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Linguistic mortality gradients in Quebec and the role of migrant composition

  • Quantitative Research
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Canadian Journal of Public Health Aims and scope Submit manuscript

Abstract

Objective

Anglophones and Allophones in Quebec (Canada) have lower mortality than Francophones, despite being linguistic minorities. This study assesses whether (1) language is a risk factor for mortality after accounting for migrant composition and (2) interprovincial migrants differ in mortality with respect to Quebec-born individuals.

Methods

We analyzed death records between 2004 and 2008 from Quebec (all-cause and main causes) and population data from the 2006 census to estimate age-adjusted mortality rates according to language and migrant status. Risk ratios by language and migrant status, adjusted for age, sex, and socioeconomic status, were estimated using Poisson generalized estimating equations.

Results

Francophone Quebec-borns had the highest mortality. Among Quebec-borns, Anglophones [RR= 0.85, 95% CI (0.79–0.91)] and Allophones [RR = 0.16, 95 %CI (0.12–0.22)] had lower mortality relative to Francophones. Interprovincial migrants had lower mortality (Anglophones [RR = 0.58, 95% CI (0.53–0.63)], Francophones [RR = 0.55, 95% CI (0.50–0.60)]) relative to Francophone Quebec-borns (Allophones were excluded due to small sample size). Among immigrants, mortality was lower for Francophones [RR = 0.62, 95% CI (0.57–0.67] and Allophones [RR = 0.35, 95% CI (0.31–0.38], but not Anglophones [RR = 0.92, 95% CI (0.84–1.01)], relative to Francophone Quebec-borns.

Conclusion

In Quebec, linguistic disparities in mortality remained after accounting for migrant status, and both Francophone and Anglophone interprovincial migrants in Quebec had lower mortality than Quebec-born Francophones. Public health initiatives to reduce linguistic disparities in health should account for migrant status.

Résumé

Objectif

Les anglophones et les allophones du Québec (Canada) ont un taux de mortalité inférieur à celui des francophones, malgré leur statut de minorité linguistique. Cette étude évalue si: 1) la langue est un facteur de risque de mortalité, après avoir contrôlé pour le statut migratoire; 2) la mortalité chez les migrants interprovinciaux diffère de celle des individus nés au Québec.

Méthode

Nous avons analysé les données de décès qui ont eu lieu de 2004 à 2008 au Québec (toutes causes confondues et selon les principales causes) et les données de population du recensement 2006, afin d’estimer les taux de mortalité ajustés pour l’âge selon la langue et le statut migratoire. Les risques relatifs par langue et par statut migratoire, ajustés selon l’âge, le sexe et le statut socioéconomique, ont été estimés en utilisant les équations d’estimation généralisées de Poisson.

Résultats

Les Francophones nés au Québec avaient le risque de mortalité le plus élevé. Parmi les personnes nées au Québec, les anglophones [RR = 0,85, IC 95% (0,79–0,91)] et les allophones [RR = 0,16, IC 95% (0,12–0,22)] avaient un risque relatif de mortalité plus faible comparativement aux francophones. Les migrants interprovinciaux avaient des risques relatifs de mortalité plus faibles (anglophones [RR = 0,58, IC 95% (0,53–0,63)], francophones [RR = 0,55, IC 95% (0,50–0,60)]), comparativement aux francophones nés au Québec (les allophones ont été exclus des analyses en raison de leur faible taille d’échantillon). Parmi les immigrants, le risque relatif de mortalité était plus faible pour les francophones [RR = 0,62, IC 95% (0,57–0,67)] et les allophones [RR = 0,35, IC 95% (0,31–0,38)], mais pas pour les anglophones [RR = 0,92, IC 95% (0,84–1,01)], comparativement aux francophones nés au Québec.

Conclusion

Au Québec, les différences linguistiques dans la mortalité demeurent après avoir contrôlé pour le statut migratoire. Les migrants interprovinciaux, autant pour les francophones que pour les anglophones, ont un taux et un risque relatif de mortalité plus bas que les francophones nés aux Québec. Les initiatives en santé publique pour réduire les différences linguistiques en santé devraient prendre en considération le statut d’immigrant.

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References

  • Abraído-Lanza, A. F., Dohrenwend, B. P., Ng-Mak, D. S., et al. (1999). The Latino mortality paradox: a test of the “salmon bias” and healthy migrant hypotheses. American Journal of Public Health, 89(10), 1543–1548.

