Recent changes in the size, ethnic composition and settlement patterns of the immigrant population will have serious implications for the health status, health utilization and the development of health policies relevant to the needs of older Canadians. The research presented here is a secondary data analysis of a national data file as part of a larger collaborative, researcher-stakeholder program of study. The program, funded by CIHR was designed to enhance the understanding of the determinants of health of urban dwelling, older visible minorities. The objectives of the study were: (1) to determine if middle-aged and older adults (45+) who belong to ethnic minorities have poorer health status compared to other minority groups and the majority; (2) to examine the impact of ethnicity and socioeconomic status on the general health status of older persons; (3) to examine the impact of ethnicity and socioeconomic status on chronic health conditions Using cross-sectional data from the 1998 National Population Health Survey of Canadian adults aged 45 years and over (N=9,167), this study compared Anglophone Whites, Francophone Whites, Blacks, Asian and South Asians on socio-demographic and economic characteristics, health characteristics including physical and mental health, long-term disability; measures of social support; hospital stays, use of health professionals and attitudes to self care. Two models were estimated that regressed chronic and general health on race/ethnicity, socio-demographic, economic, social support and self-care factors.

Results from the bivariate comparisons of ethnic groups indicated that the impact of ethnicity on health status and on health services utilization differed across socio-economic groups and that older persons of ethnic minority status had poorer health status overall, compared to those of the ethnic majority group. The ethnic majority group, however, had more chronic health problems. The logistic regression models indicated that the race effects disappeared and that being older, having less than high school education and a low income were related to poor general health. A poor sense of self coherence and a less positive attitude to self care was also related to poor health. The status of Francophone compared to Anglophone, being male and having a poor sense of self coherence were associated with chronic health problems. Because the majority of the immigrants in this study (97 percent) had been in Canada for ten years or more, the findings supported recent studies that suggested the healthy immigrant effect (immigrants are healthier than their Canadian born counterparts), diminished over time as immigrants' health converged with the Canadian norm. Age, education and socio-economic status were key factors in the health of all older adults and outweighed immigrant status in the multivariate analyses.

In a country with a national health care system, the deterioration of the health of older immigrants suggests that their health care needs are not met when they first arrived in Canada and thereafter. The relationship between immigrant status, poverty and health care requires further investigation for the planning of health services primarily from a life course perspective.