Migration and Diabetes in British Columbia and Quebec: Prevalence and Health Service Utilization

Objectives: This study describes prevalence of diabetes among immigrants and health service utilization among diabetic immigrants in British Columbia (BC) and Quebec (QC). Methods: Immigrants to BC and QC between 1985 and 1999 were identified. Using age-standardized rate ratios, they were compared with a matched comparison group with respect to their diabetes prevalence and, among those with diabetes, physician service utilization. Results: Immigrant women in both provinces and men in BC had higher rates of diabetes compared to the matched comparison group. Rates varied by region of birth and language ability. Diabetes prevalence rate ratios increased with length of stay in BC. Diabetic immigrants had lower rates of physician visits than diabetic comparisons. This gap decreased commensurate with immigrants’ length of stay in BC. Diabetic immigrants who spoke neither official language had similar or higher rates of physician visits compared with immigrants who spoke one or both official languages. Conclusions: Genetic predisposition, lifestyle changes, acculturation, resettlement stress and differential health care access may explain increased prevalence of diabetes among many immigrants. These results can inform diabetes prevention and management programs tailored to the needs of specific immigrant groups. The gap in health service use between diabetic immigrants and comparisons does not appear to be related to language ability. Further studies are required to identify reasons. Key words: Migration; diabetes mellitus; prevalence; co-morbidity; health services