Life in Canada more deadly for immigrants?

Toronto - Immigrants who come to Canada seeking a better life may

in fact be setting themselves up for possible premature death.

A study by Canadian researchers finds that the longer immigrants

remain in Canada, the worse their cardiovascular health becomes.

"The health of immigrants coming to Canada from China, South

Asia, or Europe worsens with each decade they stay in the

country," Heart and Stroke Foundation researcher Dr. Scott Lear

told the Canadian Cardiovascular Congress 2008, co-hosted by the

Heart and Stroke Foundation and the Canadian Cardiovascular

Society.

"We don't want people to think `come to Canada and die,'" says

Dr. Lear, a kinesiologist at Simon Fraser University in British

Columbia. "But there is something going on. Immigrants are very

healthy when they first come to Canada, but as their time here

increases, so does their cardiovascular risk."

Dr. Lear and his colleagues measured atherosclerosis - or

narrowing of an artery - in the carotid artery with ultrasound in

more than 600 Chinese, European, and South Asian immigrants. With

that as their determinant of health, the researchers found that

the longer the immigrant stayed in Canada, the narrower the

carotid arteries.

Length of stay in Canada remained an independent risk factor for

atherosclerosis, even after considering other factors such as

age, sex, ethnicity, family history of cardiovascular disease,

type 2 diabetes, level of education, income, body mass index,

abdominal fat, smoking status, physical activity, lipids,

insulin, blood glucose, and blood pressure.

Atherosclerosis is a leading contributor to heart disease and

stroke, which are the leading cause of death in Canada.

"Duration in Canada emerged as a very powerful risk factor of its

own," says Dr. Lear. "Now that we know this, we need to put in

place health education programs focused on immigrants. They are a

high risk group and would benefit from targeted CVD prevention

strategies."

Dr. Lear speculates that the reason new immigrants to Canada

suffer such a deterioration in their health is because their

first priorities are focused on finding suitable housing and

establishing a reliable income with little attention to personal

health. They also tend to be disenfranchised from health

services.

"Immigrants are working two or three jobs when they first come

here. They are striving to establish their families, and this is

not easy. They tend to be disenfranchised from medical services

and health care. Language is a big barrier for some, and cultural

barriers are huge challenges, too."

Dr. Chi-Ming Chow, a spokesperson for the Heart and Stroke

Foundation, has a number of immigrants in his cardiology practice

at St. Michael's Hospital in Toronto. He agrees that the stress

of setting up a new life in a new country can take its toll on a

person's health.

"Immigrants often are healthier initially because of the

immigration selection process. However, immigrants have to face a

lot of new challenges to adapt to a new country. Often the income

is reduced. Eating habits may also change over time with

acculturation," Dr. Chow said. "This is an area of investigation

that merits more work to confirm the findings and investigate the

underlying reasons for the accelerated progression of the

atherosclerosis burden in immigrants."

For information on resources about heart disease and stroke risk

factors and warning signs that have been adapted for the South

Asian, Chinese, First Nation, African, and Persian communities,

visit heartandstroke.ca.

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Statements and conclusions of study authors are solely those of

the study authors and do not necessarily reflect Foundation or

CCS policy or position. The Heart and Stroke Foundation of Canada

and the Canadian Cardiovascular Society make no representation or

warranty as to their accuracy or reliability.

The Heart and Stroke Foundation (heartandstroke.ca), a volunteer-

based health charity, leads in eliminating heart disease and

stroke and reducing their impact through the advancement of

research and its application, the promotion of healthy living,

and advocacy.