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PubMed2006

The effect of age at immigration and generational status of the mother on infant mortality in ethnic minority populations in The Netherlands.

BACKGROUND: Migrant populations consist of migrants with differences in generational status and length of residence. Several studies suggest that health outcomes differ by generational status and duration of residence. We examined the association of generational status and age at immigration of the mother with infant mortality in migrant populations in The Netherlands. METHODS: Data from Statistics Netherlands were obtained from 1995 through 2000 for infants of mothers with Dutch, Turkish and Surinamese ethnicity. Mothers were categorized by generational status (Dutch-born and foreign-born) and by age at immigration (0-16 and >16 years). The associations of generational status and age at immigration of the mother with total and cause-specific infant mortality were examined. RESULTS: The infant mortality rate in Turkish mothers rose with lower age at immigration (from 5.5 to 6.4 per 1000) and was highest for Dutch-born Turkish mothers (6.8 per 1000). Infant death from perinatal and congenital causes increased with lower age at immigration and was highest in the Dutch-born Turkish women. In contrast, in Surinamese mothers infant mortality declined with lower age at immigration (from 8.0 to 6.3 per 1000) and was lowest for Dutch-born Surinamese mothers (5.5 per 1000). Generational status and lower age at immigration of Surinamese women were associated with declining mortality of congenital causes. CONCLUSIONS: Total and cause-specific infant mortality seem to differ according to generational status and age at immigration of the mother. The direction of these trends however differs between ethnic populations. This may be related to acculturation and selective migration.

Acculturation↗

PubMed2005

Do immigrants have an increased prevalence of unhealthy behaviours and risk factors for coronary heart disease?

BACKGROUND: Although previous research has demonstrated a high risk of coronary disease in immigrants, the prevalence of unhealthy behaviours and risk factors is less known. The aim of this study was to investigate whether unhealthy behaviours and risk factors for coronary disease are more common in immigrants than in Swedish-born individuals. METHODS: Between 1 January 1996 and 31 December 2002 a simple random sample of the population was drawn and interviewed face to face. Eight immigrant groups in Sweden and a Swedish-born reference group, aged between 27 and 60 years, were studied. A log-binomial model was used to analyse the cross-sectional association between country of birth and unhealthy behaviours as well as coronary disease risk factors. RESULTS: Many of the immigrant groups showed higher risks of smoking, of physical inactivity and of obesity than Swedish-born individuals in age-adjusted models. On also adjusting for the level of education, occupational status and social network, the differences in risk persisted in the majority of groups. However, the over-risks of physical inactivity in Finnish and south European immigrant men and of diabetes in Finnish and Turkish immigrant women disappeared. CONCLUSIONS: The high prevalence of unhealthy behaviours and risk factors for coronary disease in many immigrant groups might be a lifestyle remnant from their country of birth or might be brought about by a stressful migration and acculturation into a new social and cultural environment. Nevertheless, it is important in primary healthcare to be aware of a possible preventable increased risk of unhealthy behaviours and risk factors for coronary disease in some immigrants.

Adult↗

PubMed1992

Serum IgE levels and allergic spectra in immigrants to Sweden.

We evaluated the allergy status of 134 immigrants from Asia, Africa, the Middle East and South America, who were referred to our clinic during the past 10 years. Fifty Swedish patients were used for comparison. When the atopy state was not taken into account, no significant difference was found between the two groups with respect to total IgE levels. However, IgE levels of non-atopic immigrants were significantly higher than the IgE levels of non-atopic Swedes. While there was no significant difference in IgE levels between atopic and non-atopic immigrants, this difference was significant in Swedish patients. In general, IgE levels of immigrants showed a decline with time and reached approximately the same levels as for the Swedish patients in 10.5 years. In the immigrant group atopic women had a considerably lower IgE level than the atopic men. Among the atopics there were no differences between sexes. In Swedes and immigrants pollen was the most common group of allergens. The spectrum of allergy in the immigrant group changed with time in Sweden, and gradually became more similar to the Swedish spectrum. Skin and/or RAST positivity to birch increased from 16% within 2.5 years to 53% after more than 10.5 years in Sweden. Our data indicate that environmental factors rather than hereditary differences determine the IgE state. Within a few years the immunologic status of immigrants adapts to the new environment.

Adult↗

PubMed1986

Post-war immigration in the United States and the state of Minnesota: the process of entering an all-American community.

