Health and Social Integration of Newcomer Youth: Results from a National Longitudinal Study

John P. Anchan, Esther Blum, Bong-Hwan Kim, Joyce Cabigting Fernandes & Lori Wilkinson

Prairie Metropolis Node Meeting, September 29, 2009Winnipeg

Project Overview• Longitudinal study of close to 4,900

immigrant and refugee children living in six Canadian cities

• Wave One national sample includes children aged 4-6 & 11-13 from 17 different ethnocultural communities in Canadian 6 cities

• Wave Two follow-up, children now aged 6-10 and 13-17 years

• Children born outside of Canada, arrived within last 10 years; OR children born of parents who arrived within the last 10 years

• A broad range of factors investigated including child growth and development plus those specific to the migration and resettlement process

Sampling FrameworkImmigration Status

Visibility Like Ethnic Community in Canada

Established Not Established

Immigrants Visible Hong Kong ChineseMainland ChineseFilipinoIndian (Punjabi)Jamaican

Haitian

Non-Visible IranianRefugees Visible Vietnamese Ethiopian

SomaliSri Lankan TamilAfghan

Non-Visible

Lebanese El Salvadoran, Columbian, Nicaraguan, Guatemalan

SerbianKurdish

Note: ethnocultural communities in red text were interviewed in Winnipeg

Selected Indicators of Social Integration for Newcomer Families

• Integration is a multifaceted, long-term process for all newcomers and includes several aspects related to acceptance by the host society and settlement conditions• Social supports: does my family have help from

others when needed?• Homeownership: an indication of economic

integration and attachment• Living conditions since last move: has moving to

Canada been a benefit or a detriment to my family’s livelihood?

Social Supports by Ethnocultural Group, Calgary, Edmonton and Winnipeg

26.3

26.7

27.5

22.8

25.3

26.4

24.4

0 5 10 15 20 25 30

Mainland Chinese

Hong Kong Chinese

Filipino

Kurdish

Vietnamese

Latin American

Canadian average

Homeownership by Ethnocultural Group, Prairies

Just over two-thirds (68.4%) of Canadians own their home (Statistics Canada, 2008).

38.4%

79.6%

60.2%

0.0%

63.6%

33.3%

55.4%

42.9%

0.0% 20.0% 40.0% 60.0% 80.0% 100.0%

Mainland Chinese

Hong Kong Chinese

Filipino

Kurdish

Vietnamese

Latin American

Prairies average

Canadian average

Assessment of Living Conditions in Canada by Ethnocultural Group

2%11% 11%

21%

45%

87% 89%

77%

55%

0%10%20%30%40%50%60%70%80%90%

100%

MainlandChinese

Hong KongChinese

Filipino Prairie groups

Poor Unsure Good

Physical Health• The “Healthy Immigrant Effect” suggests that

newcomer youth are significantly more healthy than Canadian-born youth due to government and self-selection processes

• After about 10 years, the health practices and behaviours of newcomers begins to mimic that of the native-born• Second-generation youth have poorer health and

exhibit more risk behaviours than immigrant youth• Rates of obesity, asthma, and diabetes are

significantly higher among Canadian-born youth• Newcomer youth are significantly more likely to

have no significant health problems as children and adolescents

Statistics Canada, 2006, 2007; Mullins Harris, 1999; Yu et al., 2003

General Health of Child, Prairie Groups

Excellent35%

Very good38%

Good17%

Fair4%

Poor6%

Poor

General Health by Immigrant Category, Prairies Only

9.5

2.8

31.9

20.7

35.340.4

23.3

36.1

05

1015202530354045

fair good v good excellent

Pmk CdnbornPmk foreignborn

Health Risk Behaviors• 9% of 11-13 year olds knew of a friend who

drank alcohol without their parents’ knowledge

• 11% of 11-13 year olds regularly smoke cigarettes

• None of the children we studied in Wave 1 reported illegal drug use, though some participants in Vancouver, Toronto and Montreal admitted to illegal drug use

• 1.4% of youth aged 11-13 in our study reported they were active members of gangs

• A very small number of youth indicated they gambled for money

Physical Activity (compared to others of same sex and age) Prairie Groups

P<0.01

52.141.4

6.5

100

0102030405060708090

100

v. active thesame

lessactive

total

% Active

Participation in Organized Sports (11-13 year olds only)

39.2%

46.2%

29.7%32.5% 33.7%

30.3%

25.3%29.2% 30.3%

23.1%24.3%15.4%

27.0%23.4%

22.0%23.0%

15.4%

27.0% 26.5%

14.0%13.5%16.2% 14.9%

17.7%

0.0%5.0%

10.0%15.0%20.0%25.0%30.0%35.0%40.0%45.0%50.0%

Calgary

Edmon

ton

Winn

ipeg

Montre

al

Toron

to

Vanco

uver

Never 1X/week 2-3X/week 4+X/week

P<0.05

Mental Health• Over 80% of mental health issues arise in

adolescence. If left untreated, they can manifest as severe illness as adults

• Among Canadian-born youth, anxiety disorders are most predominant, ranging from 2.1-22.2% incidence rates among youth as young a age 5 years

