Abstract
Background
We assessed trends in infant mortality for Arabic-speakers in Quebec, Canada between 1981 and 2017.
Methods
We computed infant mortality rates for Arabic versus French and English-speakers in Quebec over time. We used adjusted risk ratios (aRR) and 95% confidence intervals (CI) to investigate trends among Arabic-speakers according to socioeconomic status, age, and cause of death.
Results
Infant mortality rates were 3.0 for Arabic-speakers and 5.1 for French and English-speakers per 1,000 live births. Infant mortality increased for Arabic-speakers between 1989–1995 and 2010-2017 (aRR 2.07; 95% CI, 1.04–4.12), but decreased for French and English-speakers (aRR 0.77; 95% CI, 0.73–0.81). The increase in infant mortality was greater for socioeconomically advantaged Arabic-speakers (aRR 2.52; 95% CI, 1.20–5.28) and early neonatal mortality (aRR 1.64; 95% CI, 0.98–2.76).
Discussion
Arabic-speakers in Quebec have a lower risk of infant mortality than French and English-speakers, but increasing infant mortality among Arabic-speakers is narrowing the gap.
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References
Shumanty R. Mortality: overview, 2014 to 2016. Ottawa: Statistics Canada; 2018.
Guendelman S, Buekens P, Blondel B, et al. Birth outcomes of immigrant women in the United States, France, and Belgium. Matern Child Health J. 1999;3(4):177–87.
Ravelli AC, Tromp M, Eskes M, et al. Ethnic differences in stillbirth and early neonatal mortality in the Netherlands. J Epidemiol Community Health. 2011;65(8):696–701.
Gissler M, Alexander S, MacFarlane A, et al. Stillbirths and infant deaths among migrants in industrialized countries. Acta Obstet Gynecol Scand. 2009;88(2):134–48.
Troe EJ, Bos V, Deerenberg IM, et al. Ethnic differences in total and cause-specific infant mortality in the Netherlands. Paediatr Perinat Epidemiol. 2006;20(2):140–7.
Finkton DW, El-Sayed AM, Galea S. Infant mortality among Arab-Americans: findings from the Arab-American birth outcomes study. Matern Child Health J. 2013;17(4):732–45.
Auger N, Racape J, Raynault MF, et al. Stillbirth among Arab women in Canada, 1981-2015. Public Health Rep. 2020;135(2):245–52.
Bézy S, Payeur F, Azeredo AC, et al. Demographic portrait of Quebec, 2019 Edition. 2019. Institut de la statistique du Québec. https://www.stat.gouv.qc.ca/statistiques/population-demographie/bilan2019.pdf. Accessed 21 Apr 2020.
Statistics Canada. Proportion of mother tongue responses for various regions in Canada, 2016 Census. 2017. https://www12.statcan.gc.ca/census-recensement/2016/dp-pd/dv-vd/lang/index-eng.cfm. Accessed 5 Jan 2020.
Dajani G. 750,925 Canadians hail from Arab lands. 2014. https://static1.squarespace.com/static/5e09162ecf041b5662cf6fc4/t/5e5c6fe517c29a501a5a0e14/1583116261768/750%2C925+Canadians+Hail+from+Arab+Lands.pdf. Accessed 5 Jan 2020.
Ford CL, Harawa NT. A new conceptualization of ethnicity for social epidemiologic and health equity research. Soc Sci Med. 2010;71(2):251–8.
Sterne JA, White IR, Carlin JB, et al. Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ. 2009;338:b2393.
Oza S, Cousens SN, Lawn JE. Estimation of daily risk of neonatal death, including the day of birth, in 186 countries in 2013: a vital-registration and modelling-based study. Lancet Glob Health. 2014;2(11):e635–44.
Cole S, Hartford RB, Bergsjø P, et al. International collaborative effort (ICE) on birth weight, plurality, perinatal, and infant mortality. III: a method of grouping underlying causes of infant death to aid international comparisons. Acta Obstet Gynecol Scand. 1989;68(2):113–7.
Auger N, Park AL, Daniel M. Contribution of local area deprivation to cultural-linguistic inequalities in foetal growth restriction: trends over time in a Canadian metropolitan centre. Health Place. 2013;22:38–47.
Pampalon R, Hamel D, Gamache P, et al. An area-based material and social deprivation index for public health in Québec and Canada. Can J Public Health. 2012;103(Suppl. 2):S17–22.
Abuelezam NN, El-Sayed AM, Galea S. The health of Arab Americans in the United States: an updated comprehensive literature review. Front Public Health. 2018;6:262.
Reidpath DD, Allotey P. Infant mortality rate as an indicator of population health. J Epidemiol Community Health. 2003;57(5):344–6.
Blaxter M. The health of children. A review of research on the place of health in cycles of disadvantage. London: Heinemann Educational; 1981.
El Reda DK, Grigorescu V, Posner SF, et al. Lower rates of preterm birth in women of Arab ancestry: an epidemiologic paradox—Michigan, 1993–2002. Matern Child Health J. 2007;11(6):622–7.
El-Sayed AM, Galea S. Explaining the low risk of preterm birth among Arab Americans in the United States: an analysis of 617451 births. Pediatrics. 2009;123(3):e438–45.
Franzini L, Ribble JC, Keddie AM. Understanding the Hispanic paradox. Ethn Dis. 2001;11(3):496–518.
Urquia ML, Frank JW, Moineddin R, et al. Immigrants’ duration of residence and adverse birth outcomes: a population-based study. BJOG. 2010;117(5):591–601.
El-Sayed AM, Galea S. Community context, acculturation and low-birth-weight risk among Arab Americans: evidence from the Arab-American birth-outcomes study. J Epidemiol Community Health. 2010;64(2):155–60.
Heslehurst N, Brown H, Pemu A, et al. Perinatal health outcomes and care among asylum seekers and refugees: a systematic review of systematic reviews. BMC Med. 2018;16(1):89.
Hyman I, Dussault G. The effect of acculturation on low birthweight in immigrant women. Can J Public Health. 1996;87(3):158–62.
Abuelezam NN, El-Sayed AM, Galea S. Relevance of the “immigrant health paradox” for the health of Arab Americans in California. Am J Public Health. 2019;109(12):1733–8.
Negy C, Woods DJ. A note on the relationship between acculturation and socioeconomic status. Hisp J Behav Sci. 1992;14(2):248–51.
Crump C, Lipsky S, Mueller BA. Adverse birth outcomes among Mexican-Americans: are US-born women at greater risk than Mexico-born women? Ethn Health. 1999;4(1–2):29–34.
Almeida LM, Caldas J, Ayres-de-Campos D, et al. Maternal healthcare in migrants: a systematic review. Matern Child Health J. 2013;17(8):1346–54.
Trempe N, Boivin M-C, Lo E, et al. Assessment of validity for the ‘language spoken at home’ variable in Québec death records: summary. Québec: Institut national de santé publique du Québec; 2012.
Acknowledgements
This work was supported by Health Canada via the McGill Training and Retention of Health Professionals Project [3.1/2019-2021/06/01], and the Fonds de recherche du Québec-Santé [34695].
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Bolster-Foucault, C., Bilodeau-Bertrand, M., Djeha, A. et al. Infant mortality among Arabic-speakers in Quebec, Canada, 1989–2017. J Immigrant Minority Health 23, 215–221 (2021). https://doi.org/10.1007/s10903-020-01115-1
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DOI: https://doi.org/10.1007/s10903-020-01115-1