Skip to main content
main-content

01.12.2018 | Research article | Ausgabe 1/2018 Open Access

BMC Public Health 1/2018

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

Zeitschrift:
BMC Public Health > Ausgabe 1/2018
Autoren:
Natasha Ruth Saunders, Alison Macpherson, Jun Guan, Lisa Sheng, Astrid Guttmann
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12889-017-4612-1) contains supplementary material, which is available to authorized users.
An erratum to this article is available at https://​doi.​org/​10.​1186/​s12889-017-4709-6.

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.
Zusatzmaterial
Additional file 1: Table S1. Immigrant children and youth in Ontario by duration of residence, 2011 to 2012. Table S2. Rate ratios of unintentional injuries for immigrant children and youth aged 0-24 years by duration of residence, 2011-2012. Descriptive table of cohort of immigrants excluding children and youth born to immigrant mothers and table of adjusted rate ratios testing the association of duration of residency in Canada and risk of unintentional injury, excluding children and youth born to immigrant mothers. (DOCX 19 kb)
12889_2017_4612_MOESM1_ESM.docx
Additional file 2: Table S3. Children and youth from immigrant families in Ontario by duration of residence, 2011 to 2012. Table S4. Adjusted rate ratios of unintentional injuries in children aged 1-24 years by duration of residence, 2011-2012. Descriptive table of cohort of immigrants excluding children less than one year of age and table of adjusted rate ratios testing the association of duration of residency in Canada and risk of unintentional injury, excluding children less than one year of age. (DOCX 13 kb)
12889_2017_4612_MOESM3_ESM.docx
Additional file 3: Table S5. Adjusted rate ratios of unintentional injuries in children and youth aged 0-24 years by duration of residence, excluding those where region of origin is missing, 2011-2012. Sensitivity analysis testing the association of unintentional injuries in children and youth by duration of residence in Canada where those whose region of origin was missing was excluded from the analysis. (DOCX 22 kb)
12889_2017_4612_MOESM2_ESM.docx
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 1/2018

BMC Public Health 1/2018 Zur Ausgabe