The Gini coefficient has been the most popular method for operationalising income inequality in the public health literature. However, a number of alternative methods exist, and they offer researchers the means to develop a more nuanced understanding of the distribution of income. Income inequality measures such as the generalised entropy index and the Atkinson index offer the ability to examine the effects of inequalities in different areas of the income spectrum, enabling more meaningful quantitative assessments of qualitatively different inequalities. This glossary provides a conceptual introduction to these and other income inequality measures.
A growing body of literature suggests that immigrants to Canada experience deterioration in their health status after settling in the country. While self-selection processes and Canadian immigration policy ensure that, at the time of arrival, immigrants are healthier than the Canadian-born population, this health advantage does not persist over time. This study uses new data from the Longitudinal Survey of Immigrants to Canada (N=7720) to examine how health transitions vary among immigrants. Logistic regression analyses indicate that visible minorities and immigrants who experienced discrimination or unfair treatment are most likely to experience a decline in self-reported health status. The results also confirm a clear inverse socioeconomic gradient with respect to increasing levels of feelings of sadness, depression and loneliness. These findings reflect important dimensions driving population health patterns in Canada, a country with a highly lauded health care system based on the principles of universality and comprehensiveness. Our findings suggest that discrimination and inequality partly drive the health transitions of immigrants. These factors, which largely operate outside of the formal health care system, need to be understood and addressed if health inequities are to be reduced.
This review investigates the health of immigrants to Canada by critically examining differences in health status between immigrants and the native-born population and by tracing how the health of immigrants changes after settling in the country. Fifty-one published empirical studies met the inclusion criteria for this review. The analysis focuses on four inter-related questions: (1) Which health conditions show transition effects and which do not? (2) Do health transitions vary by ethnicity/racialized identity? (3) How are health transitions influenced by socioeconomic status? and (4) How do compositional and contextual factors interact to affect the health of immigrants? Theoretical and methodological challenges facing this area of research are discussed and future directions are identified. This area of research has the potential to develop into a complex, nuanced, and useful account of the social determinants of health as experienced by different groups in different places.
Key Points
Question
How do all-cause mortality rates and racial inequities in rates vary across
the 30 most populous US cities?
Findings
In this cross-sectional study of more than 26 million death records during a
10-year period, city mortality rates differed widely as did inequities
between Black and White populations. Overall mortality rates improved in
less than half of the 30 cities, and racial inequities worsened in more
cities than in which they improved.
Meaning
Given the substantial variation in city-level mortality rates and racial
inequities, cities need data specific to their jurisdiction to inform local
health policy.
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