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SCUXXX10.1177/2329496518780922Social CurrentsMontazer

Article
Social Currents

Economic Development of
2018, Vol. 5(6) 583­–604
© The Southern Sociological Society 2018
Article reuse guidelines:
Origin-countries, Life-stage sagepub.com/journals-permissions
DOI: 10.1177/2329496518780922
https://doi.org/10.1177/2329496518780922

at Immigration, and Length journals.sagepub.com/home/scu

of Residence Effects on
Psychological Distress

Shirin Montazer1

Abstract
This article reexamines the healthy immigrant effect in mental health—as measured by psychological
distress—by incorporating the modifying roles of the level of economic development of origin-
country and life-stage at arrival among a sample of immigrants to Toronto, Canada—as compared
to the native-born. The analytic sample included 2,157 adults, of which 31 percent were immigrants.
Multivariate results point to a healthy immigrant effect in distress, but only among immigrants from
less developed origin-countries who migrated to Canada in mid-adulthood (between 25 and 34
years of age). Further, this health advantage deteriorates with increase in length of residence only
among this group of migrants, in large part because of an increase in chronic stressors. Immigrants
from more developed origin-countries do not experience a healthy immigrant effect, as compared
to the native-born, nor an increase in distress with tenure in Canada, irrespective of the life-stage
at immigration.

Keywords
mental health, healthy immigrant effect, chronic stress, level of economic development, life-stage
at migration

