Bodies in yoga: tangled discourses in Canadian studios.

This paper presents the preliminary results of a one and a half-year ethnographic study conducted in Victoria, British Columbia, Canada. The research focused on participants' experiences of their bodies in the context of yoga as a health practice-specifically how they conceptualised their musculoskeletal bodies in this practice through ideas of systems, fragments, and materiality. It argues that participants' larger narratives about health and healthy bodies inform how yoga as a health practice is embedded in discourses of body work where yoga, health, and particular notions of bodily-ness become a project for the transformation of the self into a particular idea of what a body is or should be.

The Cedar Project: Relationship between child apprehension and attempted suicide among young Indigenous mothers impacted by substance use in two Canadian cities.

Indigenous leaders are gravely concerned over disproportionate representation of Indigenous children in Canada's child welfare systems. Forced separation from children is deeply traumatizing for mothers and detrimental to the wellbeing of Indigenous families, communities and Nations. This study examined relationships between child apprehension and suicide attempt within a cohort of young Indigenous women impacted by substance use. We utilized data collected every 6 months (2008-2016) by the Cedar Project, an Indigenous-governed cohort study involving young Indigenous people who use drugs in British Columbia, Canada. Recent child apprehension was defined as having a child apprehended by the Ministry of Child and Family Development since last visit. Recurrent event Cox proportional hazards models estimated the independent effect of child apprehension on maternal suicide attempt. Among 293 participants, 78 (27%) reported 136 child apprehensions; incidence of first apprehension was 6.64 (95%CI: 5.25-8.29) per 100 person-years. Forty-seven (16%) participants reported 75 suicide attempts with an incidence of 4.00 (95%CI: 2.94-5.33) per 100 person-years. Participants who reported recent child apprehension (HR: 1.88, 95%CI: 1.00-3.55), had a parent attend residential school (HR: 4.12, 95%CI: 1.63-10.46), experienced recent sexual assault (HR: 4.04, 95%CI: 2.04-7.99), violence (HR: 2.54, 95%CI: 1.52-4.27) or overdose (HR: 4.97, 95%CI: 2.96-8.35) were more likely to attempt suicide. Participants who had a traditional language spoken in the home growing up were half as likely to attempt suicide (HR: 0.49, 95%CI: 0.23-1.01). Results suggest that child welfare systems in Canada perpetuate historical and intergenerational trauma among young Indigenous mothers. Indigenous self-determination over child welfare and culturally safe services are urgently needed to end cycles of child apprehension and support the wellbeing of families, communities and Nations.

Going Nowhere: Ambivalence about Drug Treatment during an Overdose Public Health Emergency in Vancouver.

The declaration of an overdose public health emergency in Vancouver has generated an "affective churn" of intervention across youth-focused drug treatment settings, including the expanded provision of opioid agonist therapy. In this article, I track moments when young people became swept up in the momentum of this churn and the future possibilities that treatment seemed to promise. I also track moments when treatment and what happened next engendered a sense of stagnation, arguing that the churn of intervention ensnared many youth in rhythms of starts and stops that generated significant ambivalence toward treatment. The colonial past and present deepened this ambivalence among some Indigenous young people and informed moments of refusal. Youth's lives unfolded through but also around treatment programs, in zones of the city where drug use could generate a sense of momentum that was hooked not on futures, but on the sensorial possibilities of the now. [North America, overdose, drug treatment interventions, youth, affect].

Differences in risk factors for hepatitis B, hepatitis C, and human immunodeficiency virus infection by ethnicity: A large population-based cohort study in British Columbia, Canada.

OBJECTIVES: Addressing the needs of ethnic minorities will be key to finding undiagnosed individuals living with hepatitis B (HBV), hepatitis C (HCV), or human immunodeficiency virus (HIV). To inform screening initiatives in British Columbia (BC), Canada, the factors associated with HBV and/or HCV and/or HIV infection among different ethnic groups within a large population-based cohort were assessed. METHODS: Persons diagnosed with HBV, HCV, or HIV in BC between 1990 and 2015 were grouped as East Asian, South Asian, Other Visible Minority (African, Central Asian, Latin American, Pacific Islander, West Asian, unknown ethnicity), and Not a Visible Minority, using a validated name-recognition software. Factors associated with infection within each ethnic group were assessed with multivariable multinomial logistic regression models. RESULTS: Participants included 202 521 East Asians, 126 070 South Asians, 65 210 Other Visible Minorities, and 1 291 561 people who were Not a Visible Minority, 14.4%, 3.3%, 4.5%, and 6.3% of whom had HBV and/or HCV and/or HIV infections, respectively. Injection drug use was most prevalent among infection-positive people who were Not a Visible Minority (22.1%), and was strongly associated with HCV monoinfection, HBV/HCV coinfection, and HCV/HIV coinfection, but not with HBV monoinfection among visible ethnic minorities. Extreme material deprivation and social deprivation were more prevalent than injection drug use or problematic alcohol use among visible ethnic minorities. CONCLUSIONS: Risk factor distributions varied among persons diagnosed with HBV and/or HCV and/or HIV of differing ethnic backgrounds, with lower substance use prevalence among visible minority populations. This highlights the need for tailored approaches to infection screening among different ethnic groups.

