Understanding experiences of non-physical maltreatment in childhood in Canada: What is the relationship with suicidal ideation and mental health disorders?

Background: Physical and sexual childhood abuse are associated with suicidal ideation and mental health disorders. However, less is known about non-physical types of maltreatment. This study examined associations between non-physical types of child maltreatment (e.g., emotional abuse, interpersonal aggression, exposure to physical intimate partner violence, emotional and physical neglect) and suicidal ideation, and mental health disorders. Data and methods: Data from the 2018 Survey of Safety in Public and Private Spaces were used to estimate the proportion of individuals 15 years and older in Canada who experienced non-physical maltreatment during childhood. Multivariable regression analyses were used to examine associations between five types of non-physical child maltreatment and suicidal ideation, and mental health disorders. Results: Overall, interpersonal aggression was the most common (45.7%), followed by emotional abuse (40.4%) and emotional neglect (20.0%). Individuals who experienced any type of non-physical maltreatment in childhood had a higher probability of lifetime suicidal ideation than those who never experienced the maltreatment examined. Mood disorder diagnoses were more likely among those who experienced emotional abuse, interpersonal aggression, and emotional neglect than among those who never experienced these types of maltreatment. Compared with those who never experienced the maltreatment examined, individuals who experienced emotional abuse, interpersonal aggression, emotional neglect, or physical neglect were more likely to be diagnosed with an anxiety disorder. Diagnoses of post-traumatic stress disorder were more likely among those who experienced emotional and physical neglect than among those who never experienced these types of maltreatment. Interpretation: Non-physical child maltreatment is associated with suicidal ideation and mental health disorders. The findings highlight the importance of including non-physical types of child maltreatment on population-based surveys to differentiate associations with mental health outcomes to better align interventions and policies.

Difficulties accessing health care in Canada during the COVID-19 pandemic: Comparing individuals with and without chronic conditions.

Background: Individuals with chronic conditions have higher levels of health care usage and may be at higher risk of more severe outcomes from COVID-19. Therefore, they may have experienced greater difficulty accessing health care during the pandemic because of restrictions on health care services. Data and methods: Data from the Survey on Access to Health Care and Pharmaceuticals During the Pandemic were used to estimate the proportion of individuals in Canada, with and without chronic conditions, who experienced difficulties accessing health care services during the pandemic. Multivariate analyses examined associations between demographic, socioeconomic and health characteristics and the likelihood of experiencing difficulties accessing health care during the pandemic. Results: Nearly one-third (32.0%) of individuals who self-reported having one or more chronic conditions and 24.2% of those who reported no conditions had one or more medical appointments cancelled, rescheduled or delayed because of COVID-19. Smaller proportions of individuals with (19.5%) and without (16.8%) chronic conditions delayed contacting a medical professional because of fear of exposure to COVID-19 in health care settings. Individuals who were younger or had a disability were also more likely than older individuals or those without a disability, respectively, to have had a medical appointment cancelled, rescheduled or delayed because of the pandemic. Women, immigrants, and individuals with multiple chronic conditions were more likely than their counterparts (men, Canadian-born individuals, and individuals with no chronic conditions, respectively) to have delayed contacting a medical professional because of fear of exposure to COVID-19. Interpretation: Individuals with chronic conditions were more likely than those with no chronic conditions to have experienced difficulties accessing health care during the pandemic. Consequently, these individiuals may be at greater risk of experiencing health challenges in the future.

Over-education and well-being: how does education-occupation mismatch affect the life satisfaction of university-educated immigrant and non-immigrant workers?

OBJECTIVE: The increased migration of skilled workers has resulted in a focus on the economic costs of their unsuccessful labor market integration. Few studies investigate the consequences of employment difficulties on immigrants' well-being. Researchers studying over-education and life satisfaction tend to only examine the general population despite high levels of over-education among skilled immigrants. This study examines the relationship between over-education and life satisfaction among both immigrant and native-born workers in Canada. Factors associated with immigrants specifically (e.g. years since migration) are also considered. DESIGN: Descriptive and multivariate analyses are conducted using pooled data from the 2009 to 2014 Canadian Community Health Survey (CCHS). Ordinary-least-squares (OLS) regression models are estimated with life satisfaction as the outcome. The models are run separately for immigrant and Canadian-born workers, accounting for differences in the degree to which individuals are over-educated. There are 5826 immigrant respondents and 24,985 non-immigrant respondents. RESULTS: Over-education was negatively associated with the life satisfaction of both immigrants and non-immigrants, although the effect was weaker among the immigrant population. Income was the main factor mediating the negative relationship between over-education and life satisfaction among immigrants. Moreover, the negative influence of over-education on life satisfaction weakened with immigrants' increased residence in Canada. CONCLUSION: Although over-education was negatively associated with immigrants' life satisfaction, it had a stronger influence on the non-immigrant population. This may be due to differences in the reference groups to which immigrants and non-immigrants compare themselves when assessing their life satisfaction; over-education may be less influential to immigrants' life satisfaction because it is a common experience among immigrants. Additionally, over-education is less detrimental to immigrants' life satisfaction with increased time in the host country. This may be attributable to a shift in the importance immigrants assign to the employment domain of their life over time.

Source-country individualism, cultural shock, and depression among immigrants.

OBJECTIVES: To determine whether there is a relationship between source-country individualism and depression among different immigrant groups. METHODS: Pooled data from the 2009-2014 waves of the Canadian Community Health Survey (CCHS) were used. The CCHS is a cross-sectional, nationally representative household survey. A sample of 4347 immigrants in Canada were studied, representing 101 source countries. RESULTS: Multi-level logistic regression analysis showed a curvilinear relationship between source-country individualism and depression. A positive relationship was found among immigrants from countries with mid- to high levels of individualism. However, an inverse relationship was observed among immigrants from countries with low to mid-levels of individualism. Depression was significantly associated with the linear form of the source-country individualism measure [odds ratio (OR) 0.950; 95% confidence interval (CI) 0.915-0.987] and its squared term (OR 1.063; 95% CI 1.026-1.102). CONCLUSIONS: A high level of source-country individualism tends to increase the prevalence of depression among immigrants. There is also a cultural shock effect: the prevalence of depression was stronger in the initial years after immigration for those who migrated from countries with low levels of individualism.