The health of first and second generation migrant children in England and Ontario

Background
Millions of children in England, and Ontario, Canada, are international, first generation migrants, or have parents who have migrated internationally (in other words, they are second generation migrants). Despite the large number of children who are either first- or second- generation international migrants, there is very little data regarding their health outcomes, even in high income countries. This is partly due to the lack of data on migration status on routinely collected health records from hospitals and general practitioners. Instead, health data can be linked to migration records and/or other routinely collected sources, such Census or birth registration data, to examine health outcomes for migrant children and children whose parents are migrants.

Aims/Objectives:
The overall aim of this PhD is to determine the health outcomes of first and second generation migrant children in England and Ontario. The specific objectives are to:
5)    Develop and validate cohorts of first- and second-generation migrant children within relevant datasets from England; as well as control cohorts of children do not have recent family history of migration 
6)    Examine health outcomes among first or second generation migrant children in England 
7)    Repeat objectives 1 & 2 for Ontario
8)    Compare health outcomes for second generation migrant children whose parents were born in specific countries, according to whether they live in Ontario or England

Methods:
The student will use routinely collected administrative or survey, datasets from England and Ontario, two jurisdictions with different histories of international migration and associated policies, to examine health outcomes for children who are either first or second generation migrants. The student will identify groups of children who are at particularly high risk of adverse health outcomes, in each respective jurisdiction. They will also evaluate the health of second-generation migrant children from the same countries of origin but residing in different jurisdictions.

Ethics Approval:

All approvals to meet objective 1 and 2 will be in place before the student starts. Approvals to use the Ontario data will be sought during the first 18 months of the PhD so that they are in place before the students

Collaboration with University of Toronto:
The student will have a unique opportunity to spend 6 months in the Institute of Health Policy, Management and Evaluation at the University of Toronto where they will gain skills in analysing linked, administrative datasets from Ontario. 

Timeline:

We expect the student to spend 18 months at UCL, followed by 6 months in Toronto, and the final year of the PhD at UCL. 

References:
1.    … Armitage AJ, Heys M, Lut I, et al. Health outcomes in international migrant children: protocol for a systematic review. BMJ Open 2021;11(5):e041173. doi: 10.1136/bmjopen-2020-041173
2.    … Pathak N, Patel P, Burns R, et al. Healthcare resource utilisation and mortality outcomes in international migrants to the UK: analysis protocol for a linked population-based cohort study using Clinical Practice Research Datalink (CPRD), Hospital Episode Statistics (HES) and the Office for National Statistics (ONS). Wellcome Open Research 2021;5(156) doi: 10.12688/wellcomeopenres.15931.2
3.    … Urquia M, Walld R, Wanigaratne S, et al. Linking National Immigration Data to Provincial Repositories: The case of Canada. International Journal of Population Data Science 2021;6(1) doi: 10.23889/ijpds.v6i1.1412