A research agenda to improve patients' experience of knee replacement surgery: a patient-oriented modified Delphi study of patients of South Asian origin in British Columbia.

BACKGROUND: Up to 1 in 5 patients who undergo total knee arthroplasty (TKA) express dissatisfaction with their surgery. Our goal was to understand the experiences of patients of South Asian origin who undergo TKA and to identify a research agenda for this patient population. METHODS: We undertook a modified Delphi study in British Columbia to generate and prioritize potential research topics. An initial list of topics was generated using 3 focus groups with patients of South Asian origin who underwent TKA and their caregivers. Focus group sessions were audiotaped and transcribed, and the data were analyzed using thematic analysis. The resulting Delphi question-naire was administered over 2 rounds to patients, caregivers and health professionals. The second-round questionnaire included only topics that were strongly supported in the first round. A patient-oriented approach was adopted, with 3 patient partners as full research team members, who contributed to scoping, design, data collection, analysis and interpretation. RESULTS: Twenty-one patients who had undergone TKA and 6 caregivers attended the focus groups. Our analyses resulted in 6 broad themes and 25 research topics, all of which were presented in the first round of the Delphi survey. The survey was completed by 27 patients and 5 caregivers (54% combined response rate) and by 25 clinicians (76% response rate). Top priorities both for patients and caregivers and for clinicians were promoting exercise following surgery and self-management after hospital discharge. One of the highest ranked topics for patients and caregivers was improving knee implants; this was supported by only 60% of clinicians. INTERPRETATION: The patients and caregivers in our study prioritized research on promotion of exercise and self-management following surgery and improvement in knee implants. Future patient-oriented research efforts in Canada should emphasize these topics for this patient population.

Blood mercury, lead and cadmium levels and determinants of exposure among newcomer South and East Asian women of reproductive age living in Vancouver, Canada.

BACKGROUND: Biomarkers of the reproductive and neuro-developmental toxicants mercury (Hg), lead (Pb) and cadmium (Cd) have been found at higher concentrations in women born outside Canada than in Canadian-born women. We measured blood Hg, Pb and Cd in women ages 19 to 45years living in greater Vancouver (Canada) within five years of their arrival from South Asia (India) or East Asia (mainland China, Hong Kong and Taiwan) and related their biomarker concentration levels with exposures and behaviors since their coming to Canada. METHODS: Participants were recruited through advertisements in relevant ethnic media, locations and groups. Concentrations of blood Hg, Pb and Cd were analyzed by inductively coupled plasma-mass spectrometry (ICP-Q-MS) and compared with population values. Biomarker concentrations were regressed against exposures and behaviors assessed by culturally-relevant questionnaire. RESULTS: The study recruited 53 South and 111 East Asian women. Median (95th percentile) blood Pb in South Asians was 1.15 (2.71) µg/dL compared with 1.01 (1.81) µg/dL in East Asians. On the other hand, blood Hg at 2.5 (7.3) µg/L was higher in East Asians compared to 0.20 (0.83) µg/L in South Asians. Blood Cd was also higher in the East Asian group: East 0.53 (1.1) µg/L; South 0.27 (0.82) µg/L. Higher blood Hg was associated with seafood consumption, dental amalgams and traditional remedies; blood Pb with home renovations, sucking on metal jewelry, and cosmetics. Blood Pb and Cd concentrations were inversely associated with dairy consumption. CONCLUSIONS: Asian women recently arrived in Vancouver had higher blood Hg, Pb and Cd concentrations than same-age Canadian women measured in a national survey. Among South Asian newcomer women of reproductive age, exposure to Cd may continue after arrival. Local exposures to Hg occur through seafood and potentially through ingestion of imported traditional remedies.