Introduction immigrant emotional well-being for long-term

Migration from one country to another, often
highly developed country of the world, has
been steadily increasing over the past 100
years. In Canada, immigrants have accounted
for a growing proportion of the population
since the 1950s (Palameta 2004). In 2011, 6.7
million immigrants from close to 200 origin-
countries resided in Canada (Statistics Canada
2013); conservative estimates project this
number to increase by 334,000 per annum by
2035/2036 (Statistics Canada 2014). The
growing number of foreign-born Canadians
highlights the importance of understanding
societal “health” (Antecol and Bedard 2006).
While a substantial body of research has
examined the physical health of the foreign-
born (e.g., Antecol and Bedard 2006; Jasso
et al. 2004; Riosmena, Wong, and Palloni 2012),
research on the mental health of immigrants is
more limited. Yet, mental health is a central
1
Wayne State University, Detroit, MI, USA
Corresponding Author:
Shirin Montazer, Department of Sociology, Wayne State
University, 2270 F/AB, 656 W. Kirby St., Detroit,
MI 48202, USA.
Email: shirin.montazer@wayne.edu
584 Social Currents 5(6)
indicator of the adaptive response of immigra-
tion (Ataca and Berry 2002) and thus may be
more sensitive to variation in the unfolding
experience of migrants in a host-country. As
with findings for physical health, the majority
of research on nonrefugee immigrant emotional
health outcomes finds that upon arrival in the
host-country immigrants report the same or
lower levels of emotional problems than the
native-born, but that over time this psychologi-
cal health advantage decreases (Aglipay,
Colman, and Chen 2013; Cook et al. 2009;
Jasso et al. 2004). This phenomenon is called
the “healthy immigrant effect,” hereafter
referred to as the HIE. While, the better mental
health of immigrants has been attributed to
selection factors at the individual and host-
country levels (Kennedy et al. 2015), the decline
in mental health with time in the host-country
has been attributed, in part, to the accumulation
of chronic stress exposure over time (Cook et al.
2009; Montazer and Wheaton 2017).
The majority of work on immigration and
mental health has focused on specific immi-
grant groups from specific origin-countries
(Aglipay et al. 2013). Research that focuses on
immigrants migrating from the same origin-
country is important because it shines light on
the distinctiveness of the migration experi-
ence. However, such research misses similari-
ties in experience across groups that likely
exist because of origin-country contextual
level commonalities, such as the level of eco-
nomic development, at the time of migration
(Montazer and Wheaton 2011, 2017). Country-
level economic conditions reflect differences
in opportunity structures, the quality of life,
and availability of resources in origin-coun-
tries that may impact the initial adjustment and
eventual trajectory in outcomes, including
mental health, for immigrants postarrival to
the host-country (Jasso et al. 2004; Montazer
and Wheaton 2011, 2017). To achieve a
broader explanation of the immigration pro-
cess and to allow for generalization beyond
specific cases, previous scholars have advo-
cated for the incorporation of country-level
characteristics across a wide range of sending
countries (Montazer and Wheaton 2011, 2017;
van Tubergen et al. 2004). Thus, the first aim
of this article is to consider the effect of an
important macro-economic condition—eco-
nomic development—of origin-country on
immigrant mental health.
However, while macrolevel contexts of exit
are important, it is also essential to consider
individual-level factors such as life-stage at
arrival, which has been shown to have signifi-
cant mental health consequences for migrants
(Mossakowski 2007; Takeuchi et al. 2007).
For example, the HIE has mostly been
observed among immigrants who came to the
host-country as adults (Mossakowski 2007).
By using data from the Neighborhood Effects
on Health and Well-being (NEHW) study
(O’Campo et al. 2015), this article investigates
(1) whether the HIE in psychological distress is
modified by the level of economic development
of the origin-country, and (2) the life-stage at
immigration; (3) whether the increase in dis-
tress with tenure in Canada is altered by these
two factors; and, if yes, (4) whether a sense of
“failed expectations” and increase in chronic
stress exposure explain the relationship between
time in the host-country and psychological dis-
tress. The NEHW study is based out of Toronto,
a major city in North America that shares many
of the economic, social, and cultural givens of
the “new world” with other major American and
Canadian cities. Toronto is home to the largest
share of the foreign-born in Canada (Statistics
Canada 2013), making it an ideal setting for the
study of immigrant adaptation.
Background
Immigration and Mental Health
Considerable debate on whether immigrants
have higher or lower rates of emotional health
problems than the native-born has permeated
the literature over the past century (Takeuchi
2016). Early-twentieth-century scholarships on
immigrants predicted higher rates of mental-
health problems among the foreign-born that
were expected to decrease with time in the
host-country (Thomas and Znaniekcki [1918–
1920] 1984). These studies often relied on the
traditional “straight line” theory of assimilation
(Warner and Srole 1945), which (1) viewed
Montazer 585
immigration to be inherently stressful and thus
associated with poor mental health among new
arrivals; and (2) viewed the process of the
immigrant group’s adoption of the “cultural
patterns” of the host society—acculturation—
(Alba and Nee 1997) to be the only route for
the improvement of immigrants’ well-being.
Contrary to the abovementioned findings,
however, newer research on post-1965 immi-
grants overwhelmingly reports a HIE: lower
average levels of mental-health problems—
that is, depression, psychological distress, or
anxiety—among immigrants than the native-
born (Aglipay et al. 2013; Cook et al. 2009;
Jasso et al. 2004). The HIE is a counterintui-
tive finding given that immigrants, on average,
have lower social support and lower socioeco-
nomic status (SES) than the native-born—at
least initially (Antecol and Bedard 2006;
Montazer and Wheaton 2017; Riosmena et al.
2013; Salas-Wright, Kagotho, and Vaughn
2014). Both of these factors are associated
with adverse mental health (Eaton, Muntaner,
and Sapag 2010; Turner and Brown 2010).
Usually, these challenges appear to diminish
with time in the host-country, as immigrants’
economic conditions improve, they find
employment, and they develop social relation-
ships (Salas-Wright et al. 2014). Despite the
social and economic assimilation of immi-
grants, however, the process of acculturation
over time is found to be associated with a
decline in the mental-health advantage of
immigrants with tenure in the host-country.
Although the starting point in traditional theo-
ries is the opposite of the HIE reported in
newer immigration research, in both models
the end result is the same level of well-being as
the native-born: mental health assimilation.
While the former model predicts this mental
health status to be a result of progress, the later
predicts this mental health status to be a result
of deterioration.
Healthy Immigrant Effect and
Psychological Health Healthy Immigrant Effect and
Two popular theories have been put forth to
Economic Development
explain the HIE. One theory is based on the
notion of immigrant self-selection: only the most
able in terms of health and resources are able to
migrate. Another theory argues that receiving
countries’ immigration policies indirectly impact
the health profile of the immigrant population
(Kennedy et al. 2015). In Canada, for example,
the 1967 points system promotes immigrants
who are well-educated, skilled, employed, par-
ents, and married (Boyd and Vickers 2000),
which could indirectly impact the emotional pro-
file of the immigrant population (Montazer and
Wheaton 2017). These two theories, of course,
are not mutually exclusive: Canada’s attempt to
select the most qualified immigrants may also
induce positive self-selection since only those
individuals who have the greatest chances of
gaining entry will apply in the first place
(Kennedy et al. 2015). Despite the popularity of
these theories, however, the HIE often holds even
after controlling for education, age and other
health ameliorating characteristics (Kennedy
et al. 2015; Montazer and Wheaton 2017).
The deterioration of this mental-health
advantage over time has been attributed to an
increase in varying types of chronic stressors
with tenure in the host-country that accompany
acculturation (Cook et al. 2009; Montazer and
Wheaton 2017; Savage and Mezuk 2014).
Chronic stressors are threats, demands, or
structural constraints that are continuous in
nature, develop insidiously, and are usually
non-self-limiting (Wheaton et al. 2013).
However, immigrants are not a homogeneous
group and, as argued by the conditional adap-
tation model (Montazer and Wheaton 2011,
2017) and segmented assimilation theory
(Portes and Zhou 1993) there are diverse tra-
jectories of adaptation and incorporation into
the host-society that can impact the HIE. The
level of economic development of the origin-
country (e.g., Jasso et al. 2004; Kennedy et al.
2015; Read, Emerson, and Tarlov 2005) and
the life-stage at immigration (Mossakowski
2007; Takeuchi et al. 2007) are two such
important modifiers of this phenomenon.
While all immigrants, irrespective of origin-
country are positively selected at the time of
586 Social Currents 5(6)
migration (Kennedy et al. 2015), selection is
likely highest among immigrants from the poor-
est and most underdeveloped countries (Jasso
et al. 2004; Read et al. 2005). This is because
the cost of migration from such countries is
greater and may require more resources (Jasso
et al. 2004). Selection, however, may not be the
only reason for the better mental health among
this group of immigrants, since the HIE is not
explained away among this group of the for-
eign-born once studies adjust for health amelio-
rating factors (e.g., Montazer and Wheaton
2017). This health gap may also be due to unob-
served selection criteria of immigrants from the
most socioeconomically distant origin-coun-
tries, such as perseverance in the face of adver-
sary, being forward-looking (Kennedy et al.
2015) and having higher expectations about life
in a host-country perceived to offer better
opportunities and life conditions than the one
left behind (Rote and Markides 2014).
The level of economic development of ori-
gin-countries may also impact the mental
health of immigrants with tenure in the host-
country. In general, schooling and work expe-
rience obtained in less developed countries
is not recognized as equivalent to that obtained
in more economically advanced countries
(Bratsberg and Ragan 2002). While migrants
from less developed origin-countries might not
be as negatively impacted initially by the lower
transferability of their human capital because
of greater perceived social distance to the
majority group (Shibutani and Kwan 1965),
they may have a harder time accepting the bar-
riers in access to opportunities and rewards as
their perception of social distance decreases
with tenure in the host-country (Montazer and
Wheaton 2017). The above lays the ground-
work for greater feelings of disappointment, or
“failed expectations,” with time in the host-
country, which leads to greater experience of
stressors in other spheres—that is, financial
(Bratsberg and Ragan 2002), work (Magee and
Umamaheswar 2011), and family (Cook et al.
2009; Montazer and Young 2017). The deterio-
rating effect of this “stress proliferation”
