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PubMed1997

Geographic distribution of stroke mortality among immigrants to the United States.

BACKGROUND AND PURPOSE: This study examines the geographic distribution of stroke mortality among immigrants and natives of the United States. METHODS: National Center for Health Statistics and Bureau of the Census data were used to determine the geographic distribution of age-adjusted, race-, and race/sex-specific stroke mortality rates among immigrants and natives of the United States for 1979 to 1981. RESULTS: For whites and blacks and for each of the respective race/sex groups, immigrants had markedly and highly statistically significantly lower age-adjusted stroke mortality rates than either the entire US-born resident population or the US-born interregional migrant population. The spatial pattern of immigrant rates did not parallel the patterns for US-born populations. Immigrant rates were highest in the West and lowest in the Midwest for whites and highest in the Midwest and lowest in the Northeast for blacks, whereas for both US-born whites and blacks, resident and native rates were highest in the South and lowest in the Midwest. With few exceptions, region-specific immigrant rates for whites and blacks were significantly lower than rates for either US-born regional residents, US-born migrants to the regions, or US-born natives of the regions. In contrast, white immigrants to the West had significantly higher rates than US-born groups in that region. CONCLUSIONS: Selection factors strongly influence stroke mortality rates among immigrants to the United States. The aberrantly high rates among white immigrants to the West may in part reflect a bias due to large census undercounts of this population.

Adult↗

PubMed2004

Psychopathology and mental health service utilization by immigrants' children and their families.

To investigate the psychopathology of immigrants' children and psychiatric service utilization by the immigrant families, data were collected from the files of all 35 immigrant children seen over a 3-year period at the Community Mental Health Centre of the Athens University Psychiatric Department. Immigrant children were matched by age, gender and intake date with 70 Greek children. Data concerned information about the child's place of birth, current living conditions, parents' country of origin, social and economic situation, occupations and educational status, social insurance, psychiatric history, referral source, diagnostic and therapeutic services rendered, number of sessions and outcome. Utilization of services was assessed 6 months after intake. No significant differences were found regarding family's structure and parents' psychopathology. However, immigrant families had significantly worse economic situations, lower status jobs, worse housing and were usually uninsured. No significant differences were observed regarding service utilization parameters, except concerning 'cooperation with other services' No differences were found regarding frequency or type of psychiatric diagnosis. However, 91% of the immigrant group received a psychosocial diagnosis as opposed to 49% of the Greek group. Immigrant children did not present more serious or diverse psychopathology than did Greek children. Immigrant families had equal levels of service utilization as Greek families. However, it was apparent that immigrant families did not apply for help as readily as their Greek counterparts.

Adolescent↗

PubMed2001

Constructing deservingness: federal welfare reform, supplemental security income, and elderly immigrants.

On August 22, 1996, President Clinton signed the welfare reform law that ended eligibility for all immigrants to federal means tested entitlements. Poor elderly immigrants on Supplemental Security Income were specifically targeted. This article documents how the print media responded to these policy changes. The following are the major research questions: (1) How were older immigrants on Supplemental Security Income portrayed in the print media before and after federal welfare reform? (2) Who was involved in the print media coverage of older immigrants on Supplemental Security Income before and after federal welfare reform? (3) What types of statements were made by those involved in the print media coverage of older immigrants on Supplemental Security Income, before and after federal welfare reform? The approach used was an in-depth content analysis of newspaper articles from major U.S. newspapers. The findings demonstrate that older immigrants were constructed as "undeserving" in news articles prior to the passage of the federal welfare reform bill. However, after the passage of the federal welfare reform bill the coverage of older immigrants on Supplemental Security Income started to change, and older immigrants were portrayed as "deserving." In advancing aging policy for poor, vulnerable elderly, such as elderly immigrants, advocates, health and social service providers can play an influential role in bringing their voices to the print media.

Aged↗

PubMed2005

Health care expenditures of immigrants in the United States: a nationally representative analysis.

