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Canadian lifestyle hazardous to immigrant heart health; Chinese group worst off: ICES Study


More than a quarter of a million people migrate to Canada each year, with the majority settling in Ontario. Researchers at the Institute for Clinical Evaluative Sciences (ICES) found that people who stayed in Ontario longer fare worse in terms of cardiovascular risk factor profiles than recent immigrants.

“We found a negative acculturation effect, in that long-term residents of Ontario had worse cardiovascular risk profiles than recent immigrants. Moreover, the degree to which cardiovascular health declined was different for different ethnic groups. The greatest decline was observed in the Chinese group, followed by the white, black and South Asian groups,” says Maria Chiu, principal investigator of the study and ICES Doctoral Fellow.

The study compared the cardiovascular risk factors of recent immigrants (less than 15 years in Canada) with those of long-term residents (immigrants who lived in Canada for more than 15 years or people born in Canada). The study included white, South Asian, Chinese and black ethnic groups living in Ontario. The findings were:

  • For all ethnic groups, the percentage of respondents with 2 or more major cardiovascular risk factors was higher for those who lived longer in Canada.
  • The difference was greatest in the Chinese group, followed by the white, black and South Asian groups.
  • Incidentally, the Chinese group that was previously found to have the most favorable cardiovascular disease risk profile showed the worst decline in health as a result of being exposed to Western culture.

"In 2006, the Heart and Stroke Foundation launched initiatives to address the cardiovascular needs of ethnic populations,” says Vincent Bowman, Director of Research, Heart and Stroke Foundation of Ontario. "Having a better understanding of how length of time living in Canada impacts cardiovascular risk factors will help us to develop tailored prevention strategies to ensure the long-term heart health of all Canadians."

This is the first study to pinpoint which factors most likely contribute to the decline in heart health in each of Canada’s major ethnic groups.

  • The differences in the Chinese and white groups were mainly driven by increases in the prevalence of diabetes. Diabetes was 1.8-fold more prevalent among long-term residents of Chinese or white descent than among their recent immigrant counterparts.
  • This is likely driven by higher rates of obesity in these groups; for example, a 30 to 40 per cent higher rate of obesity was observed among white and Chinese long-term residents as compared to their recent immigrant counterparts.
  • The differences in the black and South Asian groups were mainly driven by increases in the prevalence of smoking, particularly among black and South Asian females. South Asian and black females who were born in Canada or lived in Canada for at least 15 years were 3 to 4 times more likely to smoke than their recent immigrant counterparts.

“Given that immigrants will be responsible for the net growth of the Canadian population by 2031, there is a need to better understand how we can preserve the healthy lifestyles and behaviours of recent immigrants and how we can reduce the negative influences of Western culture that cause health to deteriorate in long-term residents,” says Chiu.

The study “Cardiovascular risk factor profiles of recent immigrants vs. long-term residents of Ontario: multi-ethic study,” is in the August 9, 2011 issue of the Canadian Journal of Cardiology.

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.



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