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PubMed1989

The impact of immigration on the human capital of natives.

"Implications of the quantity (number) and quality (skill) of immigration on the destination economy are analyzed, including impacts on value added, wages, quasi rents, rates of return, and the skill distribution of the native labor force. Quantity-quality trade-offs are considered for both immigrant and native workers. Medium- and long-run labor-supply responses by natives to immigrant-induced changes in wage rates are shown to have second-order effects which subtantively affect the impacts of immigrants. The impact of immigration policy depends on the quality as well as quantity of immigrants, the time horizon, and the speed of factor market adjustment."

Demography↗

PubMed2005

Access to HAART in HIV-infected immigrants: a retrospective multicenter Italian study.

Since 1996, AIDS has declined in the Italian population, but cases in foreign patients, including both recent immigrants and long-term residents, have increased from 3.9% in 1995-1996 to 15.4% in 2001-2002. This increase can only be partly explained by a higher migratory flow and might reflect a delayed access to health facilities and to antiretroviral therapy in migrants. We performed a survey for the year 2003 of HIV-infected immigrants to Italy from countries outside the European Union to verify which factors might influence a lack of access to highly active antiretroviral therapy (HAART). Italian centers of infectious diseases were requested to send sociodemographic and clinical data of HIV-infected immigrant patients. A total of 553 HIV-infected immigrants (49.9% women) were evaluated, representing 6.5% of all HIV-infected patients from these centers. The mean duration of residency in Italy was 6.6 +/- 5.0 years. The country of origin was Africa (64.5%), North and South America (24.2%), Eastern Europe (7.0%), and Asia (3.8%). A total of 407 of 553 patients (73.6%) were taking antiretroviral drugs at the time of screening. Females presented a younger age (p = 0.001), a lower frequency of Centers for Disease Control (CDC) stage B/C (p = 0.008) and a more frequent heterosexual exposure to HIV (p < 0.001), while no differences were observed for time of first positive serology (p = 0.7). CD4 cell count (p = 0.9) and log plasma HIV-RNA (p = 0.1). Characteristics of HAART patients were compared to those of nontreated patients, despite a CD4 cell count less than 350 cells/mm(3). No significant difference was found for gender, country of origin, risk factor, and years of Italian residence, while legal immigrants (p = 0.018) and registered in the National Health Service (p = 0.014) were significantly more likely to receive HAART compared to illegal immigrants.

Adult↗

PubMed2006

Use of Traditional Chinese Medicine by older Chinese immigrants in Canada.

BACKGROUND: Research is needed about the usage of complementary and alternative medicines within culturally diverse groups because of a growing number of people who use these remedies. OBJECTIVE: To understand the prevalence and predictors of Traditional Chinese Medicine (TCM) use by older Chinese immigrants in Canada. METHODS: This is based on the data collected from a representative sample of 2167 elderly Chinese immigrants aged 55 years and above in seven Canadian cities. Logistic regression was used to estimate the probability of using TCM in combination with Western health services (WHS). Use of Chinese herbs, herbal formulas, and TCM practitioners (herbalists) was predicted, based upon the effects of predisposing, enabling and need factors. RESULTS: The response rate was 77%. Over two-thirds of the older Chinese immigrants reported using TCM in combination with WHS. About half (50.3%) of the older Chinese immigrants used Chinese herbs, 48.7% used Chinese herbal formulas, and 23.8% consulted a Chinese herbalist. Although separate analysis was conducted, similar predictors were identified. Country of origin, Chinese health beliefs, social support, city of residency, and health variables were the common predictors of using a form of TCM. CONCLUSION: The combined use of TCM and WHS is common among elderly Chinese immigrants. Culture-related variables are important in determining use of TCM. The predictors identified should help physicians to recognize who among the elderly Chinese immigrants are more likely to use TCM so that a more in-depth understanding toward their health practices and needs can be achieved.

Aged↗

PubMed2003

Immigrant status, living arrangements, and depressive symptoms among middle-aged and older adults.

OBJECTIVES: This research draws from social integration theory to explain the relationship between living arrangements and depressive symptoms among middle-aged and older adults. Particular attention is given to identifying differences between nonimmigrants and immigrants. METHODS: The data come from the baseline and first 2-year follow-up of the Health and Retirement Study, which were collected in 1992 and 1994. The analysis is based on 6,391 primary respondents who were aged 51 to 61 at the baseline. Descriptive statistics, cross-sectional ordinary least squares regression models, and longitudinal residualized regression models are estimated for the entire sample and by immigrant status. RESULTS: Living arrangements and immigrant status interact to influence depressive symptoms. The results confirm that depressive symptoms are higher among those who live alone, particularly among immigrants. Living with family or others is related to higher cross-sectional levels of depressive symptoms, especially for immigrants, and greater longitudinal increases in depressive symptoms among nonimmigrants. DISCUSSION: The results highlight the important influence of social integration on mental health while demonstrating that context shapes the effect of social integration. They suggest that interventions should promote social integration, particularly among older adults living alone or with family or others. However, those programs should be sensitive to the unique needs of native-born and immigrant populations.

