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Comparing Racial and Immigrant Health Status and Health Care Access in Later Life in Canada and the United States

Published online by Cambridge University Press:  24 August 2010

Steven G. Prus ,
Rania Tfaily  and
Zhiqiu Lin
Steven G. Prus*
Affiliation:
Carleton University
Rania Tfaily
Affiliation:
Carleton University
Zhiqiu Lin
Affiliation:
Carleton University
*
*Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Steven G. Prus, Ph.D., Department of Sociology Carleton University, D795 LA, 1125 Colonel By Drive, Ottawa, Ontario, K1S 5B6 Canada (steven_prus@carleton.ca)
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Abstract

Little comparative research exists on health experiences and conditions of minority groups in Canada and the United States, despite both countries having a racially diverse population with a significant proportion of immigrants. This article explores race and immigrant disparities in health and health care access across the two countries. The study focus was on middle and old age given the change and increasing diversity in health and health care policy, such as Medicare. Logistic regression analysis of data from the 2002–2003 Joint Canada/United States Survey of Health shows that the joint effect of race and nativity on health outcomes – health differences between native and foreign-born Whites and non-Whites – is largely insignificant in Canada but considerable in the U.S. Non-White native and foreign-born Americans within both 45-to-64 and 65-and-over age groups experience significant disadvantage in health status and access to care, irrespective of health insurance coverage, demographic, socio-economic, and lifestyle factors.

Résumé

Il y a peu de recherche comparative en existence sur les expériences de la santé et les conditions de groupes minoritaires au Canada et aux États-Unis, malgré le fait que les deux pays ont des populations racialement diverses avec une proportion significative des immigrants. Cet article explore les disparités raciales et immigrantes en santé et soins d’accès entre les deux pays. L’étude portait sur l’âge mûr et la vieillesse, compte tenu du changement et de la diversité croissante dans la politique de santé et les soins de santé, tel que Medicare. L’analyse de régression logistique des données de l’Enquête de la santé Canada/États-Unis 2002–2003 montre que l’effet conjoint de la race et de la nativité de santé – différences en santé entre indigènes blancs et étrangers blancs et non-blancs est en grande partie négligeable au Canada, mais considérable aux États-Unis. Americains indigènes non-blancs et américains nés à l’étranger au sein des groupes d’âge 45-à-64 et 65-et-plus expériencent une désavantage significative dans l’état de santé et aussi de l’accès aux soins, indépendamment de la couverture d’assurance-maladie et des facteurs démographiques, socio-économiques et de la mode de vie.

Keywords

santéobésitésoins de santéraceimmigrantCanadaÉtats-Unishealthobesityhealth careraceimmigrantCanadaUnited States
Type
Special SEDAP Section: Canada’s Vulnerable Older Populations / Section spéciale SEDAP: Les Populations âgées vulnérables du Canada: Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 29 , Issue 3 , September 2010 , pp. 383 - 395
Copyright
Copyright © Canadian Association on Gerontology 2010

