CMAJ (Canadian Medical Association Journal) will publish a ground-breaking series of comprehensive new guidelines on immigrant health (pre-embargo link only) beginning June 7, 2010 . The Canadian Immigrant Health Guidelines, a multi-part series, will assist clinicians, policy makers and immigrants in understanding the diverse needs of immigrants to Canada. Few resources like this exist in the international medical literature.
While most immigrants and refugees to Canada arrive in good health, some groups face health inequities because of preventable diseases, genetics, social and cultural influences and lack of access to medical treatment.
"In general, new immigrants are healthier than the Canadian population due to immigrant selection policies and socio-cultural aspects of diet and health behaviours; but there is a decline in this "healthy immigrant effect" over time after arrival," writes guideline lead author Dr. Kevin Pottie, University of Ottawa with coauthors.
Canada welcomes approximately 250,000 immigrants and refugees every year as well as about 250,000 migrant workers annually who, while not targeted directly, could benefit from the guidelines. Worldwide, there are more than 200 million international migrants.
Created by the Canadian Collaboration for Immigrant and Refugee Health, a coalition of physicians from across the country, the guidelines are ground-breaking because of the depth of content and information. The researchers focused particularly on refugees, women, children as well as the effects of mental illness.
"Often immigrants and refugees are grouped together; however, our team recognizes the complexities and differences between and within immigrant and refugee groups," write the authors. There is significant variability in health risk in immigrants related to exposure to poor water and sanitation, war and trauma, race, gender, socio-economic status, disease risks and co-morbidities and access, or lack of access, to preventative health services.
The guidelines cover broad topics such as women's health, including contraception, pregnancy and cervical cancer screening; mental health, infectious diseases such as hepatitis B, HIV, tuberculosis, anemia, chronic disease, oral and vision health. They provide clinical recommendations for physicians with immigrant and refugee patients.
"Although the recommendations are organized for the sake of clarity into separate sections, primary health care providers should be particularly attentive to the interactions of biological, psychological and social factors contributing to illness, since these interactions may be additive," write the authors of the guidelines.