Life in Canada more deadly for immigrants?

Immigrants who come to Canada seeking a better life may in fact be setting themselves up for possible premature death.

A study by Canadian researchers finds that the longer immigrants remain in Canada, the worse their cardiovascular health becomes. "The health of immigrants coming to Canada from China, South Asia, or Europe worsens with each decade they stay in the country," Heart and Stroke Foundation researcher Dr. Scott Lear told the Canadian Cardiovascular Congress 2008, co-hosted by the Heart and Stroke Foundation and the Canadian Cardiovascular Society.

"We don't want people to think 'come to Canada and die,'" says Dr. Lear, a kinesiologist at Simon Fraser University in British Columbia. "But there is something going on. Immigrants are very healthy when they first come to Canada, but as their time here increases, so does their cardiovascular risk." Dr. Lear and his colleagues measured atherosclerosis - or narrowing of an artery - in the carotid artery with ultrasound in more than 600 Chinese, European, and South Asian immigrants. With that as their determinant of health, the researchers found that the longer the immigrant stayed in Canada, the narrower the carotid arteries.

Length of stay in Canada remained an independent risk factor for atherosclerosis, even after considering other factors such as age, sex, ethnicity, family history of cardiovascular disease, type 2 diabetes, level of education, income, body mass index, abdominal fat, smoking status, physical activity, lipids, insulin, blood glucose, and blood pressure. Atherosclerosis is a leading contributor to heart disease and stroke, which are the leading cause of death in Canada.

"Duration in Canada emerged as a very powerful risk factor of its own," says Dr. Lear. "Now that we know this, we need to put in place health education programs focused on immigrants. They are a high risk group and would benefit from targeted CVD prevention strategies."

Dr. Lear speculates that the reason new immigrants to Canada suffer such a deterioration in their health is because their first priorities are focused on finding suitable housing and establishing a reliable income with little attention to personal health. They also tend to be disenfranchised from health services.

"Immigrants are working two or three jobs when they first come here. They are striving to establish their families, and this is not easy. They tend to be disenfranchised from medical services and health care. Language is a big barrier for some, and cultural barriers are huge challenges, too." Dr. Chi-Ming Chow, a spokesperson for the Heart and Stroke Foundation, has a number of immigrants in his cardiology practice at St. Michael's Hospital in Toronto. He agrees that the stress of setting up a new life in a new country can take its toll on a person's health.

"Immigrants often are healthier initially because of the immigration selection process. However, immigrants have to face a lot of new challenges to adapt to a new country. Often the income is reduced. Eating habits may also change over time with acculturation," Dr. Chow said. "This is an area of investigation that merits more work to confirm the findings and investigate the underlying reasons for the accelerated progression of the atherosclerosis burden in immigrants."

For information on resources about heart disease and stroke risk factors and warning signs that have been adapted for the South Asian, Chinese, First Nation, African, and Persian communities, visit heartandstroke.ca.

Statements and conclusions of study authors are solely those of the study authors and do not necessarily reflect Foundation or CCS policy or position. The Heart and Stroke Foundation of Canada and the Canadian Cardiovascular Society make no representation or warranty as to their accuracy or reliability.

http://www.heartandstroke.ca