OBJECTIVES: We compared the health care expenditures of immigrants residing in the United States with health care expenditures of US-born persons. METHODS: We used the 1998 Medical Expenditure Panel Survey linked to the 1996-1997 National Health Interview Survey to analyze data on 18398 US-born persons and 2843 immigrants. Using a 2-part regression model, we estimated total health care expenditures, as well as expenditures for emergency department (ED) visits, office-based visits, hospital-based outpatient visits, inpatient visits, and prescription drugs. RESULTS: Immigrants accounted for $39.5 billion (SE=$4 billion) in health care expenditures. After multivariate adjustment, per capita total health care expenditures of immigrants were 55% lower than those of US-born persons ($1139 vs $2546). Similarly, expenditures for uninsured and publicly insured immigrants were approximately half those of their US-born counterparts. Immigrant children had 74% lower per capita health care expenditures than US-born children. However, ED expenditures were more than 3 times higher for immigrant children than for US-born children. CONCLUSIONS: Health care expenditures are substantially lower for immigrants than for US-born persons. Our study refutes the assumption that immigrants represent a disproportionate financial burden on the US health care system.

Adolescent↗

PubMed1998

Perceived stress, psychopathology, and family support in Korean immigrants and nonimmigrants.

The purpose of this study was to determine the effects of immigration on perceived stress, psychopathology, and family support in Korean immigrants. A total of 105 immigrants and 32 nonimmigrants responded to the questionnaire. The Global assessment of recent stress (GARS) scale as well as anxiety, depression and somatization scales of the symptom checklist-90-revised (SCL-90-R), and the perceived social support scale were used to measure perceived stress, psychopathology and extent and of family support. Immigrants scored significantly higher on the somatization scale than nonimmigrants. However, no significant differences were found in scores on the anxiety and depression scales of SCL-90-R, total GARS scores for family support between the two groups. Immigrants with lower incomes had significantly higher scores on the anxiety, depression and somatization scales as well as total GARS scores than those with higher incomes, whereas the former were significantly lower in family support than the latter. Immigrants with nonprofessional occupations had significantly higher scores on the anxiety and somatization scales and lower scores for family support than those with professional occupations. The extent of satisfaction for family (spouses and children), job and friendship had significantly negative correlations with scores on all three scales of SCL-90-R in immigrants. These results suggest that Korean immigrants had more somatization than nonimmigrants, and that the immigrants' psychopathology, including somatization, could be greatly influenced by income, type of occupation, satisfaction for job, family and friendship.

Adult↗

PubMedDate not supplied

[Hysteria and psychosomatic disorders in Portuguese immigrants].

Seventy patients presenting symptoms of hysteria (49 women and 21 men) were selected among patients observed at the Institute Minkowska during the year. This work is part of a research work on socio-cultural and environmental factors which can change mental status of immigrants. These are all portugese workers presenting for the first time atypical mental troubles called by the author: "bastard hysterical syndrome of the immigrant" and characterized partly or totally by the following symptoms: fatigue, anxiety, sense of suffocation, dyspnea, coughing, unilateral chills or generalized chil, abdominal or gastric pains, headaches and "diffused pains", paresthesia, aching back, tears and sorrow, fear of dying or having a cancer, asthenia, leg paresthesia and contractions, vomiting, diarrhea, cardiac pains, palpitations, dizziness and collapsing. These troubles appear sometimes without apparent motives but they are almost always due to a precipitating cause expressed by the patient: a delivery, a familial death, a homosexual proposition, a trauma without importance, a working conflict etc... But the most frequent cause invoked is "the french climate" without knowing precisely what the word "climate" means: atmospheric conditions, athmosphere or reception milieu? This latest interpretation seems more likely after months of psychotherapy. Most patients are not french speaking and cannot write; their origin is rural (familial villages well structured regarding their food and sexual economy), and people well "armed" by a system of defense mechanisms and well adopted conditioned reflexes. In this work, hysteria of the portugese immigrant is compared to childhood hysteria. As the hysterical burst of the child is aimed at calling attention, love of the mother, at finding a solution to a familial or social conflict, the hysterical burst of the immigrant is aimed at the absent family or at its substitutes, the bos, social security, the doctor. Furthermore, the attitude of the hosting Country--wanting and rejecting--is very ambivalent; "tenderness" at the time of reception, followed by indifference. Early attentions are followed by constant interdictions (threat of unemployment, false statements on sexual dangers of the immigrant etc;..). The immigrant, like the hysterical child, is periodically controlled (work and visit cards), supervised (supervisors), The narcistic satisfactions of being called a good worker can be followed by threats of firing in economic crisis. The society of the hosting country requires the immigrant to be identical to this society: language, physical appearance, food. The real paradoxical situation to which the immigrant is confronted and the real or hypothetical fears constitute conditions of experimental neurosis, to which portugese immigrants react very often by a bastard symptomatology of hysterical type, characteristic of displaced man. These preliminary studies are the frame for a future epidemiological survey in this specific population.

