Early onset of type 2 diabetes among visible minority and immigrant populations in Canada

ABSTRACT

Objectives: Type 2 diabetes is a chronic condition that affects nearly over three million Canadians, including immigrants. The timing of the first onset of diabetes has been linked to several other severe diseases. Yet, there is a dearth of empirical studies that examine the timing of the first onset of diabetes among Canadians, in general, and among immigrants and ethnic minority populations within Canada, in particular.

Design: Applying event history techniques to the 2013 Canadian Community and Health Survey, we address this research void by examining factors that contribute to the first onset of diabetes among immigrant and visible minority populations in Canada (N = 8905). Given the gendered patterns in the epidemiology of diseases and the differences in risk factors for men and women, gender-specific models were estimated.

Results: Results showed that South Asian, Black and Filipino women developed diabetes earlier, compared to women from the UK. Similarly, South Asian, Chinese, Filipino, Black, South East Asian and Arab men developed diabetes earlier than men from the UK. A significant and important finding of this analysis was that the risks of developing diabetes vanished completely for Black and Filipino women, after accounting for lifestyle factors. For South Asian women, however, there was significant attenuation in their risks after accounting for lifestyle factors. The findings were strikingly different for immigrant men. Specifically, their risks of developing diabetes increased after accounting for lifestyle factors.

Conclusions: These results suggest the development of gender-specific and lifestyle interventions, targeted at specific immigrant groups with increased risks of developing diabetes earlier in the life course.

KEYWORDS:

• Type 2 diabetes
• visible minorities
• immigrants
• timing
• gender
• Cox model

Disclosure statement

No potential conflict of interest was reported by the author.

Key messages

(1) Timing of first onset of diabetes has been linked to other cardiovascular diseases.

(2) Yet, very few studies have examined the timing of first onset of diabetes in Canada.

(3) Examined timing of first onset of diabetes among visible minority and immigrants.

(4) Lifestyle factors mediated risks of immigrant women but accentuated risks of men.

(5) Education on healthy eating and lifestyles will benefit immigrant groups in Canada.

Notes

1 Breslow (1975) assumed that event times are continuous with the hazard of the event constant in the interval . Breslow suggested adding covariate-related components for all subjects experiencing the event at given time point and the results raised to a power equal to the number of events tied at (see also Borucka 2014).

Additional information

Funding

This study was made possible with funding from the Collaborative Applied Research in Economics (CARE), Department of Economics, Memorial University of Newfoundland.