Acculturation↗

PubMed1994

Implications of Russian immigration on mortality patterns in Israel.

BACKGROUND: Many immigrants from the former USSR arrived in Israel during the period 1989 to 1992 and now comprise 10% of the Israeli population. They are expected to cause a change in the health profile of the country due to their different patterns of disease and an analysis was undertaken to predict these expected changes. METHOD: Official mortality statistics from Israel and the USSR were compared for differences in major causes of death. Russian mortality rates were then incorporated into a calculation taking into account the total size of the Israeli population and the relative size of the immigrant population to give the expected overall age-adjusted mortality in Israel following the wave of immigration. RESULTS: Reported mortality rates in the European republics of the former USSR were found to be higher, by about 40%, than mortality rates in Israel. Cardiovascular diseases (40%) and cancer (20%) were found to contribute equally to male mortality in Israel and the USSR, but cardiovascular diseases were more important in females in the USSR (65% versus 44% in Israel). Cerebrovascular disease was three times more common as a cause of death in the USSR than in Israel, in both sexes. Cancer, though similar in overall rate, was differently distributed in the two countries with lung and stomach cancer predominating and causing much higher mortality in the former USSR. Projections from these observations showed an expected immediate increase in mortality of 6% in males and 4.4% in females, assuming the mortality patterns reported are valid for Russian immigrants to Israel. CONCLUSION: Massive immigration to a country has the potential to significantly affect the overall health picture of the host country. Therefore, an evaluation of the health status and health-related habits of the immigrant population is warranted to target areas requiring intervention in order to both protect the host country and to facilitate assimilation.

Adolescent↗

PubMed1999

Mortality statistics in immigrant research: method for adjusting underestimation of mortality.

BACKGROUND: It is difficult to carry out fair comparisons of the mortality of different ethnic groups in a population in register-based studies because sizeable numbers of immigrants who subsequently leave their new homeland fail to register this fact with the national registration authorities. In this article we present a method which attempts to address these problems. METHODS: Age-standardized mortality rates for native Swedes and immigrants in the age group 20-64 years were calculated for all individuals who either were included in the Swedish Population Censuses for 1985 or 1990, or who moved to Sweden during the period November 1990-1994. In order to define the population under scrutiny different sources of income are used as indicators of residence in the country. RESULTS: When an analysis is made of all nationally registered individuals, significantly reduced death rates are found among immigrants outside the north-east of Europe compared to those for Swedish-born people. Extremely low death rates are found for those born in Turkey, Southern Europe, Latin America, Asia, and Africa and for those who are younger and without any income. When the income criterion is introduced, there is a change so that the earlier significantly reduced relative death risks for immigrants born outside the north-east of Europe for some subgroups are no longer significantly lowered. CONCLUSION: This study has important implications for the interpretation of every study of mortality among immigrants based on official mortality statistics. Using information about income as an indicator of residence in the country appears to be a method which can be pursued further in order to achieve a more accurate understanding of mortality among immigrant groups.

Adult↗

PubMed2006

Experiences of Latino immigrant families in North Carolina help explain elevated levels of food insecurity and hunger.

Household food insecurity is higher among minority households in the U.S., but few data exist on households of recent minority immigrants, in part because such households are difficult to sample. Four studies of a total of 317 Latino immigrant families were conducted in different regions and during different seasons in North Carolina. A Spanish translation of the 18-item U.S. Food Security Survey Module was used to assess the prevalence of food insecurity and hunger. In 3 of the studies, a total of 76 in-depth interviews were conducted to gather information on immigrants' experiences of food insecurity. Households in the 4 studies classified as food secure ranged from 28.7 to 50.9%, compared with 82.4% in the U.S. in 2004. Food insecurity without hunger ranged from 35.6% to 41.8%, compared with 13.3% in the U.S. The highest rates of hunger reported were 18.8% (moderate hunger) and 16.8% (severe hunger) in an urban sample. Qualitative data indicate that food insecurity has both quantitative and qualitative effects on diet. Immigrants experience adverse psychological effects of food insecurity. They report experiencing a period of adjustment to food insecurity leading to empowerment to resolve the situation. Reactions to food insecurity differ from those reported by others, possibly because immigrants encounter a new and not chronic situation. Overall, these findings suggest that immigrant Latinos experience significant levels of food insecurity that are not addressed by current governmental programs.

Adolescent↗

PubMed1998

A cross-sectional study of self-reported work conditions and psychiatric health in native Swedes and immigrants.