Adult↗

PubMedDate not supplied

Immigration and mental health: Mexican Americans in the United States.

The Hispanic population in the United States continues to expand rapidly due primarily to a large flow of immigrants from Mexico. Historical observations of disadvantage in the immigrant population, when compared to the native population, had helped to shape prevailing theories on immigration and mental health. However, data emerging from new research on Mexican Americans have come to challenge the old idea that immigrants are necessarily disadvantaged. The goal of this article is to review these new studies critically, to draw conclusions concerning the relationship between immigration and psychopathology, and to offer potential explanations for the major findings. We review five recent large-scale studies that examined the prevalence of mental disorders among Mexican-born immigrants and U.S.-born Mexican Americans in the United States. Results of these studies are inconsistent with traditional tenets on the relationship among immigration, acculturation, and psychopathology. They show that Mexico-born immigrants, despite significant socioeconomic disadvantages, have better mental health profiles than do U.S.-born Mexican Americans. Possible explanations for the better mental health profile of Mexican immigrants include research artifacts such as selection bias, a protective effect of traditional family networks, and a lower set of expectations about what constitutes "success" in America. The elevated rates of psychopathology in U.S.-born Mexican Americans may be related to easier access to abused substances and an elevated frequency of substance abuse among the U.S.-born.

Acculturation↗

PubMed2001

[Maternal weight gain during pregnancy in various immigrant communities living in France].

BACKGROUND: The aim of this study was to estimate, by geographic origin, the average situation of pregnant women who recently immigrated into the Paris area, using weight gain during pregnancy and infant birth weight. METHODS: The clinical files of 559 pregnant women who attended the antenatal clinic at the Lariboisière Hospital (Paris) in 1997 and gave birth in this same hospital were analyzed. The mothers had immigrated from North Africa, Sub-Saharan Africa, Sri Lanka, China and metropolitan France. The successive body mass indexes were calculated for each woman, as well as the increase of this index during the first semester of gestation, until the third trimester and during the entire gestation. Averages in studied communities were compared with those of the non-immigrant population attending the same hospital department. The birth weights of infants from the different communities were compared with those of children born to non-immigrant mothers. RESULTS: Women from the various communities studied (with the exception of the Turkish community) showed a lower gestation weight gain than non-immigrant French women. Independently of the pregestational weight, weight gain during pregnancy accounted for 20% of the initial weight among women from North Africa, Turkey and China who gave birth to children whose birth weight was not significantly different from that of the non-immigrant French children. The mean weight gain corresponded to 15.8% of the pregestation weight in Sub-Saharan women and 18% in Sri Lanka women. Birth weights of children in these two communities were significantly lower than the French reference population. Compared with the weights observed in their original country, the frequency of low birth weight was lower and the mean birth weight was higher. CONCLUSION: Women coming from North Africa, Sub-Saharan Africa, and Asia who recently immigrated into France gave birth to children of satisfactory birthweight. The number of low birth weights decreased to the frequencies observed in their original countries. Irrespective for their reasons for immigrating, immigrant families living in France have newborns with a sufficient birth weight to allow satisfactory growth.

Adolescent↗

PubMed2001

Assimilation and ethnic boundaries: Israeli students' altitudes toward soviet immigrants.