(Pearlin 1999) may accumulate over time,
leading to an increase in mental-health prob-
lems only among this group of migrants.
Healthy Immigrant Effect, Economic
Development and the Life-stage at
Immigration
According to segmented assimilation theory,
there are various patterns of psychosocial
adaptation that depend on an individual’s char-
acteristics (Portes and Zhou 1993)—such as
the life-stage at immigration and level of eco-
nomic development of origin-country, as
argued here. Thus, the stage of the life-course
at which immigration occurs adds another
layer of complexity to the effect of the level of
economic development of origin-country on
the mental health outcome of immigrants.
There are fundamental differences in the deci-
sion and reason for migration between persons
who immigrate as adults and those who do so
as children (Rumbaut 2004). Specifically, only
adults actually go through a selection process
at the time of migration, or make the choice to
migrate in the first place (Mossakowski 2007),
and they are better able to understand the effect
migration will have on their life conditions.
Children do not choose to emigrate and their
mental health is not likely a selection criterion
by the family or by the officials of the destina-
tion-country (Landale et al. 1999). Indeed,
studies show that those who immigrate in
adulthood have better mental health than the
native-born and their foreign-born counter-
parts who migrated in childhood (Mossakowski
2007). Thus, those who immigrate in child-
hood, irrespective of the level of economic
development of origin-country, should have
the same level of mental health than the native-
born, partly because selection is less relevant
among this group and they may be less likely
to understand migration as betterment in life
conditions. Furthermore, because those who
immigrate in childhood acculturate more eas-
ily than older migrants (Cheung, Chudek, and
Heine 2011; Rumbaut 2004) and are able to
incorporate into the host-society and make
informative connections early in life (Setia
et al. 2011), this group of immigrants should
not experience an increase in failed expecta-
tions and, as a result, an increase in the level of
chronic stressors and mental-health problems
with time in the host-country, irrespective of
Montazer 587
the level of economic development of
origin-country.
Contrary to child immigrants, the specific
stage of the life-course at immigration may
have important consequences for selection and
eventual mental health trajectory among adult
migrants. People are influenced differently by
change depending on their age-specific per-
sonal histories (Elder 1987). Immigration
scholars generally agree that immigrants expe-
rience changes in a number of life outcomes
(including mental health) as they accommo-
date to life in a new society, but that these
changes are often limited to those who came to
the host-country as adults (Alba and Nee
1997). For example, while those who migrate
in early-adulthood (before 25) and those who
migrate in mid-adulthood (25–34) both may
bring a future-oriented outlook to their new
host-country (Rumbaut 2004), those who
migrate in mid-adulthood should be selected
more by immigration policies, such as the
points system in Canada, since these migrants
generally emigrate after having completed
their education, at the beginning of their work
careers, and in their peak childbearing and
family-formation years (Rumbaut 2004)—all
important variables in Canada’s selection pro-
cess of the best and brightest possible immi-
grants. This selection, as stated earlier, should
be clearest among those from the least eco-
nomically developed countries.
Mid-adulthood immigrants, particularly
those from less developed countries, should
also experience greater failed expectations, and
consequently higher chronic stressors, with
time in the host-country because the lower
return to education and experience obtained in
less developed origin-countries should be clear-
est among those who come at the most forward-
looking stage of the life-course. While those
that migrate after the age of 35 (later-adulthood)
are also a highly selected group because they
come with years of prior work experience, “they
are unlikely to shed their native languages, cus-
toms and identities in the process of their
accommodation to the new society” (Rumbaut
2004:1167). Therefore, the foreign-born who
immigrate in later-adulthood may experience a
more attenuated mental-health trajectory with
tenure in the host-country than other adult
migrants. This group of migrants may never feel
truly Canadian—experience a true decrease in
social distance—and thus may not be as nega-
tively impacted by the disappointments of
postmigration failed expectations.
The aforementioned argument leads to the
following hypotheses:
Hypothesis 1 (H1): The HIE, in psycho-
logical distress, and the ensuing decline in
the mental health gap with time in Canada
will only be observed among immigrants
from less developed origin-countries. Those
from more developed countries will not
experience different levels of distress than
the native-born.
Hypothesis 2 (H2): The level of economic
development is not enough; the HIE and
the mental health decline with time in
Canada will only be observed among immi-
grants from less developed countries who
immigrated in mid-adulthood. Those from
more developed countries will not experi-
ence different levels of distress than the
native-born, irrespective of the life-stage at
immigration.
Hypothesis 3 (H3): The pattern described
in H2 will persist once models are adjusted
for sociodemographic, immigration, neigh-
borhood, social support, and socioeconomic
variables.
Hypothesis 4 (H4): (a) The predicted
increase in distress with tenure in Canada
among migrants from less developed coun-
tries who immigrated during mid-adulthood
will be partially mediated by an increase in
failed expectations (H4a) and (b) an increase
in the experience of chronic stressors (H4b).
Method
Data
The data for the study come from the NEHW
study (O’Campo et al. 2015), which is an indi-
vidual-level data set gathered using a cross-
sectional, multilevel design across 47
neighborhoods in the metropolitan city of the
Greater Toronto Area (GTA). Face-to-face
588 Social Currents 5(6)
interviews were conducted with ~20 to 30
respondents in 87 census tracts across the city-
defined neighborhoods in Toronto. The NEHW
data set comprises interviews with 2,412 indi-
viduals conducted between 2009 and 2011. The
response rate was over 80 percent. To be eligi-
ble for study participation, individuals had to
be a resident of the selected household, between
the ages of 25 and 64, able to communicate in
English, and had lived in the neighborhood for
at least six months (for more detail on sam-
pling/study design see O’Campo et al. 2015).
Sampling weights were derived to correct for
any selection biases that may have occurred
due to these sampling restrictions, such as the
underrepresentation of the most recent immi-
grants. Refugees were excluded from the anal-
yses (N = 46) because they are a different group
socially and economically than the general
immigrant population (Setia et al. 2011).
Furthermore, only the foreign-born with valid
information on birth-country and length of resi-
dence were included in the analytic sample
yielding a final sample size of 2,157 respon-
dents of which 679 were foreign-born. The
foreign-born participants in the NEHW study
vary in age, age at immigration, and length of
residence (LOR), which is important to disen-
tangle the effect of life-stage at immigrant from
tenure in the host-country (Cheung et al. 2011).
Variables
Psychological distress is measured by taking
the mean across 16 items adapted from Radloff’s
(1977) Center for Epidemiologic Studies
Depression Scale (CES-D). Respondents were
asked how often they felt “everything was an
effort,” “depressed,” or “as though they could
not get going,” for example. Respondents are
asked whether they felt symptoms such as these
“none of the time” (1), “a little of the time” (2),
“some of the time” (3), “most of the time” (4),
or “all of the time” (5). An index of these items
was created so that higher scores reflect greater
psychological distress (α = .95).
A number of steps were taken to create eco-
nomic development/life-stage at immigration
categories. First, economic development of
origin-country was measured by the Gross
National Product (GNP) per capita of origin-
country at the time of emigration (The World
Bank, 1962–1986a, 1962–1986b; see Montazer
and Young 2017 for further detail on classifica-
tion of origin-country GNP at the time of emi-
gration), which in the analytic sample went as
far back as 1963. Respondents were asked “in
what country were you born?” and “in what
year did you come to live in Canada?” to cor-
rectly match respondent’s origin-country with
the corresponding GNP per capita category for
the year of arrival. This classification also
includes the GNP for all intermediary coun-
tries beyond origin where respondents may
have acquired additional human capital. If an
immigrant reported living in an intermediary
country, and having received his or her highest
level of education in that country, the interme-
diary country’s GNP at the time of arrival was
used instead of the origin-country GNP.
Extending origin-country human capital to
include human capital obtained in intermedi-
ary countries prior to migration—especially if
human capital acquisition occurred in devel-
oped countries—is important because it will
likely impact postmigration expectations,
whether these expectations are met, and the
occurrence of chronic stressors postarrival
(Montazer and Young 2017). GNP was coded
into two dummy variables: lower-GNP and
upper-GNP—with the native-born as the refer-
ence group (0). See Table 1 in the online
appendix for the distribution of origin-coun-
tries by the level of GNP.
Next, the age at immigration was used to
create four life-stage at immigration groups
(immigration at or before the age of 15
[childhood], between 16 and 24 [late teens/
early-adulthood], between 25 and 34 [mid-
adulthood], and after 35 years of age [later-
adulthood]) with the native-born as the
reference group (0). The decision on the cur-
rent categorization of life-stage at arrival are
based on the work of Rumbaut (2004) for the
adults and empirical reasons for the catego-
rization of those who migrated before the
age of 18.1 Finally, information on GNP and
the life-stage at immigration were used to
create a dummy variable indexed with eight
categories: Upper-GNP immigrants who
Montazer 589
immigrated in childhood (N = 143), late
teens/early-adulthood (N = 78), mid-adult-
hood (N = 84), and later-adulthood (N = 25);
and lower-GNP immigrants who immigrated
in childhood (N = 81), late teens/early-adult-
hood (N = 85), mid-adulthood (N = 99), and
later-adulthood (N = 84). The Canadian-born
are the reference group (N = 1,478).
Because the native-born do not have a value
for length of residence (LOR), this variable is
coded conditionally on foreign-born status
(see Ross and Mirowsky 1992 for a detailed
discussion) to allow for the inclusion of the
native-born in the analyses. This method treats
LOR as a conditional deviation score from the
grand-mean of LOR. Conditionally coding
allows for a test of the HIE by allowing for the
comparison of each GNP/life-stage at immi-
gration group (at the average level of LOR in
the sample) to the native-born, while simulta-
neously representing the effects of LOR only
for those who are foreign-born.
In its simplest form, this conditionally rele-
vant variable appears in a regression model as
follows:
(
distress = b0 + b1Foreign + b2 LOR − LOR ) born status to allow for the inclusion of the
Foreign.
For the native-born (Foreign = 0) respon-
