Abstract
Few empirical studies have been conducted to analyse the disparities in health variables affecting immigrants in a given country. To our knowledge, no theoretical analysis has been conducted to explain health disparities for immigrants between regions in the same country that differs in term of languages spoken and income. In this paper, we use the Canadian Community Health Survey (CCHS) to compare multiple health measures among immigrants in Quebec, immigrants in the rest of Canada and Canadian-born individuals. We propose a simple structural model and conduct an empirical analysis in order to assess possible channels that can explain the health disparities for immigrants between two regions of the same country. Our results show that well-being and health indicators worsen significantly for immigrants in Quebec, compared to their counterparts in the rest of Canada and Canadian-born individuals. Additional econometric analysis also shows that life satisfaction is statistically and significantly associated with health outcomes. The proposed structural model predicts that, when the decision to migrate to a particular area is based on income alone, and if the fixed costs associated with the language barrier are large, immigrants may face health issues.
Appendix
Well-Being and Health Measures (CCHS).
| Overall health | In general, would you say your health is: |
| (Range: 1–5) | (1) poor |
| (2) fair | |
| (3) good | |
| (4) very good | |
| (5) excellent | |
| Mental health | In general, would you say your mental health is: |
| (Range: 1–5) | (1) poor |
| (2) fair | |
| (3) good | |
| (4) very good | |
| (5) excellent | |
| Life satisfaction | How satisfied are you with your life in general: |
| (Range: 1–5) | (1) very dissatisfied |
| (2) dissatisfied | |
| (3) neither satisfied nor dissatisfied | |
| (4) satisfied | |
| (5) very satisfied | |
| Oral health | In general, would you say the health of your teeth and mouth is: |
| (Range: 1–5) | (1) poor |
| (2) fair | |
| (3) good | |
| (4) very good | |
| (5) excellent | |
| Drinking- Type of drinking | During the past 12 months, have you had beer, wine, liquor or any other alcoholic beverage?: |
| (Range: 1–3) | (1) Not at all |
| (2) Occasionally (less than once a month) | |
| (3) Regularly (once a month to every day) | |
| Smoking | Type of smoker: |
| (Range: 1–3) | (1) Not at all |
| (2) Occasionally (less than once a month) | |
| (3) Regularly (once a month to every day) | |
| Daily consumption | Total fruits and vegetables: |
| The CCHS measures the number of times (frequency), not the amount consumed. |
Summary Statistics.
| Quebec | (1) | Rest of Canada | (2) | (1)–(2) | |||
| Immigrant | Non-immigrant | Difference | Immigrant | Non-immigrant | Difference | Prob | |
| Imm-Non imm | Imm-Non imm | ||||||
| lSex | |||||||
| Male | 0.528 (0.499) | 0.497 (0.500) | 0.030 (0.012) | 0.486 (0.500) | 0.501 (0.499) | -0.016 (0.005) | 0.000 |
| lAge | |||||||
| 20–24 | 0.080 (0.272) | 0.121 (0.326) | -0.040 (0.007) | 0.086 (0.280) | 0.134 (0.340) | -0.048 (0.003) | 0.309 |
| 25–29 | 0.117 (0.321) | 0.117 (0.321) | -0.001 (0.007) | 0.095 (0.293) | 0.127 (0.332) | -0.031 (0.003) | 0.000 |
| 30–34 | 0.161 (0.367) | 0.109 (0.312) | 0.052 (0.008) | 0.109 (0.312) | 0.114 (0.318) | -0.005 (0.003) | 0.000 |
| 35–39 | 0.162 (0.368) | 0.112 (0.315) | 0.050 (0.008) | 0.142 (0.349) | 0.122 (0.328) | 0.020 (0.003) | 0.000 |
| 40–44 | 0.144 (0.352) | 0.138 (0.345) | 0.006 (0.008) | 0.163 (0.369) | 0.141 (0.347) | 0.023 (0.004) | 0.067 |