The author focuses on characteristics of Polish immigrants in Minnesota in the years since World War II. Particular attention is given to the immigrants' adaptation to the American way of life and to democratic institutions after being accustomed to centralized power in a socialist system. "This article is based on participant observation, publications concerning immigration to the United States, and unstructured interviews with newcomers from Poland and other Eastern European countries." Distinctions are made among the characteristics of Polish-Americans, pre-World War II immigrants, war immigrants, and those who have come during the last 20 years, including groups that the author identifies as the "calculated-decision" immigrants, the post-Solidarity immigrants, and the "adjusted visitor" immigrants. Consideration is given to the demographic characteristics, legal status, education and employment, and territorial mobility of 35 Poles living in Minnesota who were interviewed by the author. (SUMMARY IN FRE AND SPA)

Acculturation↗

PubMed1996

Obstetric profiles and pregnancy outcomes of immigrant women in New South Wales, 1990-1992.

This study examined the obstetric profiles and pregnancy outcomes of immigrant women in New South Wales (NSW). The source of data was the NSW Midwives Data Collection. The characteristics of 64,922 immigrant women were compared with 189,357 Australian-born non-Aboriginal women who delivered babies between 1990-1992 in NSW. The study demonstrated that immigrant women were older, generally had less private health insurance coverage and fewer teenage pregnancies. Immigrant women showed lower rates of essential hypertension, but higher rates of hepatitis B and gestational diabetes. While induced labour was conducted less frequently among immigrant women, episiotomy, instrumental delivery and Caesarean section were performed more frequently among this group. The incidence of postpartum complications was higher among immigrant women. Differences were assessed among women from European, Asian, Middle Eastern, American, New Zealand/Oceania and African backgrounds. For example, the higher rates of hepatitis B, gestational diabetes, episiotomy, instrumental delivery, Caesarean section, postpartum haemorrhage, third degree tear and puerperal infection among Asian-born women were of concern. By contrast, pregnancies among Middle Eastern-born women were associated with fewer complications in spite of their high parity and high percentage of teenage pregnancies. Infants of immigrant mothers were more likely to be resuscitated and/or admitted to special care nursery/neonatal intensive care unit. These findings in immigrant women in NSW suggested the need for culturally appropriate obstetric services, clinical practice reviews, and the greater involvement of general practitioners in obstetric care.

Emigration and Immigration↗

PubMed1999

A situation-specific theory of Korean immigrant women's menopausal transition.

PURPOSE: To extend the previous model of transitions by including the experiences of low-income Korean immigrant women in the United States during their menopausal transition. The extension results in a situation-specific theory of Korean immigrant women's menopausal transition. DESIGN: Findings from a study of menopausal transition among Korean immigrant women were used as a main source for modification of the conceptual properties of transitions, conditions shaping the transitions, and indicators of healthy transitions. The study was cross-sectional with methodologic triangulation. Quantitative analysis was based on data from 119 first-generation Korean immigrant women who engaged in low-status or low-income work outside their homes; qualitative study using theoretical sampling method included 21 women. METHODS: Analyses included descriptive and inferential statistics and thematic analysis. Integrative conceptual analysis using deductive and inductive reasoning was conducted to determine modifications in theory based on the descriptions of menopausal transition of Korean immigrant women. FINDINGS: Three main themes were identified: (a) the women gave their menopausal transition far less attention than they did to their immigrant and work transition; (b) menopause was a hidden experience in cultural background; and (c) the women "normalized," ignored, and endured symptoms. The findings indicated additions of the following concepts: (a) number, seriousness, and priority of transitions; (b) socioeconomic status; (c) gender; (d) context; (e) attitudes toward health and illness; (f) interrelationships among all conditions shaping transitions; and (g) symptom management. CONCLUSIONS: The proposed situation-specific model is limited in scope. However, it provides understanding of the menopausal transition of Korean immigrant women in context, and is a guide for nursing interventions for immigrant women experiencing transition.

Adaptation, Psychological↗

PubMed2006

Parental risk attitudes and caries-related behaviours among immigrant and western native children in Oslo.