    Article  PubMed  PubMed Central  Google Scholar 

  • Auger, N., Harper, S., Barry, A. D., et al. (2012a). Life expectancy gap between the Francophone majority and Anglophone minority of a Canadian population. European Journal of Epidemiology, 27(1), 27–38.

    Article  PubMed  Google Scholar 

  • Auger, N., Park, A. L., & Harper, S. (2012b). Francophone and Anglophone perinatal health: temporal and regional inequalities in a Canadian setting, 1981–2008. International Journal of Public Health, 57(6), 925–934.

    Article  PubMed  Google Scholar 

  • Auger, N., Harper, S., & Barry, A. D. (2013). Diverging socioeconomic inequality in life expectancy of Francophones and Anglophones in Montréal, Québec: tobacco to blame? Journal of Public Health, 21(4), 317–324.

    Article  Google Scholar 

  • Auger, N., Bilodeau-Bertrand, M., & Costopoulos, A. (2016). Language and infant mortality in a large Canadian province. Public Health, 139, 154–160.

    Article  CAS  PubMed  Google Scholar 

  • Bouchard, L., & Desmeules, M. (2013). Linguistic minorities in Canada and health. Healthc Policy Polit Sante, 9(Spec Issue), 38–47.

    Article  Google Scholar 

  • Burrows, S., Auger, N., Tamambang, L., et al. (2013). Suicide mortality gap between Francophones and Anglophones of Quebec, Canada. Social Psychiatry and Psychiatric Epidemiology, 48(7), 1125–1132.

    Article  PubMed  Google Scholar 

  • Burrows, S., Auger, N., & Lo, E. (2016). Language and unintentional injury mortality in Quebec, Canada. Injury Prevention, 22(1), 72–75.

    Article  PubMed  Google Scholar 

  • Connolly, S., & O’Reilly, D. (2007). The contribution of migration to changes in the distribution of health over time: Five-year follow-up study in Northern Ireland. Social Science & Medicine, 65(5), 1004–1011.

    Article  Google Scholar 

  • Corbeil, J.-P., Chavez, B., & Pereira, D. (2010). Portrait of official-language minorities in Canada. Ottawa: Statistics Canada, Social and Aboriginal Statistics Division Available at: http://www.deslibris.ca/ID/228980 (Accessed January 31, 2017).

    Google Scholar 

  • Floch, W., & Pocock, J. (2008). The socio-economic status of English-speaking Quebec: those who left and those who stayed. In R. Y. Bourhis (Ed.), The vitality of the English-speaking communities of Quebec: from community decline to revival (pp. 35–62). Montréal: Centre d’études ethniques des universités montréalaises, Institut canadien de recherche sur les minorités linguistiques. https://www.icrml.ca/en/research-and-publications/cirlm-publications/item/8664-the-vitality-of-the-english. Accessed Jan 2018.

  • Gauvin, L., Robitaille, E., Riva, M., et al. (2007). Conceptualizing and operationalizing neighbourhoods: the conundrum of identifying territorial units. Canadian Journal of Public Health, 98(Suppl 1), S18–S26.

    PubMed  Google Scholar 

  • Girard, C. (2010). La migration interprovinciale au Québec, 2000–2009. Institut de la statistique du Québec; Juin. (Données sociodémographiques en bref). Report No.: 14 (3).

  • Girard, C. (2016). Le bilan démographique du Québec, Édition 2016. Institut de la statistique du Québec; décembre.

  • Gushulak, B. D., Pottie, K., Roberts, J. H., et al. (2011). Migration and health in Canada: health in the global village. Canadian Medical Association Journal, 183(12), E952–E958.

    Article  PubMed  PubMed Central  Google Scholar 

  • Jedwab, J. (2008). How shall we define thee? Determining who is an English-speaking Quebecers and assessing its demographic vitality. The socio-economic status of English-speaking Quebec: those who left and those who stayed. In R. Y. Bourhis (Ed.), The vitality of the English-speaking communities of Quebec: From Community Decline to Revival (pp. 1–18). Montréal: Centre d’études ethniques des universités montréalaises, Institut canadien de recherche sur les minorités linguistiques. https://www.icrml.ca/en/research-and-publications/cirlm-publications/item/8664-the-vitality-of-the-english. Accessed Jan 2018.

  • Kennedy, S., Kidd, M. P., McDonald, J. T., et al. (2015). The healthy immigrant effect: patterns and evidence from four countries. Journal of International Migration and Integration, 16(2), 317–332.