| 45–49 | 0.119 (0.324) | 0.139 (0.346) | -0.020 (0.009) | 0.142 (0.349) | 0.136 (0.343) | 0.006 (0.004) | 0.006 |
| 50–54 | 0.109 (0.312) | 0.143 (0.350) | -0.034 (0.008) | 0.131 (0.338) | 0.123 (0.328) | 0.009 (0.003) | 0.000 |
| 55–59 | 0.108 (0.310) | 0.122 (0.327) | -0.014 (0.008) | 0.131 (0.337) | 0.103 (0.304) | 0.027 (0.003) | 0.000 |
| lHousehold size | |||||||
| 1 person | 0.131 (0.337) | 0.146 (0.349) | -0.011 (0.006) | 0.081 (0.272) | 0.110 (0.313) | -0.029 0.002) | 0.002 |
| 2 persons | 0.248 (0.432) | 0.333 (0.471) | -0.086 (0.009) | 0.214 (0.410) | 0.303 (0.459) | -0.089 (0.003) | 0.713 |
| 3 persons | 0.233 (0.423) | 0.221 (0.415) | 0.012 (0.010) | 0.220 (0.414) | 0.218 (0.413) | 0.002 (0.004) | 0.375 |
| 4 persons | 0.230 (0.421) | 0.211 (0.408) | 0.019 (0.011) | 0.270 (0.444) | 0.241 (0.427) | 0.029 (0.005) | 0.381 |
| 5 + persons | 0.159 (0.366) | 0.093 (0.291) | 0.066 (0.009) | 0.216 (0.412) | 0.129 (0.335) | 0.087 (0.004) | 0.037 |
(continued)
(continued)
| Quebec | (1) | Rest of Canada | (2) | (1)–(2) | |||
| Immigrant | Non-immigrant | Difference | Immigrant | Non-immigrant | Difference | Prob | |
| Imm-Non imm | Imm-Non imm | ||||||
| lHighest level of education attained | |||||||
| Less than high school | 0.106 (0.308) | 0.135 (0.342) | -0.029 (0.008) | 0.090 (0.286) | 0.097 (0.296) | -0.007 (0.003) | 0.010 |
| High school diploma | 0.108 (0.310) | 0.136 (0.343) | -0.029 (0.008) | 0.169 (0.375) | 0.193 (0.395) | -0.024 (0.004) | 0.560 |
| Some college | 0.047 (0.212) | 0.069 (0.254) | -0.022 (0.005) | 0.072 (0.258) | 0.099 (0.298) | -0.027 (0.003) | 0.409 |
| Bachelor’s and above | 0.739 (0.244) | 0.659 (0.474) | 0.080 (0.011) | 0.669 (0.471) | 0.611 (0.488) | 0.058 (0.005) | 0.064 |
| Marital status | |||||||
| Married/common-law | 0.689 (0.463) | 0.638 (0.481) | 0.051 (0.011) | 0.731 (0.443) | 0.648 (0.478) | 0.084 (0.004) | 0.004 |
| Single/never married | 0.214 (0.410) | 0.269 (0.443) | -0.055 (0.009) | 0.188 (0.391) | 0.268 (0.444) | -0.080 (0.004) | 0.011 |
| Widowed/divorced/separated | 0.098 (0.297) | 0.093 (0.291) | 0.005 (0.007) | 0.081 (0.272) | 0.084 (0.277) | -0.004 (0.002) | 0.266 |
| lLanguage in which the respondent can converse | |||||||
| English | 0.152 (0.359) | 0.016 (0.126) | 0.136 (0.009) | 0.857 (0.350) | 0.839 (0.367) | 0.018 (0.003) | 0.000 |
| French | 0.245 (0.430) | 0.486 (0.500) | -0.242 (0.010) | 0.110 (0.033) | 0.004 (0.060) | -0.003 (0.000) | 0.000 |
| English and French | 0.565 (0.496) | 0.497 (0.500) | 0.069 (0.012) | 0.079 (0.270) | 0.155 (0.362) | -0.076 (0.003) | 0.000 |
| Neither | 0.038 (0.190) | 0.080 (0.028) | 0.037 (0.006) | 0.063 (0.243) | 0.020 (0.045) | 0.061 (0.002) | 0.000 |
| N | 4,599 | 53,703 | 33,348 | 193,665 | |||
Notes: This table displays the weighted (sample weights from Statistics Canada) summary statistics for independent variables. The statistics are presented by region, Quebec and the rest of Canada, for immigrants and non-immigrants. Standard deviations are in parentheses (standard errors for the Differences columns). ***: significant at 1% ; **: significant at 5% ; *: significant at 10%.
Acknowledgements:
We wish to thank Professor Jean-Marie Dufour, Professor Steven Ambler, Professor Victoria Zinde-Walsh, Professor Kristian Behrens, Professor Prosper Dovonon, Professor Catherine Haeck, Professor Philip Merrigan, Professor Pierre Lefebvre, Professor Marie Connolly, the anonymous referees, and the editor for comments and suggestions.
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