Primary Biliary Cholangitis in British Columbia First Nations: Clinical features and discovery of novel genetic susceptibility loci.

BACKGROUND & AIMS: Primary Biliary Cholangitis (PBC) is a chronic autoimmune liver disease characterized by destruction of intrahepatic bile ducts, portal inflammation and cirrhosis. Although rare in most populations, it is prevalent and often familial in British Columbia First Nations. We hypothesized that major genetic factors increased the risk in First Nations. METHODS: In all, 44 individuals with Primary Biliary Cholangitis and 61 unaffected relatives from 32 First Nations families participated. Family history and co-morbidities were documented. Medical records were reviewed and available biopsies were re-reviewed by our team pathologist. Genotyping was performed on DNA from 36 affected persons and 27 unaffected relatives using the Affymetrix Human Mapping 500K Array Set. MERLIN software was used to carry out multipoint parametric and nonparametric linkage analysis. Candidate genes were identified and entered into InnateDB and KEGG software to identify potential pathways affecting pathogenesis. RESULTS: In all, 34% of families were multiplex. Fifty per cent of cases and 33% of unaffected relatives reported other autoimmune disease. Three genomic regions (9q21, 17p13 and 19p13) produced LOD scores of 2.3 or greater suggestive of linkage, but no single linkage peak reached statistical significance. Candidate genes identified in the three regions suggested involvement of IL17, NFκB, IL6, JAK-STAT, IFNγ and TGFß immune signalling pathways. Specifically, four genes-ACT1, PIN1, DNMT1 and NTN1-emerged as having roles in these pathways that may influence Primary Biliary Cholangitis pathogenesis. CONCLUSIONS: Our whole genome linkage study results reflect the multifactorial nature of Primary Biliary Cholangitis, support previous studies suggesting signalling pathway involvement and identify new candidate genes for consideration.

Fathers' Infant-Directed Speech in a Small-Scale Society.

When speaking to infants, mothers often alter their speech compared to how they speak to adults, but findings for fathers are mixed. This study examined interactions (N = 30) between fathers and infants (Mage  ± SD = 7.8 ± 4.3 months) in a small-scale society in Vanuatu and two urban societies in North America. Fundamental frequency (F0 ) and speech rate were measured in infant-directed and adult-directed speech. When speaking to infants, fathers in both groups increased their F0 range, yet only Vanuatu fathers increased their average F0 . Conversely, North American fathers slowed down their speech rate to infants, whereas Vanuatu fathers did not. Behavioral traits can vary across distant cultures while still potentially solving similar communicative problems.

Experiences of Chinese immigrant women following "Zuo Yue Zi" in British Columbia.

AIMS AND OBJECTIVES: To describe Chinese women's experiences with "zuo yue zi" in British Columbia, Canada. BACKGROUND: Women born in China and Taiwan are increasingly immigrating to westernised countries. Many women choose to follow traditional Chinese postpartum practices, also called "zuo yue zi." Few studies have examined women's use of traditional practices in western countries. DESIGN: The study used a qualitative descriptive design. METHODS: We recruited 13 mothers who were: aged 19 or older, immigrants from mainland China, Hong Kong or Taiwan in the last 5 years, and caring for infants born in the previous 6 weeks. Semistructured interviews were conducted in Mandarin, translated into English, transcribed and analysed using inductive content analysis. RESULTS: The core theme was Chinese women's novel encounters with "zuo yue zi." The women's expectations of "zuo yue zi" were acquired through birth experiences or interactions with family and friends. The participants struggled with implementing traditional practices because social support and formal institutional structures were lacking. They modified their expectations about "zuo yue zi." Factors affecting their practices were catalysts and deterrents. Catalysts included help from Chinese family members, friends and informed healthcare providers. Deterrents included unregulated paid helpers, uninformed care providers, financial constraints and structural limitations in their new environments. CONCLUSIONS: Chinese immigrant women struggled to modify and implement traditional practices in their adopted country when they encountered financial constraints, unregulated paid helpers and varying support from health care providers. RELEVANCE TO CLINICAL PRACTICE: Some postpartum women following "zuo yue zi" believed that the practice would prevent chronic illness and strengthen their intrafamily relationships. Immigrant mothers require nursing support to follow traditional postpartum practices. Nurses can advocate on patients' behalf to increase care providers' knowledge about "zuo yue zi" and public awareness for necessary regulated institutional structures.

Temporal trends in stroke incidence in South Asian, Chinese and white patients: A population based analysis.

