K. Bruce Newbold

Health status and Canada's immigrant population

Given the framework of the 1984 Canada Health Act, the health status of immigrants should be similar to average levels within whole of Canada. Yet, assuming equality of health status between immigrant and non-immigrants, or between immigrant groups is likely an unrealistic and simplistic assumption, given unseen barriers affecting accessibility, the restructuring of the Canadian health care system, and problems with the provision of health care resources to the immigrant population. Using the National Population Health Survey, this paper focuses upon the health status of the immigrant population relative to that of non-immigrants within Canada, with reference to diagnosed conditions, self-assessed health, and the Health Utilities Index Mark 3. Findings indicate that, with the exception of the most recent arrivals, immigrants experience worse health status across most dimensions relative to non-immigrants. Multivariate analysis reveals that age, income adequacy, gender, and home ownership are dimensions upon which health status differs between the two groups.

Elderly Mobility: Demographic and Spatial Analysis of Trip Making in the Hamilton CMA, Canada

Recent interest in the urban transport challenges posed by the demographic outlook of ageing societies has prompted a growing body of scholarship on the subject. The focus of this paper is on the topic of elderly trip generation and the development of models to help formalise some important relationships between trip-making behaviour and personal, household and contextual variables (such as location). The case study is the Hamilton Metropolitan Area-an important functional component of Greater Toronto, itself one of the regions in Canada where the impact of ageing is expected to be most strongly felt. Using data from Torontos Transport Tomorrow Survey and mixed ordered probit models, the study investigates the question of spatial and demographic variability in trip-making behaviour. The results support the proposition that trip-making propensity decreases with age. However, it is also found that this behaviour is not spatially homogeneous and in fact exhibits a large degree of variability-a finding that highlights both the challenges of planning transport for the elderly and the potential of spatial analytical approaches to improve transport modelling practice.

Problems in search of solutions: health and Canadian aboriginals.

The purpose of this paper is to explore the health status of Canadian Aboriginals, along with their perceived community health problems and proposed solutions to these issues. Data are drawn from the 1991 Aboriginal Peoples Survey (APS), which is a weighted random sample of the Aboriginal population. Comparisons were made with respect to group identity (North American Indian, Métis and Inuit) and geographic location (reserve, urban, rural and North) and across a series of health status and health care use indicators. Analysis reveals that geographic location, as compared with Aboriginal identity, appears to have a large impact with respect to health status and use of physician services. On-reserve Aboriginals, for example, reported a lower likelihood of having seen a physician and were more likely to rank their health as fair or poor. Location also influenced perceived community health problems and solutions. Self-identified problems included drugs, cancer and arthritis, while corresponding solutions included education, counseling and service access. Although the problems and solutions were relatively consistent across space, they too varied in their importance. In general, the results tend to reinforce the determinants of health framework, suggesting that the provision of health services is insufficient to remove health disparities on its own. Instead, broader social-welfare provisions must be considered.

Equity in health care: Methodological contributions to the analysis of hospital utilization within Canada

The main objective of this paper is to determine whether the distribution of hospital service utilization corresponds to the distribution of needs within Canada. This is accomplished by identifying the factors affecting the relationship between the incidence and quantity of hospital services and self-assessed need for such care in Canada. The data were derived from the General Social Survey (Statistics Canada, 1987) which is a weighted random sample of the Canadian population aged 15 and over. Employing methodological extensions over previous studies, the results indicate that although variation in quantity of hospital use is largely independent of income, household income has a significant positive effect on the incidence of hospital utilization. Additionally, variations in both incidence and quantity of use of hospital services are associated with variations in need and other factors within the model.

Health Care Use and the Canadian Immigrant Population

Set within the “determinants of health” framework and drawing on Statistics Canadas longitudinal National Population Health Survey, this article explores health care utilization by Canadas immigrant population. Given the observed “healthy immigrant effect,” whereby the health status of immigrants at the time of arrival is high but subsequently declines and converges toward that of the native-born population, does the incidence of use of health care facilities reflect greater need for care? Similarly, does the use of health care facilities by the native- and the foreign-born differ, and if so, are these differences explained primarily by socioeconomic, sociodemographic, or lifestyle factors, which may point to problems in the Canadian health care system? This study identifies trends in the incidence of physician and hospital use, the factors that contribute to health care use, and differences in health care use between the native- and foreign-born.