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References

Ali, J. (2002). Mental health of Canada’s immigrants. Health Reports, 13, 1–11.Google Scholar
Ali, J., McDermott, S., & Gravel, R. (2004). Recent research on immigrant health from Statistics Canada’s population surveys. Canadian Journal of Public Health, 95, 9–13.CrossRefGoogle ScholarPubMed
Berkman, L., & Kawachi, I. (2000). Social epidemiology. Oxford: Oxford University Press.CrossRefGoogle Scholar
Borrell, L.N. (2009). Race, ethnicity, and self-reported hypertension: Analysis of data from the National Health Interview Survey, 1997–2005. American Journal of Public Health, 99, 313–319.Google Scholar
Chen, J., Ng, E., & Wilkins, R. (1996). The health of Canada’s immigrants in 1994–95. Health Reports, 7, 33–45.Google ScholarPubMed
Clarke, J. (2000). Health, illness, and medicine in Canada (3rd ed.). New York: Oxford University Press.Google Scholar
Cockerham, W.C. (2011). Sociology of mental disorder (8th ed.). Upper Saddle River, NJ: Prentice-Hal.Google Scholar
Conyers, J. (2003). A fresh approach to health care in the United States: Improved and expanded medicare for all. American Journal of Public Health, 9, 89.Google Scholar
Crimmins, E., Hayward, M., & Seeman, T. (2004). Race/ethnicity, socioeconomic status, and health. In Anderson, N., Bulatao, R.A., & Cohen, B. (Eds.), Critical perspectives on racial and ethnic differences in health in late life (pp. 310–351). Washington, DC: The National Academies Press.Google Scholar
Davey Smith, G., Neaton, J.D., Wentworth, D., Stamler, R., & Stamler, J. (1998). Mortality differences between black and white men in the USA: Contribution of income and other risk factors among men screened for the MRFIT. Lancet, 351, 934–939.CrossRefGoogle ScholarPubMed
DeCoster, C., Smoller, M., Roos, N., & Thomas, E. (1997). A comparison of ambulatory care and selected procedure rates. Healthcare Management Forum, 10, 26–34.CrossRefGoogle ScholarPubMed
Derose, K., Escarce, J., & Lurie, N. (2007). Immigrants and health care: Sources of vulnerability. Health Affairs, 26, 1258–1268.CrossRefGoogle ScholarPubMed
Dunn, J.R., & Dyck, I. (2000). Social determinants of health in Canada’s immigrant population: Results from the National Population Health Survey. Social Science and Medicine, 51, 1573–1593.Google Scholar
Evans, R., & Roos, N. (1999). What’s right about the Canadian health care system. Milbank Quarterly, 77, 393–399.CrossRefGoogle Scholar
Gee, E.M., Kobayashi, K.M., & Prus, S.G. (2004). Examining the healthy immigrant effect in mid-to later life: Findings from the Canadian Community Health Survey. Canadian Journal on Aging, 23, S61–S69.CrossRefGoogle ScholarPubMed
Hayward, M., Miles, T., Crimmins, E., & Yang, Y. (2000). The significance of socioeconomic status in explaining the racial gap in chronic health conditions. American Sociological Review, 65, 910–930.Google Scholar
Hyman, I. (2001). Immigration and health. Ottawa, ON, Canada: Health Canada. Retrieved March 16, 2010, from http://dsp-psd.communication.gc.ca/Collection/H13-5-01-5E.pdfGoogle Scholar
Idler, E., & Benyamini, Y. (1997). Self-rated health and mortality: A review of twenty-seven community studies. Journal of Health and Social Behavior, 38, 21–37.Google Scholar
Idler, E., Russell, L., & Davis, D. (2000). Survival, functional limitations, and self-rated health in the NHANES I Epidemiologic Follow-up Study, 1992. American Journal of Epidemiology, 152, 874–883.Google Scholar
Jasso, G., Massey, D., Rosenzweig, M., & Smith, J. (2004). Immigrant Health—Selectivity and Acculturation. In Anderson, N., Bulatao, R., and Cohen, B. (Eds.), Critical Perspectives on Racial and Ethnic Differences in Health in Late Life (pp. 227–266). Washington, D.C.: National Academy Press.Google Scholar
Jatrana, A., & Chan, A. (2007). Do socioeconomic effects on health diminish with age? A Singapore case study. Journal of Cross Culture Gerontology, 22, 287–301.Google Scholar
Kaplan, M., Huguet, N., Feeny, D., & McFarland, B. (2010). Self-reported hypertension prevalence and income among older adults in Canada and the United States. Social Science & Medicine, 70, 844–849.CrossRefGoogle ScholarPubMed
Katz, S., Hofer, T., & Manning, W. (1996). Physician use in Ontario and the United States: The impact of socioeconomic status and health status. American Journal of Public Health, 86, 520–524.CrossRefGoogle ScholarPubMed
Kaufman, J., Cooper, R., & McGee, D. (1997). Socioeconomic status and health in blacks and whites: The problem of residual confounding and the resiliency of race. Epidemiology, 8, 621–628.Google ScholarPubMed
Kobayashi, K., Prus, S., & Lin, Z. (2008). Ethnic differences in health: Does immigration status matter? Ethnicity and Health, 13, 129–147.Google Scholar
Krieger, N. (2000). Discrimination and health. In Berkmanand, L.F. & Kawachi, I. (Eds.), Social epidemiology (pp. 36–75). New York: Oxford University Press.CrossRefGoogle ScholarPubMed
Krieger, N. (2003). Does racism harm health? Did child abuse exist before 1962? On explicit questions, critical science, and current controversies: An eco-social perspective. American Journal of Public Health, 93, 194–199.CrossRefGoogle Scholar
Ku, L., & Matani, S. (2001). ‘Left out: Immigrants’ access to health care and insurance. Health Affairs, 20, 247–256.Google Scholar
Kunitz, S., & Pesis-Katz, I. (2005). Mortality of white Americans, African Americans, and Canadians: The causes and consequences for health of welfare state institutions and policies. Milbank Quarterly, 83, 5–39.Google Scholar