BACKGROUND: Little is known about potential ethnic differences in stroke incidence. We compared incidence and time trends of ischemic stroke and primary intracerebral hemorrhage in South Asian, Chinese and white persons in a population-based study. METHODS: Population based census and administrative data analysis in the provinces of Ontario and British Columbia, Canada using validated ICD 9/ICD 10 coding for acute ischemic and hemorrhagic stroke (1997-2010). RESULTS: There were 3290 South Asians, 4444 Chinese and 160944 white patients with acute ischemic stroke and 535 South Asian, 1376 Chinese and 21842 white patients with intracerebral hemorrhage. South Asians were younger than whites at onset of stroke (70 vs. 74 years for ischemic and 67 vs. 71 years for hemorrhagic stroke). Age and sex adjusted ischemic stroke incidence in 2010 was 43% lower in Chinese and 63% lower in South Asian than in White patients. Age and sex adjusted intracerebral hemorrhage incidence was 18% higher in Chinese patients, and 66% lower in South Asian relative to white patients. Stroke incidence declined in all ethnic groups (relative reduction 69% in South Asians, 25% in Chinese, and 34% in white patients for ischemic stroke and for intracerebral hemorrhage, 79% for South Asians, 51% for Chinese and 30% in white patients). CONCLUSION: Although stroke rates declined across all ethnic groups, these rates differed significantly by ethnicity. Further study is needed to understand mechanisms underlying the higher ischemic stroke incidence in white patients and intracerebral hemorrhage in Chinese patients.

"They treated me like crap and I know it was because I was Native": The healthcare experiences of Aboriginal peoples living in Vancouver's inner city.

There is growing evidence that Aboriginal peoples often experience healthcare inequalities due to racism. However, research exploring the healthcare experiences of Aboriginal peoples who use illicit substances is limited, and research rarely accounts for how multiple accounts of stigma intersect and contribute to the experiences of marginalized populations. Our research aimed to explore the healthcare experiences of Aboriginal peoples who use illicit drugs and or illicit alcohol (APWUID/A) living in Vancouver's inner city. Using Indigenous methodologies, a community research team comprised of APWUID/A led the study design, data collection and analysis. Peer-facilitated talking circles explored community members' experiences accessing healthcare services and patient-provider encounters. Using an intersectionality framework, our research demonstrated how healthcare inequalities among Aboriginal peoples are perpetuated by systemic racism and discrimination. Stigmatizing racial stereotypes were perceived to negatively influence individual attitudes and clinical practice. Participants' experiences of medical dismissal often resulted in disengagement from care or delay in care. The findings suggest healthcare providers must understand the structural and historical forces that influence racial disparities in healthcare and personal attitudes in clinical practice. Adequate clinical protocols for pain management within the context of illicit substance use are urgently needed. The valuation of Aboriginal peoples and cultures within healthcare is paramount to addressing the health gap between Aboriginal and non-Aboriginal Canadians.

Prevalence of multiple sclerosis in Iranian emigrants: review of the evidence.

Iran has the highest prevalence of multiple sclerosis (MS) in the Middle East and Asia. Rate of emigration has been significantly raised among Iranians and though, multiple studies have been published on prevalence of MS among Iranian emigrants. Here we systematically reviewed these publications. We performed a comprehensive literature search was performed on April 30, 2015 in data bases of MEDLINE, EMBASE, Scopus and Google Scholar for the terms 'multiple sclerosis', 'incidence', 'prevalence', 'epidemiology', 'migration', 'emigrant', 'immigrant', 'Iran', 'Parsis' and 'Persian'. Study location, prevalence day or period, and age of at disease onset were recorded for all the included publications. Nine publications from Sweden, Canada, Norway, UK, and India were included. Only three reported age-adjusted prevalence and six reported age of disease onset. MS prevalence among Iranian emigrants varied from 21 per 100,000 people in Bombay, India in 1985 to 433 per 100,000 people in British Columbia, Canada in 2012. Five studies reported the prevalence in the region of interest, ranging from 1.33 in Bombay, India to 240 in British Columbia, Canada. Five studies also reported the prevalence of MS in the population of the destination country, and in all of them, the prevalence of MS was higher in Iranian immigrants compared to native people. Prevalence studies performed in Iran and also on Iranian emigrants indicate roles for both genetic and environmental factors in MS susceptibility. Data might indicate that living in a high-risk area increases the susceptibility to MS.