The attitudes of Israeli students toward new immigrants from the former Soviet Union were examined against the theoretical framework of the sociology of ethnicity and sociology of education. The main research question explored was which ethnic relationship model (assimilation, pluralism, or separation) best described the attitudes and self-reported behavior of Israeli youth toward the new immigrants. Israeli students' changing attitudes toward their immigrant counterparts were also investigated, as well as actual Israeli educational practices (not only declared policies) regarding Soviet immigrants. The study was conducted in grades 4-11 at schools in northern Israel. The results indicated positive attitudes and openness of relations by the Israelis toward the new immigrant students in the first year following their immigration. However, the attitudes were less positive in the second year. Although the Israeli students manifested positive attitudes toward immigration and to the immigrants themselves, these views were largely assimilatory; Israeli cultural capital was obviously dominant, and it was expected to be accepted as such by the newcomers. The findings point to Israeli assimilatory educational practice; immigrants are expected to blend in, abandoning their past heritage and culture.

Acculturation↗

PubMed2002

The impact of immigration on the elimination of tuberculosis in The Netherlands: a model based approach.

OBJECTIVE: To determine whether elimination of tuberculosis in the Dutch population can be achieved by the year 2030, taking into account the impact of immigration. METHODS: The incidence of tuberculosis (all forms) in the period 1970 to 2030 was estimated using a life-table model for the Dutch population without the impact of immigration. The influence of immigration on tuberculosis incidence among the Dutch was modelled using four immigrant scenarios, distinguished by the assumed contact rate between immigrants and the Dutch population, and by different projections (middle, upper) of the future size of the immigrant population in The Netherlands. RESULTS: The incidence of smear-positive tuberculosis among the Dutch is projected to be 1.4 per million in the scenario without the influence of immigrant cases, and ranging from 3.8 to 11.8 per million in the four immigrant scenarios. In all immigrant scenarios, the prevalence of tuberculosis infection will continue to decline and be less than 1% by the year 2030. At least 60% of Dutch tuberculosis cases in the year 2030 are expected to be the result of transmission from a foreign source case. CONCLUSION: Using a prevalence of tuberculosis infection of less than 1% as the elimination criterion, tuberculosis will probably be eliminated from the indigenous Dutch population by 2030. However, the incidence of smear-positive tuberculosis is expected to remain higher than 1 per million, and the majority of new tuberculosis cases among the Dutch may be attributable to recent infection from a foreign source case.

Adolescent↗

PubMed1988

Peripherization of immigrant professionals: Korean physicians in the United States.

Using data on the characteristics of 1043 physicians who graduated from a medical school in Korea, the authors analyze the effects of immigrant status, gender, and year of graduation on their choice of medical practice specialty. The specialty areas are categorized into 2 groups, "core" and "periphery," on the basis of the reported median income of practitioners in each specialty. The results of log-linear model analyses indicate that female physicians are more likely to immigrate to the United States than male physicians, although the general trend of immigration does not notably change over time. In the main equation, immigration status shows a significant peripheral effect as immigrant physicians are much more likely to practice in peripheral areas than their home-staying counterparts. Gender status is also found to have a significant peripheral effect. When these Korean immigrant physicians are compared with the US-educated physicians in regard to their areas of practice, the same pattern of peripherization is observed among the immigrants. The findings suggest that, despite their secular image of "success," immigrant professionals in the United States carry on the same kind of marginal economic activities within the professional labor market as unskilled immigrant workers do within the nonprofessional labor market.

Americas↗

PubMed1995

Legal versus illegal U.S. immigration and source country characteristics.

"Based on micro data from the Immigration and Naturalization Service (INS) on legal immigrants as well as on legalization applications that followed the passage of IRCA [the Immigration Reform and Control Act of 1986], this study exploits the variation in legal and illegal immigration flows across seventy source countries to examine the sensitivity of immigration flows to underlying source country characteristics. The study finds that earnings in the source country and the distance from the United States form significant deterrents of both legal and illegal immigration flows. We also find that illegal immigration is more sensitive to such factors than is legal immigration." The impact of the North American Free Trade Agreement on U.S. immigration from Mexico is also assessed.

