CARE Working Paper - 2015 Early onset of diabetes mellitus among visible minority and immigrant populations in Canada

Type 2 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 ailments such as acute retinopathy, end-renal diseases and micro and macro vascular complications. 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. Applying event history techniques (Cox proportional hazards model) to the most recent Canadian Community and Health Survey (CCHS 2013), this study addresses 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. These 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 earlier in life vanished completely for Black and Filipino women, after accounting for lifestyle factors. This finding implies by modifying behaviors that predispose them to developing this condition, the timing of the onset of diabetes among these ethnic groups could be significantly postponed. Similarly, for South Asian women, there was significant attenuation in their risks after accounting for lifestyle factors. However, the findings were strikingly different for immigrant men. Specifically, their risks of developing diabetes earlier increased after accounting for lifestyle factors. These results suggest the development of gender-specific interventions, targeted at specific immigrant groups with increased risks of developing diabetes earlier in the life course.