dents who do not have a value for LOR, dis-
tress equals b0. For those who are foreign-born
(= 1), distress scores vary with LOR. In these
analyses, the effect of LOR is subdivided by
GNP and life-stage at immigration for the for-
eign-born, instead of a single variable repre-
senting foreign-born.
Chronic Stressors is an index created from a
total of 40 items (Wheaton 1997) and measures
chronic stressors across a number of roles and
environments (see Table 2 in the online appen-
dix for specific items). This index is calculated
using the mean of the total number of stressors
respondents indicated experiencing at the time
of the interview, including personal, relation-
ship, parenting, employment, financial, and
ambient stressors, adjusted by the number of
questions that the respondent could potentially
answer, depending on occupied roles. If some-
one is not a parent, therefore, parental items
are missing, and cannot count overall. This
approach protects the variation in reported
chronic stress from being confounded with the
number of occupied roles (Turner, Wheaton,
and Lloyd 1995). Respondents were asked
whether a number of situations are “not true,”
“somewhat true,” or “very true” for them cur-
rently. Higher scores indicate greater chronic
stressors.
The average of three items adapted from the
work of Noh and Avison (1992) and asked only
of the foreign-born is used to create an index of
failed expectations. These respondents were
asked to indicate how often “[they] feel that
living in Canada is stressful because”: “I have
a job in Canada that is below my experience
and qualifications” (coded as missing for the
unemployed), “the education I obtained in my
country of origin/or another country prior to
coming to Canada is not recognized here,” and
“I am disappointed that my standard of living
is not what I had hoped for when I first came to
Canada.” Response options include, never (1)
to very often (4). Higher values indicate grater
failed expectations (α = .87). As with LOR,
this index is coded conditionally on foreign-
native-born in the analyses.
The analyses adjust for a number of covari-
ates since group differences in these character-
istics may contribute to health disparities
between immigrants and the native-born
(Cavazos-Rehg, Zayas, and Spitznagel 2007;
House 2002; Montazer and Wheaton 2017;
Montazer and Young 2017; Noh et al. 1999;
Riosmena et al. 2013; Turner et al. 1995). For
example, research shows that areas with higher
number of co-ethnics might be more likely to
provide practical resources and information to
facilitate the settlement process of immigrants,
which has important consequences for their
mental health (Stafford, Newbold, and Ross
2011). However, a comprehensive model of
immigration must also account for possible sup-
pressors, or protective factors—such as SES
and social support—(Beiser 2004) that may
make the association between an independent
(i.e., LOR) and dependent variable (distress)
apparent or stronger when included in the model
(Schieman 2009).
590 Social Currents 5(6)
Gender is coded 1 for women. Respondent
age is modeled as a five category dummy vari-
able to reflect its possible nonlinear effect
(O’Campo et al. 2015). The categories include
younger than 30 years of age, 30–39, 40–49,
50–59, and those above 60 (as the reference
group). Marital status is a dummy variable that
is coded as 1 if the respondent is married or
common-law and 0 otherwise. Number of chil-
dren in the household is a continuous variable
that takes the count of total number of children
under the age of 18 living with the respondent.
Total number of negative life events takes the
count of 18 negative life events (see Table 2 in
the online appendix for specific items) experi-
enced by the respondent at any time in his/her
life (Turner et al. 1995). Parental education is
a continuous variable operationalized as the
total number of years of education of the more
educated parent. Limited English language
speaking ability is coded 1 for those indicating
limited English language speaking ability ver-
sus those who indicated being proficient (0).
Immigration entrance category is a dummy
variable with three categories: work-visa,
landed immigrant (a non-Canadian citizen per-
manent resident), versus all other respondents
as the reference category.
Ethnicity/culture is a dummy variable
indexed with eight categories: Arab or West
Asian, African, Caribbean, South Asian, East
Asian Pacific Rim, Latin, European, with North
American/Canadian ethnic/cultural identity as
the reference category. These categories were
created from the standard Statistics Canada eth-
nicity coding (Statistics Canada 2008).
To measure the percent of residents with
same ethnicity as the respondent (% Ethnic
same), 14 separate ethnic groups—based on
Statistics Canada classifications used in the
2006 Census (Statistics Canada 2008)—were
used to create a percentage-measure to account
for the number of people in the census tract
who match the ethnicity of the respondent (the
latter based on self-reports). This measure is
considered an individual-level measure, since
the value varies by individual rather than by
census tract. Residents not included in these
percentages are considered dissimilar from the
respondent on that particular feature.
The analyses also adjust for premigration
human capital: premigration education and
years of employment tenure. These are particu-
larly relevant to those who came to Canada as
adults and are criteria for admission to Canada
under the points system (selection). As with
LOR, the total number of years of education
and the total number of years worked for pay
before coming to Canada are conditional on
foreign-born status.
Suppressors used in the models are perceived
social support and three variables that tap at
SES: employment status (= 1 for employed),
household income—a continuous variable that
ranges between $4,800.00 and $800,000.00,
and home ownership (= 1 for home owner).
Perceived social support is captured with an
index that takes the average of 16 items from
the Medical Outcomes Study (MOS) Social
Support Survey (Sherbourne and Stewart 1991).
Respondents were asked how often (None of
the time [1], A little of the time [2], some of the
time [3], most of the time [4], or all of the time
[5]) different kinds of support are available to
them. Some examples include “someone who
shows you love and affection” or “someone to
do something enjoyable with.” Higher values
indicated greater perceptions of social support
(α = .96).
Statistical Analyses
The NEHW study unavoidably clusters respon-
dents by neighborhood and, thus, error terms
across respondents within the same neighbor-
hood are likely correlated. To address cluster-
ing concerns and to separate the variance in
outcome across neighborhoods (Level 2) as a
proportion of the total variance in each out-
come (Level 1), all multivariate analyses
used hierarchical linear modeling (HLM;
Raudenbush and Bryk 2002). All variables
were grand-mean centered (Raudenbush and
Bryk 2002), making the intercept interpretable
at the mean value of the predictor variables.
Grand-mean centering also helps with avoid-
ing collinearity among predictors (Y.-W. B.
Wu and Wooldridge 2005). All analyses were
weighted by gender, age, household income,
household size, and nativity. Multiple
Montazer 591
imputation methods, with five data sets
imputed, were used to replace missing values
on control variables (Little and Rubin 1987).2
Table 1 presents unweighted sample char-
acteristics by GNP of origin-country and the
life-stage at immigration for all the study
variables. Significant difference at the bivari-
ate level between the different immigrant
groups and between each immigrant group
and the native-born were tested using chi-
square test for categorical variables and anal-
ysis of variance (ANOVA; Bonferroni post
hoc) for continuous variables. To test the
study hypotheses, Table 2 presents multivari-
ate results, which assess the impact of GNP/
life-stage at immigration by LOR on psycho-
logical distress. Results of post hoc tests are
used to indicate significant differences in dis-
tress between different GNP/life-stage at
immigration groups. Unadjusted results of the
effect of GNP by LOR are presented in Model
1; Model 2 presents unadjusted results of
GNP and life-stage at immigration by LOR;
controls and suppressors are added in Model
3; failed expectations is added in Model 4;
and finally, Model 5 is additionally adjusted
for chronic stressors. Mediation effects are
assessed using the three-pronged approach
outlined by Baron and Kenny (1986). Thus,
Table 3 presents results for the effects of
GNP/life-stage at immigration, and LOR on
the potential mediators.
Results
Unweighted bivariate results presented in
Table 1 indicate that, contrary to the predic-
tions of the HIE, there are no significant differ-
ences in average distress among the various
groups. However, average failed expectations
is significantly lower among immigrants who
came to Canada in childhood, irrespective of
GNP as compared to other life-stage at immi-
gration groups of the same GNP. While there
are no significant group differences in average
chronic stress, lower-GNP immigrants who
came to Canada in childhood report signifi-
cantly higher average chronic stress (p < .10,
two-tailed test; difference not shown in table)
than their upper-GNP counterparts (Low GNP:
X 4= .05; Upper GNP : X 3.26).
GNP/Life-stage at Immigration, LOR,
and Psychological Distress
As can be seen in Model 1(unadjusted results)
of Table 2, and contrary to the predictions of
the first hypothesis, there are no significant dif-
ferences in distress between either of the GNP
groups, at average LOR, and the native-born.
Furthermore, while the increase in LOR does
not have a significant effect on distress among
lower-GNP immigrants, increase in LOR tends
to decrease distress among those from upper-
GNP origin-countries. Model 2 tests the second
hypothesis. As predicted, distinction by level of
economic development alone is not enough—
the HIE and the ensuing decline in distress with
time in Canada varies by the level of economic
development of immigrant’s origin-country
and the life-stage at migration. This model
improves significantly on Model 1. At average
LOR in Canada, only immigrants from lower-
GNP countries who came to Canada in mid-
adulthood benefit from a HIE. This group has
significantly lower distress than all other lower-
GNP immigrants, the Canadian-born, and
upper-GNP immigrants who came to Canada in
mid-adulthood. The results of this model also
show how the association between each GNP/
life-stage at immigrating group and distress
changes with one-year increment in LOR. The
effect of LOR is positive and significant only
among those who migrated in mid-adulthood
from lower-GNP origin-countries. This signifi-
cant positive coefficient suggests that each year
increase in LOR increases distress by .18
among this group of immigrants. These results
persist with the addition of controls and sup-
pressors in Model 3. Indeed, the HIE among
this group of migrants becomes even stronger
(mainly because of the suppressors) in the
adjusted model and is now evident among
lower-GNP mid-adulthood immigrants in rela-
tion to only the native-born. The results for
these last two models provide support for H2
and H3. To assess whether the increase in dis-
tress with time is due to an increase in failed
expectations (H4a), this variable is added next.
However, contrary to predictions, the addition
of this variable suppresses the relationship
between LOR and distress among immigrants
who migrated in mid-adulthood from lower-
GNP countries. Finally, to test H4b, chronic
 Table 1.  Descriptive Statistics for All Variables in the Study (Unweighted).