Conceptualizing psychological processes in response to globalization: Components, antecedents, and consequences of global orientations.

The influences of globalization have permeated various aspects of life in contemporary society, from technical innovations, economic development, and lifestyles, to communication patterns. The present research proposed a construct termed global orientation to denote individual differences in the psychological processes of acculturating to the globalizing world. It encompasses multicultural acquisition as a proactive response and ethnic protection as a defensive response to globalization. Ten studies examined the applicability of global orientations among majority and minority groups, including immigrants and sojourners, in multicultural and relatively monocultural contexts, and across Eastern and Western cultures. Multicultural acquisition is positively correlated with both independent and interdependent self-construals, bilingual proficiency and usage, and dual cultural identifications. Multicultural acquisition is promotion-focused, while ethnic protection is prevention-focused and related to acculturative stress. Global orientations affect individuating and modest behavior over and above multicultural ideology, predict overlap with outgroups over and above political orientation, and predict psychological adaptation, sociocultural competence, tolerance, and attitudes toward ethnocultural groups over and above acculturation expectations/strategies. Global orientations also predict English and Chinese oral presentation performance in multilevel analyses and the frequency and pleasantness of intercultural contact in cross-lagged panel models. We discuss how the psychological study of global orientations contributes to theory and research on acculturation, cultural identity, and intergroup relations.

Primary care visits due to injuries among the Aboriginal off-reserve population of British Columbia, Canada, 1991-2010.

BACKGROUND: Aboriginal people in British Columbia (BC) have higher injury incidence than the general population. This report describes variability in visits to primary care due to injury, among injury categories, time periods, geographies, and demographic groups. METHODS: We used BC's universal health care insurance plan as a population registry, linked to practitioner payment and vital statistics databases. We identified Aboriginal people by insurance premium group and birth and death record notations. Within that population we identified those residing off-reserve according to postal code. We calculated crude incidence and Standardized Relative Risk (SRR) of primary care visit due to injury, standardized for age, gender and Health Service Delivery Area (HSDA), relative to the total population of BC. RESULTS: During 1991 through 2010, the crude rate of primary care visit due to injury in BC was 3172 per 10,000 person-years. The Aboriginal off-reserve rate was 4291 per 10,000 and SRR was 1.41 (95 % confidence interval: 1.41 to 1.42). Northern and non-metropolitan HSDAs had higher SRRs, within both total BC and Aboriginal off-reserve populations. In every age and gender category, the HSDA-standardized SRR was higher among the Aboriginal off-reserve than among the total population. For all injuries combined, and for the categories of trauma, poisoning, and burn, between 1991 and 2010, crude rates and SRRs declined substantially, but proportionally more rapidly among the Aboriginal off-reserve population, so the gap between the Aboriginal off-reserve and total populations is narrowing, particularly among metropolitan residents. CONCLUSIONS: These findings corroborate our previous reports regarding hospitalizations due to injury, suggesting that our observations reflect real disparities and changes in the underlying incidence of injury, and are not merely artefacts related to health care utilization.

A systematic review of the effectiveness of school-based obesity prevention programmes for First Nations, Inuit and Métis youth in Canada.

First Nations, Inuit and Métis (FNIM) youth are disproportionately affected by obesity and represent known a high-risk group in Canada. School-based prevention programmes may have the potential to effectively influence obesity-related health behaviours (i.e. healthy eating and physical activity) among this population. We conducted a systematic review of nine electronic databases (2003-2014) to identify studies that describe school-based programmes that have been developed to improve obesity-related health behaviours and outcomes among FNIM youth in Canada. The objectives of this review were to identify and evaluate the effectiveness of these programmes and assess the strength of the methodologies used to evaluate them. Fifteen studies, representing seven distinct interventions, met our inclusion criteria. The majority of these programmes did not result in significant improvements in outcomes related to obesity, healthy eating, or physical activity among FNIM youth. The studies varied in design rigour and use of evaluation activities. The lack of literature on effective school-based programmes for FNIM youth in Canada that target obesity-related outcomes highlights a priority area for future intervention development, evaluation and dissemination within the peer-reviewed literature. Further research is needed on interventions involving Métis and Inuit youth, secondary school-aged FNIM youth and FNIM youth living in urban settings.

Case Study on Ancestry Estimation in an Alaskan Native Family: Identity and Safeguards Against Reductionism.

