The Health Behaviors of Immigrants and Native-born People in Canada

This paper analyzes the incidence of participation in various activities generally expected to have an impact on current and future physical health. Attention is focused on the incidence of these activities among immigrant and minority groups compared to native-born white Canadians. Immigrants generally exhibit significantly lower rates of alcohol consumption, binge drinking, and daily smoking but also lower participation in vigorous physical activity and consumption of fruit and vegetables. Differences are particularly pronounced for immigrants from Asia and Africa, and this is true for both men and women. For most immigrant men, alcohol consumption and smoking both increase with years in Canada, ceteris paribus, and in the case of immigrants from Europe and the USA, reach native-born white levels after between 10-20 years in Canada. For other immigrant men, the incidence of alcohol consumption remains low even for long-term residents of Canada. Interestingly, there is no significant change with years-since-migration in any of the health behaviors for immigrant women. Canadian born members of visible minorities also display significantly lower rates of alcohol consumption, smoking and (for women) vigorous physical activity than native-born whites, although these rates were still higher than for immigrants from Asia and Africa. Finally, native- born white lifestyle choices are found to exert a significant positive influence on the behaviors of immigrants and native-born minorities who are residents of the same province.immigrants, health, acculturation, smoking, alcohol

Determinants of Mammography Usage across Rural and Urban Regions of Canada

Breast cancer is a leading source of mortality among Canadian women; however early detection via mammography considerably improves survival rates. Accordingly, national guidelines advocate biennial screening for asymptomatic women aged 50 to 69 years. Unfortunately many women do not abide by such recommendations, and there is some evidence that compliance rates are lower in rural areas. This report explores the extent of regional variation within and between Canadian provinces using a new and more detailed set of rural indicators based on economic zones of influence. We find the incidence of ever having a mammogram and screening within the last two years are significantly lower for women most removed from large urban centers. This result is obtained after controlling for demographic and socio-economic characteristics, concentration of physicians and specialists in the local area and whether the woman has a regular family doctor. An important reason for the observed differences across rural and urban areas is found to be awareness of the need for regular screening. We also observe that differences in mammography usage between rural and urban areas vary significantly across Canadian provinces.mammography, cancer screening, rural health, women's health

Cancer-related health behaviors and health service use among Inuit and other residents of Canada’s north

Objective – To identify the extent to which differences between Inuit and other residents of Canada’s North in a set of health behaviors and health service use related to cancer incidence and diagnosis can be accounted for by demographic, socio-economic and geographic factors. Study Design – Data on residents aged 21-65 who live in Canada’s North are drawn from the 2000-01 and 2004-05 Canadian Community Health Surveys and the 2001 Aboriginal People’s Survey. Methods – Multivariate Logistic regression analysis is applied to 1) a set of health behaviors including smoking, binge drinking and obesity, and 2) a set of basic health service use measures including consultations with a physician and with any medical professional, Pap smear testing and mammography. Results – Higher smoking and binge drinking rates and lower rates of female cancer screening among Inuit are not accounted for by differences in demographic characteristics, education, location of residence or distance from a hospital. Conclusions – Factors specific to Inuit individuals and communities may be contributing to negative health behaviors associated with increased cancer risk, and to a lower incidence of diagnostic cancer screening. Policy interventions to address these issues may need to be targeted specifically to Inuit Canadians.Inuit, aboriginal, cancer screening, smoking, health

Incidence and Returns to Apprenticeship Training in Canada: the Role of Family Background and Immigrant Status

Immigrant men and women in Canada from recent arrival cohorts have especially low rates of having an apprenticeship credential when compared to either their counterparts from earlier arrival cohorts or the Canadian born. Among the native born, a second generation man is more likely to have completed an apprenticeship if his father’s generation of immigrant men in Canada (from the same source country) have a high probability of apprenticeship completion. The same effect is present for first generation men who arrived in Canada as children. However, this effect is not found for either first generation or second generation women. An analysis of earnings indicates a strong wage return from the completion of an apprenticeship in Canada is found for men. However, women who have completed an apprenticeship in Canada actually have lower weekly earnings than women with only a high school diploma. The empirical results suggest that the increased emphasis on university education in the selection of economic immigrants is creating an imbalance between the supply of both first and second generation immigrants with an apprenticeship, and the demand for workers with these credentials.Apprenticeships, Education, Immigration, and Second Generation

Ethnicity, Immigration and Cancer Screening: Evidence for Canadian Women

Introduction: Canada's annual immigrant intake is increasingly composed of visible minorities, with 59% of immigrants arriving in 1996-01 coming from Asia. However, only a small number of studies have used population health surveys to examine Canadian women's use of cancer screening. We use recent population health surveys to analyze immigrant and native-born women's use of Pap smears, breast exams, breast self-exams, and mammograms. Methods: We study women aged 21-65 drawn from the National Population Health Survey and Canadian Community Health Surveys that together yield a sample size of 105,000 observations. Results: We find that for most forms of cancer screening, recent immigrants have markedly lower utilization rates, but these rates slowly increase with years in Canada. However, there is wide variation in rates of cancer screening by ethnicity. Screening rates for white immigrants approach Canadian-born women's utilization rates after 15-20 years in Canada, but screening rates for immigrants from Asia remain significantly below native-born Canadian levels. Discussion: Health authorities need to tailor their message about the importance of these forms of cancer screening to reflect the perceptions and beliefs of particular minority groups if the objective of universal use of preventative cancer screening is to be achieved.immigrants, ethnic groups, cancer, screening, acculturation