OBJECTIVES: Immigrant children make up a large proportion of the school populations in many western cities. It is likely that their parents have different attitudes and knowledge of dental health than resident populations, and thus provide a challenge to public dental services. This study sought to map existing disparities in oral health among immigrant and western native children in Oslo and to identify differences in parental, cultural and ethnic beliefs and attitudes towards oral health and caries-related behaviours. METHODS: Caries was recorded of 735 children (3- and 5-year olds), supplemented with radiographs among 5-year olds. Their parents responded to a questionnaire. RESULTS: Immigrant background, consumption of sweet drinks at bed and social status were the dominant caries risk indicators among the 3-year olds. Among the 5-year olds, the caries risk indicators were immigrant background, parental indulgence, attitude to diet, attitude to oral hygiene, social status and age starting toothbrushing. Being an immigrant was closely associated with higher caries prevalence and experience. Parental attitudes to oral hygiene, diet and indulgence, and caries-related behaviours distinguished immigrants from western natives. CONCLUSIONS: The results suggest that immigrant groups in western societies require different information packages, modified strategies for forming oral hygiene habits and attitudes related to dental care of children, and encouragement to exercise discipline on factors known to be risks for oral health. These strategies must recognize that immigrants and western natives attach different levels of importance to oral health and dental parameters. It should be paid extra attention to some caries high-risk subgroups.

Age Factors↗

PubMed1993

Inequalities in risk factors and cardiovascular mortality among Australia's immigrants.

Inequalities in biomedical and life-style risk factors for cardiovascular disease were examined for 6,116 immigrants to Australia and 14,941 people born in Australia, using data collected in the 1980, 1983 and 1989 risk-factor prevalence surveys. After adjusting for age and study design, significant differences were identified between immigrant groups and the Australian-born reference group, particularly for systolic blood pressure, overall obesity and behavioural risk factors. There were few substantial differences in blood lipid concentrations and little evidence to suggest that total plasma cholesterol has played a major role in lower cardiovascular mortality among immigrants. Overall, the results suggested that profiles of risk factors commonly accepted as determinants of cardiovascular disease are an insufficient explanation of the lower standardised mortality ratios from cardiovascular disease which characterise immigrants in Australia. Systolic blood pressure best explained variation in cardiovascular mortality among male immigrants, and smoking prevalence among female immigrants. The acculturation process affected immigrant groups differently. Generally, systolic blood pressure increased with period in Australia. Body mass index increased among Asian immigrants, as did participation in physical activity during leisure time.

Adult↗

PubMed1978

Tuberculosis among immigrants in Britain. Memorandum from the Joint Tuberculosis Committee.

Tuberculosis is much commoner among immigrants to Britain than among the native-born. In 1971, 5% of the population were immigrants yet they accounted for 32% of tuberculosis cases. The notification rate among immigrants is falling in some areas but rising in others, and many immigrants are still arriving in Britain. Most immigrants arrive at London Airport, and as many as possible are x=rayed there with the resources available; Many cases escape detection, however, and it is therefore important that accurate information about all immigrants is sent to the medical officer for environmental health at their destination. New arrivals should then be sought out, tuberculin-tested, and positive reactors x-rayed. All those who are tuberculin-negative should be vaccinated with BCG whatever their age. Positive reactors should undergo annual radiography and be encouraged to report symptoms early. For both new and established immigrants with strongly positive tuberculin reactions chemoprophylaxis is suggested. All children of immigrants should be given BCG at birth and tuberculin-tested when they start school so that omissions can be rectified. Implementation of these recommendations could contribute considerably to the control of tuberculosis in Britain.

Africa↗

PubMedDate not supplied

[Tuberculosis in immigrants: clinical and epidemiological differences as compared to the native population (1999-2002)].

BACKGROUND: Tuberculosis in immigrants is an emerging disease in industrialized countries. METHOD: We retrospectively analyzed the clinical and epidemiological characteristics of culture-positive tuberculosis cases in the immigrant and native populations. RESULTS: One hundred and five cases of tuberculosis were observed; 22 cases (21%) were in immigrants. The 2002 incidence was 64.3 cases per 100,000 immigrants. Mean age of the affected immigrants was 28.5 years lower than that of the affected native population (p < 0.001). The rate of HIV coinfection was 9.1%. In 81.8% (18) of immigrants, presentation was exclusively pulmonary, a higher percentage than in the native population (59.2%) (p = 0.05). Loss to follow-up was more common among immigrants (35%) than among the native population (9.2%) (p < 0.001). CONCLUSIONS: Tuberculosis in the immigrant population generally involves the lungs, appears in younger subjects and is a public heath problem because of the high rate of losses to follow-up.

Adult↗

PubMed2005

Depression among Latina immigrant mothers separated from their children.