592
Immigrants from upper-GNP origin-countries Immigrants from lower-GNP origin-countries

  Life-stage at immigration Life-stage at immigration

Late teens/ Late teens/

early- Mid- Late- early- Mid- Later-
Canadian-born Childhood adulthood adulthood adulthood Childhood adulthood adulthood adulthood
Variables (N = 1,478) (N = 143) (N = 78) (N = 84) (N = 25) (N = 81) (N = 85) (N = 99) (N = 84)

  Psychological distress 10.22 9.18 8.94 9.24 14.00 10.29 10.02 9.97 11.05
(9.52) (8.49) (7.28) (8.98) (11.70) (10.36) (9.48) (8.75) (9.71)
  Length of residence in Canada — 43.39 31.55 20.78 9.84 35.22 23.74 18.09 12.11
(Foreign-born only) (11.44)a,b,c (11.49)b,c (11.12)c (6.88) (11.29)a,b,c,d (11.10)b,c,d (8.85)c (6.46)
  Failed expectations — .39 3.91 4.74 5.34 .85 4.65 5.48 6.74
(1.18)a,b,c (1.54) (2.77) (2.88) (1.77)a,b,c (2.52)c (2.57)c (2.90)
  Chronic stressors 3.72 3.26 3.32 3.91 3.86 4.05 4.16 3.91 4.37
(2.59) (2.31) (1.89) (2.74) (2.47) (2.83) (3.09) (2.50) (2.74)
  Premigration years of — 2.06 12.67 15.58 17.56 3.85 12.55 15.46 15.96
education (foreign-born only) (3.10)a,b,c (3.39)b,c (3.59) (3.29) (4.78)a,b,c,d (2.54)b,c (2.96) (3.68)
  Premigration employment — .12 3.67 7.20 16.64 .52 3.61 6.77 15.71
tenure (foreign-born only) (.79)a,b,c (3.73)b,c (4.69)c (6.48) (1.31)a,b,c (3.54)b,c (4.37)c (7.40)
  Female (vs. Male) .56 .55 .64 .63 .60 .62a,c .79c,d,e .67c,e .39e
  Age (vs. 60 or older)::
  <30 .07 .06b .04 .00e .00 .17b,c,d,e .11b,c .01e .00e
  30–39 .16 .10e .11 .15 .04 .18c .25c,d,e .17c .02e
  40–49 .26 .29 .18 .28 .36 .28 .27 .39e .34
  50–59 .33 .32 .28 .29 .40 .25c .21c,e .29c .44e
  Married or common-law .61 .65 .63c .69 .84e .54b,c .59b,c .79e .87e
(vs. other)
  Number of children under the .57 .50 .42 .68 .60 .89 .82 1.02 .74
age of 18 years (.92) (1.05) (.81) (1.01) (1.04) (1.06) (1.00) (1.23)e (1.35)
  Race/ethnicity (vs. North American/Canadian):
   Arab or West Asian .07 .04b .11 .17e .12 .11a .02b,d .10 .07
  African .00 .00a,b .08e .03e .00 .06d,e .11e .04e .07e
  Caribbean .01 .04e .01 .02 .00 .15a,c,d,e .27b,c,d,e .12c,d,e .04e
   East Asian Pacific Rim .01 .03b,e .08e .11e .12e .14a,c,d,e .29d,e .22d,e .31e

(continued)
 Table 1.  (continued)

Immigrants from upper-GNP origin-countries Immigrants from lower-GNP origin-countries

  Life-stage at immigration Life-stage at immigration

Late teens/ Late teens/

early- Mid- Late- early- Mid- Later-
Canadian-born Childhood adulthood adulthood adulthood Childhood adulthood adulthood adulthood
Variables (N = 1,478) (N = 143) (N = 78) (N = 84) (N = 25) (N = 81) (N = 85) (N = 99) (N = 84)

  European .14 .45a,b,e .28b,e .15c .36e .21a,d .07b,d .22e .13d
  Latin .00 .01b,c .01 .07e .08e .12d,e .10d,e .07e .06e
  South Asian .02 .07e .13e .11e .12e .17d,e .09c,e .18e .30e
  Negative life events 2.67 2.72 2.59 2.68 2.60 2.62 2.35 2.55 2.50
(2.05) (2.06) (1.98) (2.23) (1.84) (2.06) (1.72) (1.87) (1.66)
  Maximum parental educ. 12.89 11.61 12.18 13.23 12.68 13.12 12.44 13.39 12.86
(4.04) (5.01)e (4.52) (3.77) (4.41) (3.82) (4.03) (3.90) (4.25)
  Limited English speaking ability .01 .00a,b,c .05e .04e .04 .02b .07e .10e .09e
(vs. proficient)
  Percent of residents with same 14.58 24.94 20.76 17.87 18.08 13.01 8.81 16.76 14.75
ethnicity as respondent (% (12.27) (17.91)b,e (19.27)e (17.94) (18.84) (14.47)d (11.74)b,d,e (19.66) (17.90)
Ethnic same)
  Immigrant entrance class (vs. all other):
  Work visa — .02a,b,c .09c .13c .32 .00a,b .07 .08 .04d
  Landed immigrant — .81a,b,c .56 .68 .56 .81a .65b,c .80 .78d
  Home owner (vs. not home .77 .82c .73 .80 .64 .81a,c .68e .75 .63e
owner)
  Household income (in 127.54 102.14 92.21 97.55 160.21 95.33 75.85 91.16 74.89
thousands) (108.63) (73.71) (69.00) (88.25) (124.31) (69.81) (60.34)e (71.19)e (51.41)d,e
  Employed (vs. unemployed) .71 .70 .68 .57c,e .80 .79a .65 .68 .77
  Perceived social support 4.27 4.27 4.12 4.12 3.98 4.22 4.02 4.07 3.88
(.73) (.70) (.76) (.74) (.92) (.72) (.83) (.73) (.78)e

Note. significant mean/proportional differences between age at immigration/GNP subgroups are based on ANOVA (Bonferroni post hoc) and chi-square tests (α = .05), respectively.
Proportions presented for categorical variables and means (SD) presented for continuous variables. GNP = Gross National Product; SD = standard deviation.
a
Significantly different from immigrants who came to Canada between 16 and 24, p < .05 (two-tailed test).
b
Significantly different from immigrants who came to Canada between 25 and 34, p < .05 (two-tailed test).
c
Significantly different from immigrants who came to Canada at or after 35, p < .05 (two-tailed test).
d

