Gender, Income and Immigration Differences in Depression in Canadian Urban Centres
Smith, Katherine L. W., Matheson, Flora I., Moineddin, Rahim, Glazier, Richard H., Canadian Journal of Public Health
Background: Immigrants tend to initially settle in urban centres. It is known that immigrants have lower rates of depression than the Canadian-born population, with the lowest rates among those who have arrived recently in Canada. It is established that women and low-income individuals are more likely to have depression. Given that recent immigration is a protective factor and female gender and low income are risk factors, the aim of this study was to explore a recent immigration-low income interaction by gender.
Methods: The study used 2000-01 Canadian Community Health Survey data. The sample consisted of 41,147 adults living in census metropolitan areas. Logistic regression was used to examine the effect of the interaction on depression.
Results: The prevalence of depression in urban centres was 9.17% overall, 6.82% for men and 11.44% for women. The depression rate for recent immigrants was 5.24%, 3.87% for men and 6.64% for women. The depression rate among low-income individuals was 14.52%, 10.79% for men and 17.07% for women. The lowest-rate of depression was among low-income recent immigrant males (2.21%), whereas the highest rate was among low-income non-recent immigrant females (11.05%).
Conclusions: This study supports previous findings about the effects of income, immigration and gender on depression. The findings are novel in that they suggest a differential income effect for male and female recent immigrants. These findings have implications for public health planning, immigration and settlement services and policy development.
MeSH terms: Canada; depressive disorder; immigrants; gender; socio-economic factors
Immigrants constitute a growing proportion of the Canadian population. Since the early 1990s, between 175,000 and 250,000 immigrants have come to Canada each year.1 These individuals enter the country as legal immigrants (e.g., skilled workers, family reunification) and refugees.1 In 2001, approximately 1.8 million of Canada's immigrants had arrived in the previous 10 years, representing 6.2% of the population in 2001.1 This was an increase from 4.3% in 1996. Of the 1.8 million recent immigrants, 58% arrived from Asia and the Middle East.1 In 2001, 94% of recent immigrants were living in Canada's census metropolitan areas, with 73% settling in Toronto, Vancouver and Montreal.2
Depression is an important mental health condition. Worldwide, major depression is the leading cause of years lived with disability and the fourth cause of lost disability adjusted life years.3 A recent review on immigrant health reported that immigrants have lower rates of mental illness than the Canadian-born population, with the lowest rates among recent and non-European immigrants.4 With increasing length of residence in Canada, rates of immigrant physical and mental health conditions begin to mirror the rates experienced by the Canadian-born population.4-6
It is well established that low-income individuals and women are at a high risk of depression relative to those with middle/high income and men, respectively.7 To date, however, no studies have looked at the effect of low income on the mental health of immigrants. Given that being a recent immigrant is a protective factor for depression and having a low-income level is a risk factor and that there are noted gender differences in depression, the objective of this study was to explore a recent immigration-low income interaction stratified by gender. Since the proportion of immigrants is increasing, it is important to understand the health needs of these individuals in order to provide appropriate health and setdement services.
Since immigrants are most likely to settle in urban areas, the sample was restricted to individuals living in the 25 Census Metropolitan Areas (CMAs) across Canada.2 CMAs consist of one or more adjacent municipalities situated around a major urban core.8
The 2000-01 Canadian Community Health Survey (CCHS 1. …