加拿大亚洲移民健康状况及影响因素研究

The health status of Asian immigrants and the associated factors in Canada

目的评估加拿大亚洲移民的健康状况及相关影响因素。方法采用横断面研究，利用加拿大统计局提供的2003年加拿大人群健康状况调查数据进行分析。采用描述性分析比较不同人群中健康影响因素分布差异。通过对患病率进行年龄标化，比较亚洲移民、非移民及其他移民的慢性病患病情况差异。利用多因素logistic回归分析控制可能影响因素，比较不同人群中选定的6种慢性病指标的OR值及95％CI。结果经年龄标化后，亚洲移民患有1～5种慢性病患病率与非移民无明显差异，患有5种以上慢性病的患病率为3．56％，明显低于非移民慢性病患病率5．31％。亚洲移民患有至少一种慢性病的风险（OR=0．49，95％CI：0．46～0．51）明显低于非移民患病风险（OR=1．00）。新移民患病风险（OR=0．34，95％CI：0.31～0．37）低于老移民的患病风险（OR=0．62，95％CI：0．58～0．66）。调整社会经济特征和生活方式等因素后，亚洲移民4种常见病的患病风险仅有微小改变，除心脏病的患病风险变化明显。结论亚洲移民总体慢性病的患病率及患病风险低于非移民，但这种健康优势随着在加拿大的居住年限的推移逐渐消失。社会经济特征和生活方式的不同不能完全解释亚洲移民和非移民的健康状况差异。

Objective The aim of this study was to systematically evaluate the health status of Asian immigrants in Canada and the associated factors. Methods Using data from the 2003 Canadian Community Health Survey, a descriptive analysis was performed to estimate the frequency of health associated factors among different populations. Age-standardization rates was also used to compare the prevalence of chronic conditions among Asian immigrants, other immigrants and native residents. Logistic regression analysis was used to estimate the adjusted Odds ratio （OR） associated with each health outcome and 95% confidence interval （95%CI） after controlling for potential confounding factors. Results After age-standardization, Asian immigrants had a similar prevalence of 1-5 chronic conditions and a lower prevalence of 5＋ chronic conditions （3.56%） compared with non-immigrants （5.31%）. Asian immigrants were less likely to report any chronic disease （OR=0.49, 95% CI： 0.46-0.51） than non- immigrants （OR=1.00）. Recent Asian immigrants were less likely to report any chronic condition （OR= 0.34, 95% CI： 0.31-0.37） than long-term Asian immigrants （OR=0.62, 95% CI： 0.58-0.66）. After adjusting for socioeconomic status and lifestyle factors, Asian immigrants had a slightly changed risk of four chronic conditions with exception of heart disease. Conclusion Asian immigrants had lower risk of chronic conditions as a whole, however, these health advantages decreased along with increasing length of residence in Canada. Socioeconomic factors and lifestyles cannot fully explain the differences of health status between Asian immigrants and non-immigrant Canadians reported in this paper.