diets were low in cholesterol (<100 mg/day) and high in dietary fiber (>/=25 g/day). Reported intakes of vitamin D, calcium (women only), potassium (women only), copper and zinc were less than two-thirds of the recommendations. Significant differences (p < 0.05) in macronutrient intake were observed based on length of residence in the U.S. and SES. Regression analysis indicates age, total energy intake, length of residence in the U.S. and SES to have a significant influence on the nutrient intake of these Gujarati Asian Indian immigrants. CONCLUSION: The nutrient intakes of these Gujarati Asian Indian immigrants indicate both inadequacies and excesses of select macro and micronutrients. These nutrient inadequacies and excesses can impact overall health and risk of chronic diseases of these individuals. Further investigation of the influence of the diets of these immigrants on their health is warranted.

Aged↗