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Immigrant status and having a regular doctor among Canadian adults Michelle L. Degelman, Katya M. Herman, PhD Faculty of Kinesiology & Health Studies, University of Regina

Background 67% of Canada s population growth up to 2011 due to immigration. Projected to increase to 80% by 2031. (Statistics Canada, Catalogue no. 98-310-X2011003, 2011) Immigrants comprised 21% of Canada s population in 2011. Canada s largest immigrant source Asia Canada s largest immigrant groups South Asians, Chinese, African Am. (Statistics Canada, Catalogue no. 99-010-X2011001, 2011)

Background cont d Healthy immigrant effect American Immigrants Higher life expectancy Lower disability rates Lower mortality rates (Singh et al, Sci World J, 2013) Obesity Overweight Smoking Canadian Immigrants Positive associations between years of residency and poor self-reported health, overweight and obesity, and alcoholic drinking. (Subedi et al, Soc Sci Med, 2014) Poor access to health services (Dastjerdi et al, Int J Equity, 2012)

Background cont d Doctor First point of contact for health care. Having a doctor More physician and specialist visits. Important Early prevention and treatment of diseases. (Statistics Canada, Catalogue no. 82-625-X, 2014) 85% of Canadians 12 y reported having a regular doctor in 2013. Females (88%) Males (81%) (Statistics Canada, Catalogue no. 82-221-X, 2014)

Background cont d Immigrants less likely to have doctor vs. native-born population. (Lasser et al, Am J Public Health, 2006; Lebrun et al, Health Serv Res, 2010) Only new immigrants. (McDonald et al, Soc Sci Med, 2004) Need for further studies

Objective To examine the association between immigrant status and having a regular doctor among Canadian adults.

Methods 2011-2012 Canadian Community Health Survey 73,958 participants aged 18-64 Independent variable: Immigrant status New immigrant (0-9 years) Established immigrant (10+ years) Non-immigrant Outcome: Having a regular doctor Association between immigrant status and having a regular doctor among Canadian adults

Methods cont d Stratified by gender Adjusted for age, BMI, race/ethnicity, education, province of residence, physical activity, chronic condition presence, self-perceived health, official language knowledge, number of children in household

Results

Sample Characteristics

Having a Regular Doctor By 100 90 80 77.9 84.3* 88.2 Immigrant Status Category 91.2* 70 68.0* 60 55.3* % 50 40 30 20 10 0 Males Females Non-Immigrants Established Immigrants New Immigrants

Logistic regression: Odds of having a regular doctor among Canadian adults

Summary Women more likely to have a regular doctor vs. men across all immigrant status categories. New immigrants 60% less likely to have a regular doctor vs. non-immigrants. Established immigrants 40% more likely to have a regular doctor vs. non-immigrants.

Strengths Large dataset representative of the Canadian population. Rich dataset allowing control of multiple relevant confounders and assessment of gender differences.

Limitations Cross-sectional data Broad categories of immigrant status variable (0-9 years vs. 10+ years) Self-reported data

Conclusion Immigrant status is associated with having a regular doctor among Canadian adults.

Acknowledgements CIHR Frederick Banting and Charles Best Canada Graduate Scholarship

Thank you! Questions?