OBJECTIVE: Latinas who immigrate to the United States and leave their children in their homelands may experience psychological consequences of this separation. This study examined whether immigrant Latinas who were separated from their children differed in rates of probable major depression from those who lived with their children and from those who did not have any children. METHODS: Data were obtained between March 1997 and May 2002 from women in Women, Infants, and Children programs that target low-income pregnant and postpartum women and their children (up to five years of age), women in county-run Title X family planning clinics, women in pediatric clinics for low-income families, and women who were living in a subsidized-housing project or attending programs for county welfare recipients. Latinas in this study were all immigrants to the United States. The women were screened for major depressive disorders with the Primary Care Evaluation of Mental Disorders. RESULTS: A total of 5,122 Latina immigrants were screened. Overall, 11.7 percent of the sample screened positive for major depression. The rates of depression were 11.4 percent for women who lived with their children, 10.9 percent for those who did not have children, and 18.1 for those who were not living with their children. When the analyses controlled for demographic differences, the odds of depression for immigrant Latinas who were separated from their children were 1.52 times as great as the odds for those whose children were currently living with them (p=.02). Odds of depression were similar among women who lived with their children and those who did not have children. CONCLUSIONS: Separation from children during immigration may lead to increased risk of depression for immigrant Latinas. Health care clinicians who treat young immigrant women should pay close attention to signs of depression among women who have left children with relatives in their homelands.

Adult↗

PubMed1994

Relationship of migrant status (refugee or immigrant) to mental health.

This study investigated and compared mental health levels among refugees and immigrants living in New Zealand. One hundred and twenty-nine Indochinese refugees, 57 Pacific Island immigrants and 63 British immigrants to New Zealand were surveyed. A questionnaire and the Hopkins Symptom Checklist-25 (HSCL-25) in English and in three Indochinese translations, were administered face-to-face. The hypothesis that migrant status (being a refugee or immigrant) affects mental health and that refugees experience more emotional distress than immigrants was only supported by the comparison with British immigrants. Both Indochinese refugees and Pacific Island immigrants experienced relatively low levels of mental health. However, the incidence of clinical depression and clinical total emotional distress tended to be higher among Indochinese refugees than in either immigrant group. In contrast clinical anxiety occurred most often among Pacific Islanders.

Adult↗

PubMed2005

Government dependence of Chinese and Vietnamese community organizations and fiscal politics of immigrant services.

Few studies have examined the impact of government support and policies on immigrant services within ethnic enclaves. This paper seeks to address this gap and examines the structure and challenges of ethnic community based organizations (CBOs) that serve low income immigrant populations and the impact of government support and policies on these CBOs. The study utilized case study and ethnographic methodologies and examined 2 Chinese and 2 Vietnamese CBOs in the San Francisco Bay Area. The findings show that ethnic CBOs critically depend on government fiscal support for survival. In exchange for fiscal support, ethnic CBOs represent public assistance and legitimacy interests for government in immigrant communities. However, culturally proficient and community leadership resources of ethnic CBOs can serve as bargaining chips to secure government funding, reduce compliance to government demands, and advance immigrant community interests. Nevertheless, in times of government fiscal crisis, ethnic CBOs and immigrant services tend to be most vulnerable to budget cuts due to lack of political voice. In sum, government-community collaboration through ethnic CBOs has a central role to play in facilitating and strengthening health and human services for rapidly growing, culturally diverse immigrant populations. These collaborative efforts in immigrant services are vital to cultivating healthy immigrant human capital and multicultural communities across the United States.

Asian People↗

PubMed2001

All-cause and cause-specific mortality of immigrants and native born in the United States.

OBJECTIVES: This study examined whether US-born people and immigrants 25 years or older differ in their risks of all-cause and cause-specific mortality and whether these differentials, if they exist, vary according to age, sex, and race/ethnicity. METHODS: Using data from the National Longitudinal Mortality Study (1979-1989), we derived mortality risks of immigrants relative to those of US-born people by using a Cox regression model after adjusting for age, race/ethnicity, marital status, urban/rural residence, education, occupation, and family income. RESULTS: Immigrant men and women had, respectively, an 18% and 13% lower risk of overall mortality than their US-born counterparts. Reduced mortality risks were especially pronounced for younger and for Black and Hispanic immigrants. Immigrants showed significantly lower risks of mortality from cardiovascular diseases, lung and prostate cancer, chronic obstructive pulmonary diseases, cirrhosis, pneumonia and influenza, unintentional injuries, and suicide but higher risks of mortality from stomach and brain cancer and infectious diseases. CONCLUSIONS: Mortality patterns for immigrants and for US-born people vary considerably, with immigrants experiencing lower mortality from several major causes of death. Future research needs to examine the role of sociocultural and behavioral factors in explaining the mortality advantage of immigrants.