Americas↗

PubMed2004

Suicide in Canada's immigrant population.

OBJECTIVES: This article compares suicide in the immigrant and Canadian-born populations. DATA SOURCES: The suicide data are from the Canadian Vital Statistics Data Base and the World Health Statistics Annual of the World Health Organization. The socio-demographic information used to determine denominators for suicide rates in Canada comes from the Census of Population. ANALYTICAL TECHNIQUES: Age-standardized suicide rates by sex and place of residence were calculated for the immigrant and Canadian-born populations, as were age- and sex-specific suicide rates. Three-year average rates, centred on census years 1991 and 1996, were used. A weighted data set based on 8 of the top 10 countries of birth for immigrants to Canada was created for international comparisons. Differences between rates were tested for statistical significance. MAIN RESULTS: Suicide rates for the immigrant population were about half those for the Canadian-born. Among immigrants, suicide rates increase with age; among the Canadian-born, suicide is a "younger" phenomenon. Although male suicide rates exceeded female rates in both populations, the difference was less pronounced among immigrants. The pattern of suicide among immigrants was more like that in their countries of origin than that of the Canadian-born population. Immigrants living in Toronto, Montréal and Vancouver had lower suicide rates than immigrants in other parts of Canada.

Age Factors↗

PubMedDate not supplied

New approaches to immigrant health assessment.

While immigrant subgroups may present vulnerabilities in terms of health status, health service use, and social determinants, comprehensive information on their health is lacking. To examine mortality (1980-1998) and health service utilization (1985-2002) patterns in Canadian immigrants, a record linkage pan-Canadian research initiative using immigration and health databases has been undertaken. Preliminary results indicate that overall mortality is low among Canadian immigrants as compared to the general population for most leading causes (thus supporting the notion of "healthy immigrant effect"), with cause-specific exceptions. Moreover, results from British Columbia show that overall physician visits are low for immigrants, but not for all subgroups. Results from Ontario demonstrate a sharp increase in physician claims approximately three months following landing. Future analyses will address the short- and long-term health outcomes of immigrant subgroups, including less common diseases. Results are pertinent to practitioners working with immigrants and can inform immigrant health policy.

Canada↗

PubMedDate not supplied

Toward immigration reform.

For the most part, immigrants in the United States do not have access to the very safety-net benefits supported by their taxes, nor to essential due-process rights, simply because they are not citizens or legal residents. Contemporary demographics of immigration and post-9/11 security concerns have colored our traditional hospitality as a nation of immigrants and made life more difficult for immigrants. The Catholic Church has a rich history of scriptural and social teaching that addresses the question of immigration. Stories of forced migration in the Pentateuch led to commandments regarding strangers and the responsibility to be welcoming. In the New Testament, we see that the Holy Family themselves were refugees. The Gospel of St. Matthew tells us that we will be judged by the way we respond to migrants and others in need. In Exsul Familia, Pope Pius XII reaffirms the commitment of the church to care for pilgrims, aliens, exiles, and migrants. In Ecclesia in America, Pope John Paul II states that the ultimate solution to illegal immigration is the elimination of global underdevelopment and that, in the meantime, the human rights of all migrants must be respected. In 2003, the bishops of Mexico and the United States jointly issued the pastoral letter Strangers No Longer: Together on the Journey of Hope. In this letter, the bishops say that U.S. immigration policy should protect the human rights and dignity of immigrants and asylum seekers. The bishops also offer a number of proposed public policy responses toward that end. To advance the principles contained in Strangers No Longer, the bishops have decided to mount a national campaign designed to unite and mobilize a growing network of Catholic organizations and individuals, as well as others of good faith. In addition, the campaign will seek to dispel myths and misperceptions about immigrants.

Catholicism↗

PubMed2005

[The treatment of acute myocardial infarction among new immigrants in Israel].