• Mental health of newcomer youth has been a topic of sustained interest • Refugee youth have higher rates of PTSD• Refugee youth have slightly higher rates of other

illnesses• Immigrant youth have good mental health though

some may struggle with the transition to a new country

Flannery-Schroeder, 2004; Costello et al., 2004, 2005; Leitch, 2007

Self-assessment of Current Life Stress

73%67%

83%

67%

27%33%

8%

33%

9%

0%10%20%30%40%

50%60%70%80%90%

MainlandChinese

Hong KongChinese

Filipino Prairie groups

Low Medium High

P<0.05

Prosocial Behaviour by Integration Stage

P<0.05

23.19 23.29

22.02

22.88

21.221.421.621.8

2222.222.422.622.8

2323.223.4

Mean

short termmedium termCdn bornTotal

Mean score on prosocial behaviours index

Hyperactivity-Inattention by Stage of Integration

P<0.05

12.6

11.311.4

11.9

10.610.8

1111.211.411.611.8

1212.212.412.6

Mean

short termmedium termCanadian-borntotal

Mean score on hyperactivity-inattention index

Tentative Conclusions• Overall, newcomer youth are adjusting to life

in Canada • Housing & neighborhood conditions: good for some,

fair for others• Physical Health: excellent & active• Mental Health: excellent, with few behavioural

problems

• Wave 2 interviews are complete; longitudinal analysis to commence in fall

• Your ideas for specific analyses and exploration are most welcome-there are over 1300 data points needing analysis!

Selection of Forthcoming Papers• Predicting Emotional Disorder/Anxiety and Physical

Aggression among Hong Kong Chinese, Mainland Chinese, and Filipino Immigrant Children in Canada.

• Immigrant Families and Access to Primary Health Care for their Children

• Examining the impact of ethnic discrimination and social exclusion on visible minority immigrant children’s psychosocial development.

• Cultural Affiliation and Identification Patterns among Newcomer Immigrant Children in Canada

• School & Parental Influences on the Academic Achievements of Filipino, Hong Kong & Mainland Chinese Youth

• Neighbourhood Influences on the health of Canada’s Immigrant and Refugee Youth: A Vancouver Study

• A Snapshot of the Health & Well-being of Newcomer Children and their Families-to appear on PMC website soon!

Mental health

Physical health

Discrimination

Identity &Cultural Preservation

Health &Neighbourhood

EducationalAchievements

AcknowledgementsThis presentation is a product of the New Canadian Children and Youth Study (Morton Beiser, Nominated Principal Applicant; Robert Armstrong, Linda Ogilvie, Jacqueline Oxman-Martinez, Joanna Anneke Rummens, Principal Applicants), a national longitudinal survey of the health and well being of more than 4,000 newcomer immigrant and refugee children living in Montreal, Toronto, Winnipeg, Edmonton, Calgary and Vancouver. The NCCYS is a collaboration between a large team of more than 25 investigators, two national coordinators, other research staff, community advisors, and trainees affiliated with four Canadian Metropolis Centres of Excellence for research on immigration and settlement, and community organizations representing sixteen different immigrant/refugee populations across Canada.

The Winnipeg Research Team wishes to acknowledge the assistance of Alison Kalischuk, Swati Mandal

University of ManitobaSara Deane, University of Winnipeg

and the cooperation of newcomer families, the assistance of our Local Advisory Committee and 7 Community Consultation

Groups

Funding Sources

Prairie Site: PCERII, AHFMR, CIHR, Canadian Heritage, Health Canada, Citizenship and Immigration Canada, Manitoba Labour and Immigration, Winnipeg Foundation, and Alberta Learning.

National: Canadian Institutes for Health ResearchSite Specific Funding: Federal departments of Canadian

Heritage, Citizenship and Immigration Canada, Health Canada, Justice Canada; Alberta Heritage Foundation for Medical Research, Alberta Learning, B.C. Ministry of Social Development and Economic Security, B.C. Ministry of Multiculturalism and Immigration, Conseil Quebecois de la Recherche Sociale, OASIS (CIC); and the Montreal, Prairies, and Toronto Metropolis Centres of Excellence for Research on Immigration and Integration.

Universities In-Kind Support: Universities: Alberta, British Columbia, Calgary, Manitoba, McGill, Montreal, Toronto, Winnipeg, Metropolis Centres of Excellence: Toronto, Montreal, Prairies, Vancouver, Statistics Canada, Citizenship and Immigration Canada.