593
Significantly different from upper-GNP group of the same age at immigration group, p < .05 (two-tailed test).
e
Significantly different from Canadian-born, p < .05 (two-tailed test).
594 Social Currents 5(6)
stressors are added to Model 5. The inclusion
of this variable reduces the coefficient for the
effect of LOR on distress among this group of
migrants by 42 percent (.26 – .15 / .26 × 100).
Interestingly, while the HIE among this group
(at average LOR) is reduced to nonsignificant,
the addition of chronic stressors suppresses the
effect of having immigrated in later-adulthood
from an upper-GNP origin-country on distress.
This later group reports significantly higher
distress than their mid-adulthood counterparts
from upper-GNP countries and their lower-
GNP counterparts who immigrated during the
same stage of the life-course.
GNP/Life-stage at Immigration,
LOR, Failed Expectations, and
Chronic Stress
To better understand the role of mediators,
Table 3 presents adjusted results intended to
evaluate (1) the impact of GNP/life-stage at
immigration by LOR on failed expectations,
and (2) chronic stressors, controlling for failed
expectations. Since a sense of failed expecta-
tions is only measured among the foreign-
born, the adjusted results for this variable as
outcome are restricted to the foreign-born only.
Failed expectations is on average higher
among all of the immigrant groups (at average
LOR) as compared to those who migrated in
childhood from upper-GNP countries. Child
immigrants from lower-GNP countries have
the same average levels of failed expectations
than their upper-GNP counterparts and lower
average failed expectations than their adult
counterparts from lower-GNP countries.
Despite the higher average failed expectation
among adult immigrants, and contrary to the
predictions of H4a, experience of failed expec-
tations tends to decrease with LOR among
immigrants who migrated in mid-adulthood,
irrespective of GNP. As can be seen in the sec-
ond column of this table, failed expectations
tend to increase chronic stressors (b = .27,
p < .001; stress proliferation) and chronic
stressors are, on average, lower among adult
immigrants from lower-GNP countries as
compared to the native-born. Child immigrants
from lower-GNP countries report higher (not
the same) average chronic stressors than the
native-born. Chronic stressors increase with
each additional year in Canada among some
GNP/life-stage at immigration groups: namely,
lower-GNP immigrants who came to Canada
in their late teens/early-adulthood and lower
and upper-GNP immigrants who migrated in
mid-adulthood. The results of this table in con-
junction with those reported in Models 4 and 5
of Table 2, provide support for H4b but do not
fully support the predictions of H4a: while
increase in failed expectations tends to increase
chronic stressors, immigrants from lower-GNP
countries who migrated in mid-adulthood
experience a decrease (not an increase) in
failed expectations with time in Canada.
Discussion
By using data out of Toronto, a city with a pop-
ulation that consists of almost 50 percent
immigrants (O’Campo et al. 2015), the current
article found evidence for the commonly
reported HIE in mental health but with one
important qualification: only immigrants from
lower-GNP origin-countries who migrated in
mid-adulthood experienced a HIE in psycho-
logical distress, at average LOR in Canada, as
compared to the native-born. This was also the
only group that experienced an increase in dis-
tress with time in the host-country. A parallel
increase in chronic stressors, despite a decline
in failed expectations, with time in the host-
country among this group of immigrants partly
explained the effect of LOR on psychological
distress. As predicted, immigrants from devel-
oped origin-countries, irrespective of the life-
stage at immigration, did not experience a
mental-health advantage or an eventual decline
in mental health with tenure in the host-country.
This group of immigrants in general migrate
from countries with similar life outcomes—in
terms of income and quality of life—that may
minimize the health effects of migration
between developed countries (Urquia, Frank,
and Glazier 2010). The findings here compli-
ment the predictions of segmented assimilation
theory (Portes and Zhou 1993) that there are
various patterns of psychosocial adaptation that
depend on an individual’s characteristics.
 Table 2.  Effects of Level of Economic Development of Origin-country by the Life-stage at Immigration, and Length of Residence in Canada on Distress
(N = 2,157).
Adjusted results
GNP/life-stage (covariates and (3) Plus failed (4) plus general
GNP by LOR by LOR suppressors) expectations chronic stress

Unadjusted Unadjusted
  results (1) results (2) (3) (4) (5)

Estimated Estimated Estimated Estimated Estimated

coefficient coefficient coefficient coefficient coefficient
Variables b (SE) b (SE) b (SE) b (SE) b (SE)

Level of economic development: a

 Upper-GNP .26 (.81)  
 Lower-GNP −.90 (.64)  
Level of economic development by LOR: b
 Upper-GNP −.07 (.03)**  
 Lower-GNP .00 (.03)  
Level of economic development and life-stage at immigration: a
 Upper-GNP
  Childhood −1.87 (1.98) −2.25 (1.92) −1.26 (1.92) −1.10 (1.74)
  Late teens/early-adulthood −.64 (1.85) −2.83 (1.92) −2.89 (1.94) −.96 (1.61)
  Mid-adulthood .57 (1.09) −1.71 (1.59) −2.11 (1.59) −.69 (1.37)
  Later-adulthood 3.17 (1.88) 1.99 (2.48) 2.43 (2.50)c 4.00 (2.11)d,c
 Lower-GNP
  Childhood 2.71 (2.02)c −.93 (2.04) .16 (2.04)c −2.61 (1.86)
  Late teens/early-adulthood .01 (1.24)c −2.66 (1.51) −2.70 (1.50) −.62 (1.32)
  Mid-adulthood −3.02 (1.04)**e −4.07 (1.45)*** −4.57 (1.45)** −2.31 (1.27)
  Later-adulthood −.22 (.89)c −1.44 (1.88) −1.72 (1.90)e .59 (1.61)c,e
By LOR: b
 Upper-GNP
  Childhood .00 (.06) .01 (.05) .03 (.05) .02 (.05)
  Late teens/early-adulthood −.08 (.08) .001 (.07) .03 (.07) −.01 (.06)
  Mid-adulthood −.12 (.08) −.01 (.07) .05 (.07) −.05 (.06)
  Later-adulthood .06 (.27) .17 (.24) .12 (.24) .07 (.21)

595
(continued)
 Table 2.  (continued)

596
Adjusted results
GNP/life-stage (covariates and (3) Plus failed (4) plus general
GNP by LOR by LOR suppressors) expectations chronic stress

Unadjusted Unadjusted
  results (1) results (2) (3) (4) (5)

Estimated Estimated Estimated Estimated Estimated

coefficient coefficient coefficient coefficient coefficient
Variables b (SE) b (SE) b (SE) b (SE) b (SE)

 Lower-GNP
  Childhood −.10 (.08) .01 (.07) .04 (.07) .07 (.07)
  Late teens/early-adulthood −.11 (.08) .04 (.07) .06 (.07) −.04 (.07)
  Mid-adulthood .18 (.09)* .21 (.09)* .26 (.09)** .15 (.08)*
  Later-adulthood −.02 (.11) .06 (.11) .06 (.11) −.04 (.10)
Plus controls and suppressors
  Female (vs. male) 1.09 (.40)** 1.11 (.40)** 1.00 (.34)**
  Age (vs. 60 or older):
  <30 5.31 (1.07)*** 5.53 (1.06)*** 1.62 (.93)
  30–39 3.55 (.88)*** 3.55 (.88)*** −.07 (.77)
  40–49 3.48 (.82)*** 3.57 (.82)*** −.20 (.71)
  50–59 1.99 (.73)** 1.96 (.73)** −.09 (.64)
  Married or common-law (vs. other) −.82 (.49) −.95 (.49) .36 (.43)
  Number of children <18 −.18 (.22) −.18 (.22) .16 (.19)
  Race/ethnicity (vs. North American/Canadian)
   Arab or West Asian 3.16 (.92)*** 2.87 (.92)** 1.70 (.81)*
  African 2.65 (1.19)* 1.76 (1.20) 1.56 (1.03)
  Caribbean −1.63 (1.02) −1.86 (1.04) −.41 (.91)
   East Asian Pacific Rim 1.68 (.90) 1.13 (.91) .66 (.81)
  European 1.85 (.68)** 1.90 (.68)** 1.55 (.61)**
  Latin 2.31 (1.16)* 2.16 (1.16) .64 (1.04)
  South Asian 1.09 (.88) 1.12 (.88) 1.02 (.77)
  Negative life events .98 (.10)*** .95 (.10)*** .27 (.09)**
  Maximum parental educ. −.03 (.05) −.02 (.05) .03 (.05)
  Limited English speaking ability (vs. 3.70 (1.04)*** 3.41 (1.04)** 1.91 (.95)*
proficient)

(continued)
 Table 2.  (continued)