BACKGROUND: We hypothesized that recent immigrants presenting with a poor cardiac profile may have a worse outcome after acute myocardial infarction compared with veteran Israelis. METHODS: Of 1,490 consecutive acute myocardial infarction patients investigated in a 2-month survey conducted in 2002, 256 had immigrated since January 1990 and 1,234 were veteran Israelis. RESULTS: Recent immigrants were older with a higher percentage of women compared with veteran Israelis (mean age 67.5 vs. 63.6 years, and 30 vs. 21%, p<0.001 respectively). More recent immigrants had hypertension (60%), higher total cholesterol (201 mg/dl) and prior angina (40%) compared to counterparts (45%; 194 mg/dl; 30%, p<0.01 respectively). Previous coronary interventions (7.4%) and coronary bypasses (4.3%) had been performed less frequently in recent immigrants, compared with veteran Israelis (13.8 and 8.3%, p<0.03 respectively). There were no differences between the two groups regarding thrombolysis, primary PCI, coronary angiography, IIb/IIIa and Clopidogrel treatment. Higher 7-day (6.3 vs. 4.1%), 30 day (9.0 vs. 6.3%), 6-month (14.1 vs. 10.0%), p<0.05 and 1-year mortality (18.0 vs. 11.7%, p<0.006) were observed along recent immigrants compared to veteran Israelis, respectively. Trend for increased mortality among recent immigrants may be explained by significant age and gender differences and co morbidity. After multiple adjustment for age, sex, prior angina, hypertension, prior PCI, CABG and Killip class 1I+, mortality rates among recent immigrants were not different from veteran Israelis. CONCLUSION: In a national acute myocardial infarction survey, recent immigrants were found to have a more adverse coronary profile than veteran Israeli patients, but were treated comparably and exhibited the same short-term prognosis.

Aged↗

PubMed2006

[Patterns of contact with the out-of-hours service and emergency rooms by guest workers with immigrant and refugee background in Copenhagen municipality, 1998].

INTRODUCTION: Outside normal office hours, patients in Denmark with acute conditions are treated by the out-of-hours service connected to general practice and in the emergency rooms of hospitals. Little is known about the contact pattern of immigrants with these services. The purpose of this study was to compare the contact rates for immigrants (guest workers and refugees) and non-immigrants with out-of-hours service and emergency rooms and compare the results with the total number of contacts with general practice (out-of-hours service, daytime contacts) and emergency rooms. MATERIALS AND METHOD: Data from 2,243,633 contacts in Copenhagen 1998 registered in the National Patient Registry and 112,733 visits to emergency units were merged with information about citizenship and place of birth in the Central Office of Civil Registration. The contacts were described by the average number of contacts per person at risk per year. RESULTS: The contact rates with the out-of-hours service were significantly lower for immigrant children than for non-immigrants, whereas the number of visits to emergency rooms did not show any differences. For both sexes aged 19-59, the contact rates for out-of-hours service and emergency rooms were higher for immigrants. The total number of contacts was 31-11% lower for children and those 60+ years of age and 4-20% higher for 19- to 59-year-old immigrants. CONCLUSION: Significant differences in the use of acute services by immigrants and non-immigrants were observed. Whether this is appropriate is questionable.

Adolescent↗

PubMed1985

Dentists' experiences of immigrants as patients.

The use of dental services by immigrants in Sweden has been the object of several recent studies, but no investigations have been made about immigrants as patients from the dentist's point of view. A questionnaire, including detailed questions about treatment of adult immigrant patients during 1983, was sent to all private practising dentists and PDS clinics in the 10 local council areas with the highest percentages of immigrants in Stockholm County. The response rate was 93%. All PDS clinics and 84% of the private practitioners had treated immigrants. Language difficulties, poor knowledge of dentistry, difficulties in keeping treatment times and exaggerated expressions of pain were the most frequent problems with immigrant patients. The need for treatment was considered to be generally higher among immigrants than native patients. Prophylaxis and periodontics were unanimously considered to be the most difficult treatment measures for immigrants. Better information to immigrants on dental disease and dental care and a better interpreter service were suggested to improve the situation.

Attitude of Health Personnel↗