Diabetes is a disease that affects the Hispanic population in disproportionate numbers. With larger numbers of immigrants coming to the United States who are of Hispanic origin, the individual risk and health burden of this disease will have a major impact on the quality of life and the health care system. Research into the influence of the timing of changes in lifestyle suggested an association between specific levels of socioecological exposures and certain health conditions. This study examined that possibility. The use of the National Health Interview Survey, 2005-2011, provided adequate data for examining whether age at migration was associated with self-reported diabetes; if there was a relationship between age at migration, diabetes, and obesity; and, if the age at migration-diabetes relationship differed depending on the Hispanic subgroup. It was a quantitative, cross-sectional study using a logistic regression. The outcomes indicated that migration early in life influenced diabetes diagnosis in later life and, with the addition of obesity to the model, the relationship between age at migration and diabetes persisted. This research can be a catalyst for social change in allowing for the identification of individuals most at risk, the timeframes for that increased risk, and a better understanding of the factors that predispose individual to diabetes. Public policy initiatives to target specific time periods can provide avenues for social change among this population with preventive measures to reduce long-term negative consequences of diabetes, thus improving quality of life and providing a more effective use of the health care system.

This thesis focuses on the comparison between immigrants and non-immigrants with respect to various health-related behaviours perspective/viewpoints. Specifically, this thesis comprises three essays. First, I investigate any differences in the factors for utilizing general practitioners (GP) and specialists (SP) between immigrants and non-immigrants in Canada. Second, I examine the causal effects of language proficiency on the health and health behaviours of immigrants to Canada. Finally, I investigate whether there are any differences in the claiming patterns of the Medical Expense Tax Credit (METC) and/or Medical Expense Supplement (MES) for immigrants compared to non-immigrants in Canada. Chapter 1 investigates any differences in healthcare utilization patterns between immigrants and non-immigrants. We implement a two-part model, where the first part applies logistic regressions to assess factors associated with visiting a physician, and the second applies zero-truncated negative binomial regression models to capture the frequency of using healthcare services, conditional on having at least one visit. Our results show that the patterns of healthcare utilization are different for immigrants compared to non-immigrants; differences are also observed by gender and age. More specifically, prescription drug insurance coverage and chronic conditions play opposing roles for male and female immigrants compared to their non-immigrants counterparts. Moreover, the number of years since migration is an important factor in increasing the probability of any general practitioner (GP) and specialist (SP) visit for all immigrants. Chapter 2 is to my knowledge, the first research on the causal effects of language proficiency on health outcomes and healthcare utilization of immigrants in Canada. My finding contradicts the idea that immigrants with poor language facilities are less likely to have a regular doctor. I find that good self-reported health is positively associated with language proficiency. However, I find no statistically significant causal effect of language proficiency on reporting ‘good mental health’. In addition, I find strong evidence that the utilization of hospital and mental health care services are positively associated with being English-language proficient even after controlling for many possible sets of factors. Chapter 3 contributes by supporting existing literature, but with a completely different dimension: the medical tax perspective. I am unaware of any previous research that directly compares the claim patterns of the Medical Expense Tax Credit (METC) and/or refundable Medical Expense Supplement (MES) for immigrants with those of non-immigrants in Canada. My results show that there are differences in the proportions of tax filers who claimed the METC and/or MES, and the amounts of a claim for the METC and/or MES for immigrants compared to non-immigrants; differences are also observed by age, years since migration (YSM), province and immigration categories. In both couples and single families, a lower proportion of immigrant tax filers claimed gross immediate family medical expenses (GME), potential METC claims, and METC refunds compared to non-immigrants. In the case of single families, a higher proportion of non-immigrant tax filers claimed MES compared to their immigrant counterparts. / Thesis / Doctor of Philosophy (PhD) / This thesis focuses on the comparison between immigrants and non-immigrants with respect to various health-related behaviours perspective/viewpoints. Specifically, this thesis comprises three essays. First, I investigate any differences in the factors for utilizing general practitioners (GP) and specialists (SP) between immigrants and non-immigrants in Canada. Second, I examine the causal effects of language proficiency on the health and health behaviours of immigrants to Canada. Finally, I investigate whether there are any differences in the claiming patterns of the Medical Expense Tax Credit (METC) and/or Medical Expense Supplement (MES) for immigrants compared to non-immigrants in Canada.