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Poverty is a significant risk factor for premature death


Poverty is one of the strongest determinants of health, regardless of immigration status, according to a new study from the Institute for Clinical Evaluative Sciences (ICES) and the University of Toronto.

“What our study found was despite the healthy immigrant effect, those living in the most deprived areas, irrespective of immigration status had the highest mortality rates,” says Laura Rosella, the study’s lead author, ICES scientist and assistant professor of epidemiology at the University of Toronto’s Dalla Lana School of Public Health.

The “healthy immigrant effect” refers to a trend where new immigrants to Canada are healthier than the Canadian population, but over time and successive generations, their health as well as that of their children and grandchildren tends to decline.

In the study, published today in Journal of Epidemiology & Community Health, the researchers examined data representing all deaths in Ontario from 2002 to 2012 to analyze how socioeconomic factors impact mortality according to immigration status.

The study found:

  • All-cause and premature mortality were about 60 per cent lower among immigrants compared to Canadian or long-term residents. Over the 10 year study period, this translated into 42,700 fewer deaths overall and 18,400 fewer premature deaths in immigrants compared to Canadian-born or long term residents.
  • The average age at death for female and male immigrants was approximately six years younger than that of female and male long-term residents.
  • In both immigrants and non-immigrants, those living in the most deprived areas had higher rates of all-cause and premature mortality, although immigrant mortality was lower across all levels.
  • The advantage in all-cause and premature mortality among male immigrants over male long-term residents was slightly more pronounced than the advantage among female immigrants over female long-term residents.

“These findings support the need to better examine the factors that drive these inequalities to ensure equitable health for the totality of the population,” says Rosella, who is also a scientist at Public Health Ontario.

“Socioeconomic gradients in all-cause, premature and avoidable mortality among immigrants and long-term residents using linked death records in Ontario, Canada,” was published today in the Journal of Epidemiology & Community Health.

Author block: Khan A, Urquia M, Kornas K, Henry D, Cheng S, Bornbaum C, Rosella L.

The Institute for Clinical Evaluative Sciences (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. For the latest ICES news, follow us on Twitter: @ICESOntario

About the Dalla Lana School of Public Health: The Dalla Lana School of Public Health is a Faculty of the University of Toronto that originated as one of the Schools of Hygiene begun by the Rockefeller Foundation in 1927. The School went through a dramatic renaissance after the 2003 SARS crisis and it is now the largest public health school in Canada, with over 800 faculty, 850 students, and research and training partnerships with institutions throughout Toronto and the world. With $33.5-million in research funding per year, the School supports discovery in global health, tobacco impacts on health, occupational disease and disability, air pollution, inner city and Indigenous health, among many other areas. For more information, visit the website.


Deborah Creatura
Media Advisor, ICES
(o) 416-480-4780 or (c) 647-406-5996
[email protected]

Nicole Bodnar
Director of Communications
Dalla Lana School of Public Health, University of Toronto
[email protected]

Read the Journal Article