俺看过你发过一次表格，但是就觉得有问题，方法学统计学上。
但因为自己大学时候统计学也学得不是太好，不想纠缠。
如果可以，你把你的链接发给俺，俺明天有空看看，俺要是看不出毛病，让胖熊等高人看看。。
大家可以想象加拿大统计局人才如云，医学统计学都有专家：
统计学如果不精，可以看结论部分：
Introduction
In recent years, annual immigration to Canada has totalled
more than 230,000.1 About two-thirds (69.3%) of the 1.6
million increase in the Canadian population between 2001 and
2006 was attributable to immigration. By 2006, immigrants
made up one-fi fth (19.8%) of the population, a percentage
that is expected to reach 25% to 28% by 2031.2
The health and the health care needs of this large and
growing share of the population are not necessarily the same
as those of people born in Canada.3,4 Earlier studies have
found a “healthy immigrant eff ect”; specifi cally, immigrants’
health is better than that of the Canadian-born, but it tends
to decline as their years in Canada increase.5,6 This reduction
in immigrants’ health advantage is apparent in self-reported
general health,7-9 chronic diseases,10,11 disability,12 and mental
health.13-15 However, the relationship between immigration
and health is complex. It involves both pre- and postmigration
factors, for which information is often lacking.
Hence, comparing the health of immigrants to that of the
Canadian-born population is challenging.16
An additional factor is the increasing diversity in immigrants’
origins. Since the 1960s, the major source countries have shifted
from European to non-European nations. Consequently, it is
important to analyze the healthy immigrant eff ect by world
region and by period of immigration. However, small sample
sizes have meant that most studies could not be conducted at
this level of detail.
A comprehensive review of analyses of the relationship
between immigration and health17 found that the relatively
few studies of disease-specifi c mortality among immigrants
compared with the Canadian population generally supported
the healthy immigrant eff ect.18-22 More recently, all-cause
mortality in immigrants was compared with that in the
Canadian-born population.23-26 Using unlinked 1991 mortality
data, Trovato23 found evidence of a healthy immigrant eff ect,
but could not examine associations with period of immigration,
immigration class, or socio-economic factors. DesMeules et
al.26 linked a random sample of 1980 to 1990 Citizenship and
Immigration Canada landing fi les to 1980 to 1999 mortality
data for all provinces and to health care data for Ontario,
Quebec and British Columbia to study mortality risks by age,
sex, region of birth, immigration category and time in Canada.
The results generally supported the healthy immigrant eff ect
and its eventual loss, notwithstanding some cause-specifi c
exceptions. Though lacking in socio-economic data, that
study contained detailed information about immigration (for
example, immigration status, immigration class and period
of immigration). It also found higher mortality rates among
refugees than among other immigrants.
The present analysis used the 1991 to 2001 census mortality
follow-up study to explore associations between mortality
and dimensions of immigration such as country of birth
and period of immigration. An earlier analysis of the same
database by Wilkins et al.26 showed a healthy immigrant eff ect,
but the results pertained to the total immigrant population,
with the sexes combined. The objectives of the present study
were to determine:
1. if immigrants tend to have better health as measured by
age-standardized mortality rates (ASMRs) than does the
Canadian-born population (overall healthy immigrant
effect);
2. if immigrants’ initial health advantage lessens over time
(duration effect); and
3. how results vary for immigrant subgroups, by world
regions and selected countries at the Canada level and in
Toronto, Montreal and Vancouver.
The analysis was conducted separately by sex for all causes
combined and for circulatory diseases and cancer. To simplify
the presentation, the disease-specifi c results are included in
the appendix.
Discussion
The 1991 to 2001 census mortality follow-up study permits
analysis of the healthy immigrant eff ect—the dominant
hypothesis in immigrant health research—by world region
of birth and for diff erent areas of Canada.
This hypothesis
suggests that immigrants arrive with better health than the
Canadian-born population, but that this health advantage
tends to disappear over time. The results of this study provide
overall support for this trend. However, similar to earlier
research,24,25 the analysis of ASMRs by world region of origin,
period of immigration and residence reveals underlying
diff erences that may not be evident when only the overall
results are examined.
For example, the study found that female immigrants
from South Asia tended to have high ASMRs for circulatory
disease. This result confi rms previous research that found
high circulatory disease mortality rates among South Asians
in Asian and non-Asian countries,28 although results had been
* significantly different from Canadian-born population at Census Metropolitan Area level
Note : Reference population (person-years at risk) for age standardization was taken from age distribution of entire cohort (5 -year age groups).
Source: 1991 to 2001 Canadian census mortality follow-up study.
mixed for fi rst-generation immigrants from these areas and
resident in Canada. A study based on Canadian mortality
data from the 1960s to the 1980s, which did not reveal an
elevated risk for circulatory disease, reasoned that because
of the immigration system’s selection criteria pertaining to
health status, South Asian immigrants might not be fully
representative of the South Asian population in general.22
Nonetheless, a more recent study based on mortality data
from 1979 to 1993 found high circulatory disease mortality
among South Asians of both sexes in Canada.20
Heterogeneity in ASMRs within immigrant subgroups living
in Vancouver, Toronto and Montreal was also evident in
this study. For example, men born in Eastern Europe and
resident in Vancouver were found to have relatively high
circulatory disease ASMRs, but their counterparts in Toronto
and Montreal did not. This result highlights the importance
of conducting country-specifi c and disease-specifi c research
at the the CMA level.
了。。。
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