Adult↗

PubMed2001

Subjective evaluation of health in old age: the role of immigration status and social environment.

The study investigated the role of immigration status on self-rated health, general health, and well-being among elderly persons by comparing two groups of elderly persons who immigrated from Eastern European countries to Israel-veterans and new immigrants. It also examined the factors that explain self-rated health in both groups. Data for this study (n = 784) were taken from a study based on structured home interviews of a random sample of Israeli Jewish elderly (70+) conducted in 1994. The results show that the new immigrants are younger and have higher education than the veterans, but their economic status is lower and they have a lower percentage of men and married persons. The new immigrants also rank themselves lower than the veterans on a variety of measures of health and psycho-social well-being. It is suggested that the stress caused by immigration and factors related to the standard of living and health services in the countries of origin outweigh the relative advantage that the new immigrants have, in terms of age and education, in influencing their health and well-being. Self-rated health among the new immigrants is explained mainly by objective measures of health, economic status and a feeling of control over life, while among the veterans it is explained by these variables as well as by other psycho-social variables such as self-esteem and social support. These findings suggest careful analyses of subjective evaluations of health in different socio-cultural subgroups in society for theoretical reasons and for purposes of planning interventions directed to promote health and psycho-social well-being of elderly persons on the community level.

Aged↗

PubMed1998

Projecting immigrant earnings: the significance of country of origin.

This article asks whether information about immigrants beyond their age, education, and years since migration can be productively used to project their earnings. Although many factors could affect immigrant earnings, what is most useful for Social Security modelling purposes is relevant information that is readily available on a continuous basis. Country of origin is a good candidate, as it is regularly and readily available from several administrative and survey data sources. In this article, microdata samples from the 1960-90 censuses are used to examine the relationship between country of origin and the earnings of immigrants. By following cohorts of immigrants over 10-year intervals, we learn how country of origin affects the initial earnings of immigrants and how the relationship between country of origin and immigrant earnings changes as immigrants continue to live in the United States. The article also presents theoretical insights and empirical evidence about the underlying causes of the link between country of origin and immigrant earnings.

Adult↗

PubMed1999

Health problems of Asian and Latino immigrants.

Many different circumstances influence Asian and Latino immigration to the United States, including poverty, war, educational opportunities, and protection of financial assets. Such varying circumstances point clearly to a different set of expected health problems. Immigrants often lack resources necessary to acquire quality health care. These resources involve language skills, knowledge of US health care and social services, and insurance. Risk factors to which immigrants may have been exposed include poor nutrition, lack of immunizations and vaccinations, inadequate or inappropriate treatment, and inadequate or inaccurate beliefs about illness and treatment. Frequent health problems among Latino and Asian immigrants are tuberculosis, hepatitis B, sexually transmitted diseases, cancer, diabetes, and substance abuse. The nursing care of immigrants involves not only attention to reducing risk and treating illness, but also attention to the provision of resources. Nurses face several ethical dilemmas in the health care of immigrants including a public anti-immigrant sentiment, and political attempts to limit health care and education to immigrants.

Asian↗

PubMed1999

Suicide ideation among recent immigrants to Israel from the former Soviet Union: an epidemiological survey of prevalence and risk factors.

This paper reports results of a national community survey of self-reported suicide ideation and attempts and their relation to psychological distress, depression, social support, and adjustment difficulties in a sample of recent immigrants from the former Soviet Union (FSU) to Israel. Using a door-to-door sampling procedure, a sample of 788 Russian-born Jewish immigrants, ages 18-74 years, was selected to match the age and sex structure of the total immigrant population. An indigenous sample of Jews in Russia (n = 411) was matched with the immigrants for comparison. Parameters of interest were measured with the Demographic Inventory, Talbieh Brief Distress Inventory, Beck Depression Inventory, and Multidimensional Scale of Perceived Social Support. The 1-month prevalence rate of suicide ideation in the immigrant sample (15.1%) was found to be significantly higher than that in Russian controls (6.6%). A total of 5.5% of immigrants but only 0.5% of controls had made a suicide attempt at some time in their lives. Risk factors for suicide ideation included younger age, living without a spouse, low level of social support, being a physician or teacher, a history of immigration from the Baltic countries or Moscow, or duration of stay in Israel from 2 to 3 years. The strongest risk factors were higher level of psychological distress and symptoms such as depression, hostility, and paranoid ideation. These findings can be used as a point of departure for the development of community-based suicide prevention programs for recent immigrants.

Adolescent↗