Return and Onwards Migration in Canada and Australia: Evidence From Fixed Interval Data

Analysis of return and onwards migration flows has typically relied upon lifetime migration definitions. Both Canada and Australia have collected data on usual place of residence both one and five years prior to the census, which provide a richer source of information on return and onwards moves. Utilizing data drawn from complementary sources, this article examines the incidence, composition and spatial patterning of return and onwards migration at the state and provincial level in Canada and Australia over the period of 1986–1990–1991. Results indicate a high degree of symmetry in these processes between the two countries. While many of the findings are consistent with those derived from analysis of lifetime data, we find that one quarter to one third of return moves were to the original (1986) dwelling, indicating a planned return rather than the failed migration as previous literature has often assumed.

Counting Migrants and Migrations: Comparing Lifetime and Fixed-Interval Return and Onward Migration

Abstract Lifetime measures of return and onward migration that use place of birth may be rather arbitrary, as they may not capture the essence of “home” region and therefore may not adequately represent ties to place, including where an individual grew up or went to school. The recent availability of census data that include information on place of residence five years prior to the census, one year prior, and at the time of the census allow an alternative definition of return and onward migration based upon fixed-interval data. Employing data from the 1996 Canadian census, in this paper I first compare and examine the incidence, composition, and spatial patterns and explanations of return and onward migration through measures of lifetime and fixed-interval data. I then suggest a typology of return migration. Findings indicate that although both measures result in similar patterns and demographic effects, fixed-interval measures provide additional detail into the processes at work. Planned returns among younger and older adults that are most likely associated with education or employment and represent 24 percent of returns define two types of return migration. A third type is more consistent with the stereotypical image of a “failed” migration.

Forecasting Ontario's blood supply and demand

BACKGROUND: Given an aging population that requires increased medical care, an increasing number of deferrals from the donor pool, and a growing immigrant population that typically has lower donation rates, the purpose of this article is to forecast Ontarios blood supply and demand.

Migration Propensities, Patterns, and the Role of Human Capital: Comparing Mexican, Cuban, and Puerto Rican Interstate Migration, 1985–1990

This paper expands the human capital model to compare the migration propensities of Cubans, Mexicans, and Puerto Ricans within the U.S. between 1985 and 1990. Using the 5% PUMS from the 1990 U.S. Census, both aggregate migration streams and micro-level migration propensities are estimated for Cubans, Mexicans, and Puerto Ricans. The effects of personal factors, the economic environment, and the presence of fellow nationals are examined in the context of larger geographic patterns, and discussed in terms of each nationalitys immigration history and cultural context. While many factors effect migration behavior similarly, there are notable differences in the way education, English fluency, and unemployment rate affect migration propensity of the native-born and foreign-born of each nationality. Differences are also apparent at the macro-level. Puerto Ricans show signs of dispersing out of New York; Mexicans are redistributing within the Southwest; and Cubans are re-concentrating in Florida. Both levels of analysis point to how immigration history, settlement patterns, and cultural context influence migration behavior. The results demonstrate the benefits of using an expanded human capital approach to explain migration differences, and highlight the diversity of population redistribution occurring within Hispanic nationalities.

Internal Migration of the Foreign-Born: Population Concentration or Dispersion?

Recent analyses of the 1990 census migration data have pointed to the different demographic effects of internal migration and immigration. States and metropolitan areas either have large population gains through immigration or internal migration, but rarely both, leading to what has been labeled as an increasing demographic ‘balkanization’ of the U.S. population. This paper explores the proposition that the internal migration of the foreign-born (pre-1985 arrivals) is likely to reinforce the demographic effects of immigration. Analysis is based on the five-percent Public Use Microdata file of the U.S. Census, with the demographic effects evaluated at both the state and metropolitan area levels. Distinctions were also made between nineteen separate national origin groups, increasing the detail of the analysis. Despite high internal migration rates and large net migration, there was little change in the overall distribution and concentration of the foreign-born population between 1985 and 1990. More important, however, distinctions were found across the national origin groups. While secondary migration leads to dispersion among some groups, other groups were becoming increasingly concentrated, suggesting that demographic balkanization of the American population is more variable than the literature would suggest.