Opportunity costs: Underemployment and mental health inequities between immigrant and Canadian-born labour force participants, a cross-sectional study

Objectives To examine the association of underemployment (operationalized as unemployment or overqualification) to fair/poor self-rated mental health (SRMH) in: 1. labour force participants, 2. between a. immigrant vs. Canadian-born and b. recent (< 10 years in Canada; arrived 1993-2003) vs. long-term immigrant (³ 10 years in Canada) labour force participants. Methods Data from the Canadian Community Health Survey (CCHS) 2.1 (2003) was used to explore associations within the context of a 1993 national immigration policy shift prioritizing admission of skilled immigrants. Logistic regression analyses were performed to estimate odds ratios associating underemployment with fair/poor SRMH for the full study sample, then stratified by a. immigrant status, and b. length of time in Canada. Data was weighted to reflect the CCHS 2.1 sample design, adjustments for nonresponse, and post-stratification. The study sample included 57 308 labour force participants aged 18–64. Following a listwise deletion of participants with missing values for independent variables, dependent variable, and/or covariates, the resulting sample was 54 064 (94% of the eligible sample). Results Underemployment was positively associated to fair/poor SRMH for labour force participants. Overqualification was positively associated to fair/poor SRMH for immigrant (AOR 1.63; 95% CI 1.16 to 2.27), but not for Canadian-born labour force participants (AOR 1.03; 95% CI 0.90 to 1.20). Unemployment (AOR 3.41; 95% CI 1.79 to 6.48) and overqualification (AOR 1.52; 95% CI 1.04 to 2.21) only had significant positive associations with fair/poor SRMH for long-term immigrants. The magnitude of association of overqualification was greater for recent (AOR 2.04) than long-term immigrants and this may have practical importance. Conclusions The findings suggest the need for tailored interventions to prevent underemployment and fair/poor SRMH for immigrant vs. Canadian-born labour force participants. A whole of government approach is needed to reduce underemployment of immigrants and its mental health impact.