Lasser, K., Himmelstein, D., & Woolhandler, S. (2006). Access to care, health status, and health disparities in the United States and Canada: Results of a cross-national population-based survey. American Journal of Public Health, 96, 1300–1307.Google Scholar
Lobb, A. (2009). Health care and social spending in OECD Nations. American Journal of Public Health, 99, 1542–1544.CrossRefGoogle ScholarPubMed
Lucas, J., Barr-Anderson, D., & Kington, R. (2003). Health status, health insurance, and health care utilization patterns of immigrant Black men. American Journal of Public Health, 93, 1740–1747.CrossRefGoogle ScholarPubMed
Mansson, N., & Rastam, L. (2001). Self-rated health as a predictor of disability pension and death—A prospective study of middle-aged men. Scandinavian Journal of Public Health, 29, 151–158.Google Scholar
McDonald, J., & Kennedy, S. (2004). Insights into the ‘healthy immigrant effect’: Health status and health service use of immigrants to Canada. Social Science and Medicine, 59, 1613–1627.Google Scholar
Meadows, L., Thurston, W., & Melton, C. (2001). Immigrant women’s health. Social Science and Medicine, 52, 1451–1458.Google Scholar
Mohanty, S., Woolhandler, S., Himmelstein, D., Pati, S., Carrasquillo, O., & Bor, D. (2005). Health care expenditures of immigrants in the United States: A nationally representative analysis. American Journal of Public Health, 95, 1431–1438.Google Scholar
Mossey, J., & Shapiro, E. (1982). Self-rated health: A predictor of mortality among the elderly. American Journal of Public Health, 72, 800–808.Google Scholar
Newbold, K. (2005). Self-rated health within the Canadian immigrant population: Risk and the healthy immigrant effect. Social Science and Medicine, 60, 1359–1370.CrossRefGoogle ScholarPubMed
Newbold, K., & Danforth, J. (2003). Health status and Canada’s immigrant population. Social Science and Medicine, 57, 1981–1995.CrossRefGoogle ScholarPubMed
Newbold, K., & Filice, J. (2006). Health status of older immigrants to Canada. Canadian Journal on Aging, 25, 305–319.CrossRefGoogle ScholarPubMed
Ng, E., Wilkins, R., Gendron, F., & Berthelot, J.-M. (2005). Dynamics of immigrants’ health in Canada: Evidence from the National Population Health Survey. Statistics Canada Catalogue 82–618, Ottawa: Ministry of Industry.Google Scholar
Perez, C. (2002). Health status and health behaviour among immigrants. Health Reports, 13, 1–12.Google Scholar
Read, J., & Emerson, M. (2005). Racial context, black immigration and the U.S. black/white health disparity. Social Forces, 84, 181–199.Google Scholar
Ross, N., Wolfson, M., Dunn, J., Berthelot, J., Kaplan, G., & Lynch, J. (2000). Relation between income inequality and mortality in Canada and in the United States: Cross sectional assessment using census data and vital statistics. British Medical Journal, 320, 898–902.CrossRefGoogle ScholarPubMed
Sanmartin, C., Berthelot, J., Ng, E., Murphy, K., Blackwell, D., Gentleman, J., et al. . (2006). Comparing health and health care use in Canada and the United States. Health Affairs, 25, 1133–1142.CrossRefGoogle ScholarPubMed
Sanmartin, C., Ng, E., Blackwell, D., Gentleman, J., Martinez, M., & Simile, C. (2004). Joint Canada/United States Survey of Health, 2002–03. Statistics Canada and the National Center for Health Statistics, U.S. Centers for Disease Control and Prevention. Statistics Canada Catologue 82–M0022, Ottawa: Ministry of Industry.Google Scholar
Schnittker, J., Pescosolido, B., & Croghan, T. (2005). Are African Americans really less willing to use health care? Social Problems, 52, 255–271.CrossRefGoogle Scholar
Siddiqi, A., & Nguyen, Q. (2010). A cross-national comparative perspective on racial inequities in health: The USA versus Canada. Journal of Epidemiology and Community Health, 64, 29–35.CrossRefGoogle ScholarPubMed
Siddiqi, A., Zuberi, D., & Nguyen, Q. (2009). The role of health insurance in explaining immigrant versus non-immigrant disparities in access to health care: Comparing the United States to Canada. Social Science and Medicine, 69, 1452–1459.CrossRefGoogle ScholarPubMed
Torrey, B., & Haub, C. (2004). A comparison of US and Canadian mortality in 1998. Population and Development Review, 30, 519–530.Google Scholar
Vega, W., & Rumaut, R. (1991). Ethnic minorities and mental health. Annual Review of Sociology, 17, 351–383.Google Scholar
Wagner, T., & Guendelman, S. (2000). Healthcare utilization among Hispanics: Findings from the 1994 minority health survey. American Journal of Managed Care, 6, 355–364.Google Scholar
Williams, D. (2001). Racial variations in adult health status: Patterns, paradoxes and prospects. In Smelser, N.J., Wilson, W.J., & Mitchell, F. (Eds.), America becoming: Racial trends and their consequences (pp. 371–410). Washington, DC: National Academy Press.Google Scholar
Williams, D., & Collins, C. (1995). U.S. socioeconomic and racial differences in health: Patterns and explanations. Annual Review of Sociology, 21, 349–386.CrossRefGoogle Scholar
Williams, D., Neighbors, H., & Jackson, J. (2003). Racial/ethnic discrimination and health: Findings from community studies. American Journal of Public Health, 93, 200–208.CrossRefGoogle ScholarPubMed
Wu, Z., Noh, S., Kaspar, V., & Schimmele, C.M. (2003). Race, ethnicity, and depression in Canadian society. Journal of Health and Social Behavior, 44, 426–441.CrossRefGoogle ScholarPubMed
Zuberi, D. (2006). Differences that matter: Social policy and the working poor in the United States and Canada. New York: Cornell University Press.Google Scholar