Understanding the complexities of ancestry-related identity is a necessary component of ethically sound research related to the genetic ancestry of modern-day communities. This is especially true when working with indigenous populations, given the legal and social implications that genetic ancestry interpretations may have in these communities. This study employs a multicomponent approach to explore the intricacies of ancestry-related identity within one extended family with members who identify as Alaskan Native. The seven participants were interviewed about their own self-identity, perceptions regarding genetic ancestry estimation, and their knowledge of oral family history. Additionally, each participant consented to having his or her genetic ancestry estimated. The researchers also surveyed ancestry-related documents, such as census records, birth certificates, and Certificates of Indian Blood. These three different perspectives-oral family history and self-identity, genetic ancestry estimation, historical and legal documentation-illustrate the complex nature of ancestry-related identity within the context of indigenous and colonial interactions in North America. While estimates of genetic ancestry broadly reflected each individual's self-reported biogeographic ancestry and supported all described and historically reported biological relationships, the estimates did not always match federally recorded blood quantum values, nor did they provide any information on relationships at the tribe or clan level. Employing a multicomponent approach and engaging study participants may help to safeguard against genetic essentialism and provide a more nuanced understanding of ancestry-related identity within a larger political, legal, and historical context.

Diabetes in the young: a population-based study of South Asian, Chinese and White people.

AIMS: Rates of diabetes mellitus in the young have not been quantified on a population level, particularly in South Asian and Chinese populations, which bear high rates of diabetes. We determined the incidence of diabetes (Type 2 diabetes and diabetes using insulin only) and rates of hospitalizations among South Asian, Chinese and White people aged 5-29 years with newly diagnosed diabetes. METHODS: People with newly diagnosed diabetes (1997-2006) in British Columbia, Canada were identified using population-based administrative data and pharmacy databases. Age-standardized incidence rates were calculated for people with diabetes prescribed insulin only and those with Type 2 diabetes. They were followed for up to 8 years for all hospitalizations and diabetes-related complications. RESULTS: There were 712 South Asians, 498 Chinese and 6176 White people aged 5-29 years with diabetes. Most youth with diabetes had Type 2 diabetes (South Asian 86.4%; Chinese 87.1% and White 61.8%). The incidence of diabetes on insulin only was highest in White people compared with the other groups. The incidence of Type 2 diabetes was highest in South Asians, particularly in 20-29-year-olds, with rates 2.2 times that of White people and 3.1 times that of Chinese people. Hospitalization and diabetes-related complications were uncommon in all groups. CONCLUSION: The incidence of Type 2 diabetes is higher than previously estimated among youth and is now surpassing diabetes on insulin only. Significant reductions in Type 2 diabetes screening ages in South Asians need to be considered and prevention efforts are urgently required in childhood and adolescence. Global estimates need to consider the epidemic of Type 2 diabetes in the young.

Renal leukocyte chemotactic factor 2 (LECT2) amyloidosis in First Nations people in Northern British Columbia, Canada: a report of 4 cases.

Leukocyte chemotactic factor 2 (LECT2) amyloidosis is a recently identified type of amyloidosis that may represent an underdiagnosed cause of chronic kidney disease. LECT2 amyloidosis typically is reported as being renal limited and, in the United States, more prevalent in Hispanic patients. We add to the epidemiologic data of this condition by describing 4 First Nations people from Northern British Columbia, Canada, who presented with slowly progressive chronic kidney disease that was found to be due to LECT2 amyloidosis.

Preservation of lower incidence of chronic lymphocytic leukemia in Chinese residents in British Columbia: a 26-year survey from 1983 to 2008.

The incidence of chronic lymphocytic leukemia (CLL) in the Asian population is up to 10 times lower than that in Caucasians. Studies on CLL in Asian residents in North America may help to determine the relative genetic and environmental causes of such a difference. Computerized records of CLL incidence from the combined British Columbia (BC) databases (n = 2736) and the Hong Kong Cancer Registry (HKCR, n = 572) were traced. Ethnic Chinese cases of CLL in BC were identified (n = 35). The world age standardized rates (WASRs) of CLL (per 100 000) were calculated in BC (1.71), HK (0.28) and BC Chinese (0.4), respectively. Using standard incidence ratios (SIRs), the observed BC Chinese case number was comparable to the figure projected from HK rates (SIR 1.3, p = 0.1) but significantly lower than the figure following BC rates (SIR 0.22, p < 0.0001). The difference was maintained over both genders, in all age groups and through the years. Our data over three decades suggest that genetic factors outplay environmental factors to give lower CLL rates in Chinese.