The Health Services Use Among Older Canadians in Rural and Urban Areas

Even though universal health care is one of the fundamental pillars of Canadian society, the rising cost of all services has resulted in the relocation and redistribution of funding and services between rural and urban areas. While most econometric analyses of health service use in Canada include broad controls by province and rural/urban status, there has been relatively little econometric work that has focused specifically on geographical variation in health service use. Using the 2002-03 wave of the Canadian Community Health Survey, we examine the determinants of a range of health services use by older Canadians across different types of urban and rural areas of residence. The regression analysis suggests two general conclusions: 1) other things equal, health service use is lower among older residents of rural areas in terms of visits to a GP, to a specialist and to a dentist compared to residents of urban core CMA/CAs, but there are no significant differences in hospital nights; and 2) these results are surprisingly robust across a range of specifications that control variously for demographic characteristics, socio-economic status, private health insurance, and physical health. However, the magnitude of the estimated differences is quantitatively not very large. In addition, the self-reported incidence of unmet healthcare needs overall shows no systematic variation across rural and urban areas.health service use, rural urban differences

Immigration, Ethnicity and Cancer in U.S. Women

This study examines differences in the prevalence of various forms of cancer among American women identified by both ethnicity and immigrant status. Our focus is on four types of cancer – breast, cervical, ovarian, and uterine – that afflict adult working-age women. We analyse the extent to which the prevalence of these cancers among immigrants changes with years in the United States, after controlling for age and socio- economic influences. The paper also examines the extent to which use of preventative health screening and/or lifestyle behaviors might help to explain any observed differences. Data are drawn from the U.S. National Health Interview Survey (NHIS) over the period 1998 to 2005. We find significant evidence of differences in cancer occurrence among immigrants by ethnicity that change with years spent in the USA, as well as pronounced differences by race. The results confirm that the healthy immigrant effect is present in terms of the prevalence of certain forms of cancer in comparison with both US born whites and with US born ethnic minority groups. The result appears not to be due to differences in health behaviors or in the utilization of general health services.cancer, immigrants, ethnic minorities, women's health

The Impact of Skill Mismatch among Migrants on Remittance Behaviour

This paper considers the issue of skill mismatch among immigrants and its impact on their remittance behaviour using cross-sectional data from two linked surveys in the Philippines: the Survey on Overseas Filipinos (SOF) and the Family Income and Expenditure Survey (FIES) for the years 1997, 2000, and 2003. Our main hypothesis is that skills mismatch - broadly defined here as the over-qualification of migrants in terms of educational attainment relative to occupation in their destination country - is prevalent among skilled migrants and exerts a downward pressure on the level of international remittances received by the sending economies. Accordingly, a high incidence of skill mismatch implies that the remittances expatriated would be significantly less compared to conditions of no skills mismatch. We find evidence of substantial skill mismatch, particularly among highly educated women, but there is also systematic variation in the incidence of skill mismatch by family characteristics and host country. In terms of remittances, we find that for women, higher education levels are associated with lower incidence of remittances but larger amounts remitted. However, negative skill mismatch leads to men and women both being more likely to remit money, but for women the amount is significantly less than it otherwise would have been.remittances, immigrants, education mismatch

Labour Productivity, Import Competition and Market Structure in Australian Manufacturing

Through altering competitive conditions, globalisation can have a significant impact on productivity of the domestic economy. Foreign competition can stimulate the productivity improvements by domestic firms or it can lead to the elimination of inefficient producers. Alternatively, the threat or reality of foreign competition can impede investment in new equipment and techniques, thereby slowing the adaptation of productivity improvements. Thus, the impact of globalisation on productivity growth needs to be explored empirically. In this paper, we estimate the impact of import competition on labour productivity growth in Australian manufacturing using a panel data analysis for a three-decade period. The estimates extend and complement earlier work by Bloch and McDonald (2001), which applies panel data analysis to a sample of Australian manufacturing firms for a one-decade period. The use of industry level data in place of firm-level data, allows us to include the effects of entry or exit of firms, while the longer time period allows determine whether the impact of import competition on productivity growth changes to following micro-economic reform in the Australian economy. As with Bloch and McDonald, we also examine whether the impact of import competition varies across industries with domestic market structure. Reference: Bloch, H and J T McDonald (2001), Import Competition and Labour Productivity, Journal of Industry, Competition and Trade, 1(3), 301-319.productivity growth, Australian manufacturing

Immigrant Selection Systems and Occupational Outcomes of International Medical Graduates in Canada and the United States

We analyze the process of immigrant selection and occupational outcomes of International Medical Graduates (IMGs) in the US and Canada. We extend the IMG relicensing model of Kugler and Sauer (2005) to incorporate two different approaches to immigrant selection: employer nomination systems and point systems. Analysis of the model indicates that point systems can allow IMGs to immigrate who would be unable to gain entry to the receiving country under an employer nomination system and who are subsequently unable to relicense and work as physicians in the receiving country. We apply the model to the case of IMGs migrating to the US and Canada since the 1960s and evaluate the empirical predictions from the model based on an analysis of the occupational outcomes of IMGs in Canada (where a point system has been in place) and in the US (where IMGs enter through employer nomination). In Canada, IMGs are less likely to be employed as a physician than are IMGs in the US and a large percentage of the IMGs in Canada either find work in lower skill occupations or are not employed. The empirical findings are consistent with our hypotheses based on the theoretical framework on the effects of immigrant selection systems on the probability of working as a physician in the two countries.physicians, immigration, occupation, skills, human capital