Adjusted results
GNP/life-stage (covariates and (3) Plus failed (4) plus general
GNP by LOR by LOR suppressors) expectations chronic stress

Unadjusted Unadjusted
  results (1) results (2) (3) (4) (5)

Estimated Estimated Estimated Estimated Estimated

coefficient coefficient coefficient coefficient coefficient
Variables b (SE) b (SE) b (SE) b (SE) b (SE)

  Percent of residents with same ethnicity .02 (.02) .02 (.02) .01 (.02)
as respondent (% ethnic same)
  Immigrant entrance class (vs. all other):
  Work visa −.04 (1.26) .42 (1.25) −.33 (1.10)
  Landed immigrant −.73 (.67) −.66 (.67) −.56 (.58)
  Household income −.01 (.002)** −.01 (.002)* −.002 (.002)
  Employed (vs. unemployed) −1.79 (.44)*** −1.67 (.45)*** −.95 (.38)*
  Home owner (vs. not home owner) −.88 (.48) −.73 (.48) .63 (.44)
  Perception of social support −4.20 (.28)*** −4.11 (.28)*** −1.72 (.25)***
  Premigration human capital
   Premigration years of education −.04 (.09) −.15 (.09) −.09 (.08)
   Premigration employment tenure .02 (.09) .00 (.09) −.06 (.08)
Mediator
  Failed expectations .62 (.12)*** .05 (.11)
  General chronic stress 2.02 (.09)***
 Constant 11.40 (.38)*** 11.21 (.35)*** 28.60 (1.30)*** 28.16 (1.29)*** 9.88 (.46)***
−2 Log likelihood/DF 16,716.90/5 16,679.56 /17 16,081.19 / 43 16,060.96 / 44 15,449.20 / 45

Note. GNP = Gross National Product; LOR = length of residence; SE = standard error.
a
Canadian-born is the reference group.
b
Measured as deviation from the grand-mean for foreign-born persons.
c
Significantly different from Immigrants who came to Canada at between 25 and 34, p < .05 (two-tailed test).
d
Significantly different from Immigrants who came to Canada at between 16 and 24, p < .05 (two-tailed test).
e
Significantly different from upper-GNP group of the same age at immigration group, p < .05 (two-tailed test).
*p < .05. **p < .01. ***p < .001 (two-tailed test).

597
598 Social Currents 5(6)

Table 3.  Effects of Level of Economic Development of Origin-country by the Life-stage at Immigration,
and Length of Residence in Canada on Failed Expectations and General Chronic Stress.

Failed expectations N = 679 General chronic stress N = 2,157

Estimated coefficient Estimated coefficient

Variables b (SE) b (SE)
Level of economic development and life-stage at immigration: a
 Upper-GNP
  Childhood Reference −.06 (.52)
  Late teens/early-adulthood 2.42 (.61)*** −.93 (.54)
  Mid-adulthood 2.84 (.48)*** −.69 (.40)
  Later-adulthood 2.09 (.67)** −.68 (.56)
 Lower-GNP
  Childhood .93 (.70)b,c,d 1.22 (.52)*
  Late teens/early-adulthood 2.28 (.51)*** −1.02 (.37)**
  Mid-adulthood 2.98 (.47)*** −1.06 (.37)**
  Later-adulthood 2.71 (.49)*** −1.10 (.40)**
By length of residence: e
 Upper-GNP
  Childhood — .01 (.01)
  Late teens/early-adulthood −.04 (.02) .02 (.02)
  Mid-adulthood −.07 (.02)** .05 (.02)**
  Later-adulthood .13 (.07) .02 (.06)
 Lower-GNP
  Childhood −.04 (.03) −.01 (.02)
  Late teens/early-adulthood −.03 (.03) .05 (.02)**
  Mid-adulthood −.07 (.03)** .05 (.02)*
  Later-adulthood .03 (.04) .04 (.03)
Failed expectations .28 (.03)***
Constant 4.27 (.14)***

Note. Models include control and suppressor variables presented in Table 1. SE = standard error; GNP = Gross
National Product.
a
Immigrants from upper-GNP origin-countries who came to Canada at or before the age of 15 are the reference
group for perceived underemployment; Canadian-born is the reference group for chronic stress.
b
Significantly different from immigrants who came to Canada at between 16 and 24 p < .05 (two-tailed test).
c
Significantly different from immigrants who came to Canada at between 25 and 34 p < .05 (two-tailed test).
d
Significantly different from immigrants who came to Canada at or after 35 p < .05 (two-tailed test).
e
Measured as deviation from the grand-mean for foreign-born persons.
*
p < .05. **p < .01. ***p < .001 (two-tailed test).

