A growing body of literature suggests that immigrants to Canada experience deterioration in their health status after settling in the country. While self-selection processes and Canadian immigration policy ensure that, at the time of arrival, immigrants are healthier than the Canadian-born population, this health advantage does not persist over time. This study uses new data from the Longitudinal Survey of Immigrants to Canada (N=7720) to examine how health transitions vary among immigrants. Logistic regression analyses indicate that visible minorities and immigrants who experienced discrimination or unfair treatment are most likely to experience a decline in self-reported health status. The results also confirm a clear inverse socioeconomic gradient with respect to increasing levels of feelings of sadness, depression and loneliness. These findings reflect important dimensions driving population health patterns in Canada, a country with a highly lauded health care system based on the principles of universality and comprehensiveness. Our findings suggest that discrimination and inequality partly drive the health transitions of immigrants. These factors, which largely operate outside of the formal health care system, need to be understood and addressed if health inequities are to be reduced.