This study aims to shed light on health disparities among immigrant groups in the U.S. relative to health conditions in their sending countries and to contribute to our understanding of the public health implications of immigrant incorporation processes. We specifically address explanations for immigrant health selection and acculturation by comparing the health status and (cross-sectional) age-specific health trajectories of immigrant men and women from five origin nations against those of non-migrants with similar characteristics who remain in the origin society. The origin-society comparison will offer a more appropriate analytic counterfactual than that used in most existing studies, which only compare immigrants to natives or to other immigrant cohorts. A cross-national comparison will allow us to further examine the relevance of a) conditions of emigration in determining sex-specific migrant selectivity and b) the context of reception immigrants'face in destinations in influencing immigrant health trajectories. We look at five major immigrant groups where health outcomes, conditions of emigration, and contexts of reception vary conspicuously: Chinese, Dominicans, Indians, Mexicans, and Filipinos. We use nationally-representative data from both the United States and each of these five sending countries, namely National Health Interview Survey and New Immigrant Survey in the former and World Health Survey and the Survey of Global Ageing and Adult Health in the latter. We look at several health outcomes theoretically affected in different ways by acculturation and which are key risk factors of major chronic conditions, including self-reported height, body mass index (BMI) levels, and current smoking status, in addition to self-reported diabetes status. We also employ self-rated health (SRH) measures, which capture objective health, general well-being, and even acculturation to U.S. society. A combination of multivariate regression and matching techniques will allow us to focus on the health selectivity issue while minimizing health differences arising from the fact that migrants do not represent a random subset of their populations of origin. Finally, we will estimate summary measures for hypothetical groups of people across the life course (according to the timing of their migration) based on multistate life table techniques in order to compare the potential health trajectories of individuals according to their level of acculturation while keeping non-migrant trajectories as the counterfactual of interest.

PUBLIC HEALTH RELEVANCE: This project compares several major health outcomes (height, BMI, smoking, diabetes, self-rated health) and their age-specific trajectories among immigrant adult men and women coming from five major immigrant origins (China, the Dominican Republic, India, Mexico, and the Philippines) with those prevalent among non-migrants in their respective sending countries. By comparing both the levels and trajectories of immigrants with those of non-migrants in origin, this study aims to shed light on health disparities among immigrant groups in the U.S. relative to health conditions in their sending countries and to contribute to our understanding of the public health implications of immigrant incorporation processes.

R03HD066061

2010-08-24

2013-07-31