    Article  Google Scholar 

  • Kravdal, Ø. (2009). Mortality effects of average education in current and earlier municipality of residence among internal migrants, net of their own education. Social Science & Medicine, 69(10), 1484–1492.

    Article  Google Scholar 

  • Lussier, M.-H. (2012). The socioeconomic status of anglophones in Québec report. Montréal: Vice-présidence aux affaires scientifiques, Institut national de santé publique Québec Available at: http://collections.banq.qc.ca/ark:/52327/2221331 (Accessed January 31, 2017).

    Google Scholar 

  • Lussier, M.-H., & Trempe, N. (2013). Quelques habitudes de vie et indicateurs de santé des anglophones du Québec. Available at: http://site.ebrary.com/id/10785007. Accessed August 31, 2016.

  • Ng, E. (2011). Statistics Canada, Health Analysis Division. Insights into the healthy immigrant effect mortality by period of immigration and birthplace. Ottawa: Statistics Canada, Health Analysis Division.

    Google Scholar 

  • Pampalon, R., Hamel, D., Gamache, P., et al. (2012). An area-based material and social deprivation index for public health in Québec and Canada. Canadian Journal of Public Health, 103(8 Suppl 2), S17–S22.

    PubMed  Google Scholar 

  • Pan, W. (2001). Akaike’s information criterion in generalized estimating equations. Biometrics, 57(1), 120–125.

    Article  CAS  PubMed  Google Scholar 

  • Schoumaker, B., Dal, L., & Poulain, M. (1998). L’effet de barrière dans la migration interne: la frontière linguistique en Belgique. In: Régimes démographiques et territoires: les frontières en question. 2000pages 125–138. (Actes du colloque international de La Rochelle, 22–26 septembre).

  • Sipila, P., & Martikainen, P. (2009). Language-group mortality differentials in Finland in 1988−2004: assessment of the contribution of cause of death, sex and age. European Journal of Public Health, 19(5), 492–498.

    Article  PubMed  Google Scholar 

  • Statistics Canada. (2007). The evolving linguistic portrait, 2006 census: Census year 2006. Ottawa: Ont.: Statistics Canada Available at: http://www.deslibris.ca/ID/210409. Accessed January 31, 2017.

    Google Scholar 

  • Survey Methodology Program. (2011). IVEware: imputation and variance estimation. Version 0.2 Users Guide (Supplement). Survey Research Center, Institute for Social Research: University of Michigan.

  • Thacker, S. B., Stroup, D. F., Carande-Kulis, V., et al. (2006). Measuring the public’s health. Public Health Reports (Washington, D.C.: 1974), 121(1), 14–22.

    Article  Google Scholar 

  • Trempe, N., Lussier, M. H., & Barry, A. B., et al. (2013) La mortalité évitable des deux principales communautés linguistiques du Québec. Available at: http://public.eblib.com/choice/publicfullrecord.aspx?p=3289242. Accessed January 31, 2017.

  • Trempe, N., Boivin, M.-C., Lo, E., et al. (2014). L’utilisation de la variable sur la langue d’usage à la maison du Registre des décès du Québec. Cahiers Quebecois De Demographie, 43(1), 163–180.

    Article  Google Scholar 

  • Wingate, M. S., & Alexander, G. R. (2006). The healthy migrant theory: variations in pregnancy outcomes among US-born migrants. Social Science & Medicine, 62(2), 491–498.

    Article  Google Scholar 

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Acknowledgements

We thank Jérôme Martinez and Marie-Hélène Lussier for the useful discussions. We thank an anonymous reviewer whose comments greatly helped to improve the quality of this work.

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Correspondence to Ernest Lo.

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Conflict of interest

This study is part of a series of projects funded by Health Canada through the Community Health and Social Services Network (CHSSN).

Appendix

Appendix

Table 6 ANOVA p values and QIC results for statistical comparisons between the full model and a reduced model with language effects removed, for all-cause and by-cause mortality
Table 7 ANOVA p values and QIC results for statistical comparisons between the full model and a reduced model with interprovincial migrants aggregated with Quebec-borns into a single “non-immigrant” category
Table 8 Codes from the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD) used to define the main causes of death
Table 9 All-cause age-adjusted mortality rates (expressed as number of deaths per 100,000 persons, and 95% CI) by migrant status and linguistic communities, for the province of Quebec and over a broad urban-rural continuum

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Lo, E., Tu, M.T., Trempe, N. et al. Linguistic mortality gradients in Quebec and the role of migrant composition. Can J Public Health 109, 15–26 (2018). https://doi.org/10.17269/s41997-018-0023-z

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