While this theory was originally developed to
better understand second generation racial/eth-
nic minorities’ path toward integration into the
American society, the results here suggest that
there are also various patterns of psychosocial
adaptation among adults migrating to other
contexts—that is, Canada—that are conditional
on the life-stage at immigration and the level of
economic development of the origin-country at
the time of migration (Montazer and Wheaton
2011, 2017).
Healthy Immigrant Effect and
Distress
The emotional health advantage among immi-
grants has been attributed to selection factors at
the individual and host-country levels (Kennedy
et al. 2015). This article argued that health
selection should be highest among immigrants
from lower-GNP countries, particularly those
who migrated in mid-adulthood, because these
immigrants generally immigrate after having
Montazer 599
completed their education, at the beginning of
their work careers, and in their peak child­
bearing and family-formation years (Rumbaut
2004)—all important variables in Canada’s
immigrant selection process. While results indi-
cate the HIE to only be evident among lower-
GNP immigrants who came to Canada in
mid-adulthood, the data do not provide support
for the assertion that this HIE is due to selection
since the gap in distress continued to be present
despite adjustment for possible selection, as
well as other factors. Selection on such measur-
able factors, therefore, may not be the only rea-
son for the lower rate of distress among this
group of immigrants in the sample. Furthermore,
unlike the assertion that immigrants from lower-
GNP origin-countries are more selected by the
host-country than those from developed coun-
tries (Jasso et al. 2004), “lower-GNP” adult
immigrants did not have higher years of educa-
tion or work experience than their counterparts
who migrated from upper-GNP countries dur-
ing the same stage of the life-cycle (Table 1).
Similar to results reported in previous work
using national-level panel data (Montazer and
Wheaton 2017), multivariate results indicate
that the observed HIE among mid-adulthood
lower-GNP immigrants is in large part due to
fewer chronic stressors (at average LOR)
among this group, as compared to the native-
born. This finding, although counterintuitive,
may be due to unobserved selection criteria of
immigrants from the most socioeconomically
distant countries of origins, such as persever-
ance in the face of adversary and being for-
ward-looking (Kennedy et al. 2015). These
factors may either help these immigrants to
overcome or combat chronic stressors, or not
to view life conditions (such as financial prob-
lems) as stressful because they are still better
off than those family and friends left behind
(Montazer, Wheaton, and Noh 2016), leading
to lower psychological distress in this group.
Of course, it is also possible that immigrants,
especially those from the most distinct origin-
countries, either express mental-health prob-
lems with different symptoms than are asked
here or are more motivated to hide problems
(Montazer and Wheaton 2017). However, psy-
chological distress—measured with similar
questions used in the construction of the cur-
rent psychological distress scale—has been
used in numerous studies in many countries
(in diverse languages) for the World Mental
Health Survey (Wu et al. 2003). Thus, this
possibility is likely to account for a small por-
tion of the variation in distress. Nonetheless,
future scholarship should extend the current
research to consider additional mental-health
outcomes.
Failed Expectations, Length of
Residence and Distress
This article argued that despite the potential
higher selection (on observable or unobservable
factors) among immigrants from lower-GNP
countries, this group should experience a steady
increase in the sense of “failed expectations”
with time in Canada, which should lead to an
increase in other chronic stressors (stress prolif-
eration), and psychological distress as a conse-
quence. According to Shibutani and Kwan
(1965), a reduction in social distance precedes
and stimulates economic advancement and
structural assimilation. It is thus natural that as
time in the host-country increases, perception of
social distance should decrease. Research has
shown, however, that even with time in the host-
country immigrants from less developed origin-
countries continue to be underemployed
(Galarneau and Morissette 2008). While recent
immigrants from lower-GNP countries might
accept that their lower economic standing, for
example, is due to the fact that they are from
countries that are fundamentally different in
opportunity structure—that is, education sys-
tem—than that of the developed host-country,
this acceptance will likely decrease as tenure in
the host-country increases, perception of social
distance decreases, and the immigrants com-
parison group shifts from other co-ethnics to the
dominant group (Hurh and Kim 1990). With
increase in time in the host-country, immigrants
from lower-GNP countries, particularly those
who came to Canada at the most forward-look-
ing time of the life-course—mid-adulthood—
were predicted to have a harder time accepting
being underemployed, for example, because
of the lower return to skills and education
600 Social Currents 5(6)
obtained in less developed origin-countries
(Bratsberg and Ragan 2002), leading to greater
relative deprivation (Hurh and Kim 1990) or,
as conceptualized here, a general sense of
“failed expectations.”
However, while “failed expectations” were
generally higher among all immigrants as com-
pared to those who migrated in childhood from
the same GNP origin-countries (Table 3), it
decreased with tenure in Canada among those
who migrated in mid-adulthood, irrespective of
GNP. Indeed, failed expectations suppressed
the effect of LOR on distress among mid-adult-
hood migrants from lower-GNP origin-coun-
tries suggesting that a decline in this feeling
with time in Canada is protective against the
experience of distress. It appears that at least in
this sample, LOR is associated with betterment
in life conditions and a decline in failed expec-
tations among these immigrants.
Chronic Stressors, Length of
Residence and Distress
Another proposition of this article was that the
decline in mental health with time in the host-
country would in part be due to an increase in
general chronic stressors (Cook et al. 2009;
Montazer and Wheaton 2017). The analyses
did not find support for the mechanism—that
is, failed expectations—linking chronic stress
to distress among lower-GNP immigrants who
migrated in mid-adulthood. But, a parallel
increase in chronic stressors uniquely medi-
ated a large percentage of the effect of LOR on
distress among this group, despite the protec-
tive effect of a decrease in failed expectations
with tenure in Canada.
What could be the reason for the increase
in chronic stressors with time in the host-
country among mid-adulthood immigrants
from lower-GNP origin-countries? One rea-
son may be that this group of migrants is more
likely to find a partner and have children in the
host-country (Rumbaut 2004). The 2.5 gener-
ation children born to one parent from a less
economically developed origin-country and
one Canadian-born parent have been found to
be more likely to experience mental-health
problems because of difficulties experienced
by these children in both the private and pub-
lic spheres (Montazer and Wheaton 2011).
Thus, stressors concerning child mental health
and family stressors among those with a part-
ner and/or children due to dissonant accultura-
tion may be especially prevalent among this
group of immigrants where the “tug of war”
between family members may be clearest
(Montazer and Wheaton 2011). Other studies
have attributed the increase in mental-health
problems to an increase in perceived discrimi-
nation (Cook et al. 2009). While the chronic
stress scale used here does not measure per-
ceived discrimination directly, it might be tap-
ping into this indirectly through stressors in
work, neighborhood, and financial spheres.
However, lower-GNP immigrants who
migrated in mid-adulthood were not the only
group that experienced an increase in chronic
stressors with time in Canada, as mid-adult-
hood immigrants from upper-GNP immigrants
also experienced an increase in general
chronic stressors with time in the host-coun-
try. It may be, however, that the specific
chronic stressors experienced by these two
groups are fundamentally different.3 Future
research should examine the mediating effects
of specific stressors in the relationship
between LOR and distress among migrants.
Future Research and Limitations
Future research should also examine the effect
of economic development of origin-country
and life-stage at immigration on distress in
conjunction with membership in other statuses
that the individual may hold, including gender,
religion, social class, and English language
proficiency (Brondolo et al. 2015). The sample
of immigrants in the current study was too
small to allow for such distinctions. An alter-
native finding that needs to be explored in
future work is whether the observed patterns
are due to the region of origin of the immi-
grants in the sample. The current analyses
adjusted for ethnicity to control for differences
across GNP that may be due to ethnicity.
Furthermore, auxiliary analyses not shown
(but available) controlled for region of origin
and the main findings remained, which
Montazer 601
confirms the robustness of the association
between economic development, life-stage at
immigration, and distress postarrival. Research
should examine the effect of immigration from
different regions of origin conditional on the
level of economic development within region
and life-stage at immigration as a further dis-
tinction. Again, the sample of immigrants here
was too small to allow for this type of
categorization.
The current study is limited in several ways.
First, the analyses are based on cross-sectional
data and cannot address issues of causal order
for relationships between mediators, some
controls/suppressors (i.e., perceived social
support, negative life events), and outcomes.
Second, while the analyses control for one
macrolevel contextual factor at the time of
emigration—GNP—and migration entrance
category, they do not account for all of the pull
or push factors in the migration process that
may determine the migratory forces unique to
any year of arrival, such as the political and
legal conditions (Jasso et al. 2004) in origin-
countries. Third, participation in this study
required respondents to have reasonable skills
in English and to have lived in their neighbor-
hood for at least six months. These restrictions
may have attributed to the overrepresentation
of more established immigrants in the sample
who have, for the most part, overcome the
most difficult phase of adjustment, which may
have underestimated the effect of LOR on dis-
tress among some groups. The analyses, how-
ever, included individual-level sample weights
to ensure that the sample was representative of
the census tracts from which the participants
were drawn (O’Campo et al. 2015). Finally, it
is necessary to replicate these analyses with a
larger sample of migrants to Canada. It may
be, for example, that nonsignificant results
observed among some groups, such as the
later-adulthood upper-GNP group of immi-
grants, are due to small numbers in these
groups.
The benefits of the current study, however,
outweigh the above noted limitations. This
scholarship provides evidence that the HIE in
psychological distress is not universal. It is
dependent on the economic context of the
origin-country and the stage of the life-course
at migration. Only those from the most eco-
nomically distant origin-countries who left
the life they knew in mid-adulthood benefit
from a HIE. This is also the group that experi-
ences a decline in mental health with tenure in
the host-country in large part because of a
parallel increase in chronic stressors over
time.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of
interest with respect to the research, authorship,
and/or publication of this article.
Funding
The author(s) disclosed receipt of the following
financial support for the research, authorship, and/or
publication of this article: This research was funded
by Canadian Institutes of Health Research (CIHR)
Grant MOP-84439 and the Social Sciences and
Humanities Research Council (SSHRC) Grant 410-
2007-1499 (Blair Wheaton, Patricia O’Campo, PIs).
Notes
1. Sensitivity tests were conducted for a number
of alternate operationalization of life-stage at
immigration, including a cutoff age of 12 for
the 1.5 generation. No matter the categoriza-
tion, however, the reported results persist only
for those who migrated in mid-adulthood from
less developed origin-countries (results avail-
able upon request).
2. Results of analysis with the nonimputed data
(N = 1,828) generated comparable results
to those presented here. However, the posi-
tive effect of length of residence on distress
among lower-GNP (Gross National Product)
mid-adulthood immigrants failed to reach sig-
nificance (p = .11), likely due to the significant
loss of cases in this group.
3. It is possible that the increase in stressors
among both of these groups with time reflects
an increase in stressors that have to do with
poor health of self and that of family mem-
ber (see items 36–40 in Table 2 of the online
appendix). In auxiliary analyses (available
upon request), this possibility was tested by
removing these five items from the chronic
stressors index. However, the results did not
change. Therefore, these items continue to be
included in the chronic stressors index.
602 Social Currents 5(6)
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