Several studies have demonstrated that immigrants in Scandinavian countries are more affected by psychosocial disabilities than the native-born population. The aim of the study was to evaluate the possible impact of work-related stressors on psychiatric health in immigrants compared to native Swedes. The study included a cluster selected cohort of 1,040 men born in 1944 (participation ratio = 79.9%), living in Gothenburg, Sweden. Of these, 182 (18.0%) were immigrants, defined as being born outside Sweden. Information on work conditions and psychiatric health were obtained by self-administered questionnaires. Employment in native Swedes showed inverse associations to frequent use of anxiolytics [relative risk (RR) = 0.2; 95% confidence interval (CI) = 0.06-0.4], frequent use of hypnotics (RR = 0.1; CI = 0.02-0.2) and use of antidepressants (RR = 0.3; CI = 0.2-0.5). None of the employed immigrants used anxiolytics or hypnotics frequently. Swedes seemed to display a number of psychiatric ill-health factors related to working conditions. These factors included frequent use of hypnotics, frequent insomnia, use of antidepressants, a high degree of melancholy, and were related to shift work, dissatisfaction with current work and management and a low degree of influence on work situation, often related to a high degree of stress at work and a frequent desire to change type of work. These associations were not seen in immigrants, apart from the risk of frequent insomnia (RR = 4.7; CI = 1.2-18.3) and dissatisfaction with colleagues (RR = 10.4; CI = 2.2-48.8) when working in shift. With a few exceptions, non-optimal working environment was associated with a low degree of life satisfaction in both groups. It was hypothesized that optimal working conditions are important for maintaining psychiatric health, and that immigrants, when employed, seem less affected by impaired working conditions than native Swedes.

Anti-Anxiety Agents↗

PubMed2005

Out-of-home placement of children with intellectual disability: Israeli-born parents vs. new immigrants from the ex-USSR.

Although the policy of deinstitutionalization encourages parents to raise a child with development disability at home, professionals are becoming increasingly aware of these parents' care-giving roles. Immigrant parents from the ex-USSR who have children with developmental disabilities are potential clients for placement, but to date, the tendency in Israel to out-of-home placement by immigrant parents, compared with Israeli-born parents, has not been studied. The placement variables were examined as a function of place of birth, emotional stress and social support. The sample was 100 parents who have children aged 6-21 years with mild to moderate mental retardation (according to the American Association on Mental Retardation definition) who live at home. Fifty parents were immigrants (arrived in Israel after 1990) and 50 were Israeli-born. They live in the region of Haifa and the north of Israel. The following measurements were carried out: (1) Demographic Questionnaire for data such as place of birth, age, socioeconomic status, etc., (2) Questionnaire of Resources and Stress, (3) Family Support Scale and (4) Out-of-Home Placement Questionnaire. The results showed that parents' readiness to apply for out-of-home placement proved to be related to their stress level and child's age, regardless of their origin (immigrants or Israeli-born) and regardless of social support resources. The older the children with mental retardation and the higher the stress levels felt by their parents, the higher was these parents' potential to apply for out-of-home placement. Immigrant parents tended to report a significantly higher level of stress than Israeli-born parents. No difference was found in the social support resources available to both research groups. Immigrant parents' stress level was higher as the child's mental retardation level was more moderate and their time in Israel was longer. Stress level among Israeli-born parents was higher among those who were religious, were of lower socioeconomic status and/or when, in addition to the mental retardation, the child suffered from other medical problems. In conclusion, families with children with mental retardation should be referred to services in an integrative way, regardless of the origin of the children's parents. Professionals must increase their own awareness of parents' level of stress and its impact on their readiness to apply for out-of-home placement. Recommendations for practical work and for future researches are made.

Adaptation, Psychological↗

PubMed1990

Correlates of Korean immigrants' mental health.

The main objectives of this paper are an empirical investigation of major structural and situational variables related to Korean immigrants' mental health and a theoretical exploration of the meaning of the empirical findings. As part of a larger epidemiological research, the data for this paper derive from diagnostic interviews of 622 Korean immigrants (20 years and older) residing in the Chicago area. Data analyses reveal that, among the respondents in general, those who are married, highly educated, and currently employed in a high-status occupation indicate better subjective mental health (less demoralized and more satisfied with life) than others. Of other variables examined, however, significant gender differences in the correlates of mental health are observed. For the male immigrants, a set of work-related variables is clearly the strongest correlate of their mental health, whereas no such distinctive set of variables accounts for the female immigrants' mental health. Nevertheless, the family life satisfaction and several ethnic attachment variables are moderately related to the female immigrants' mental health. Theoretical implications of these findings are discussed in light of the confluence of ethnic attachment and acculturation on immigrants' mental health.

Acculturation↗

PubMed2006

Immigrant perceptions of discrimination in health care: the California Health Interview Survey 2003.

BACKGROUND: U.S. healthcare disparities may be in part the result of differential experiences of discrimination in health care. Previous research about discrimination has focused on race/ethnicity. Because immigrants are clustered in certain racial and ethnic groups, failure to consider immigration status could distort race/ethnicity effects. OBJECTIVES: We examined whether foreign-born persons are more likely to report discrimination in healthcare than U.S.-born persons in the same race/ethnic group, whether the immigration effect varies by race/ethnicity, and whether the immigration effect is "explained" by sociodemographic factors. RESEARCH DESIGN: The authors conducted a cross-sectional analysis of the 2003 California Health Interview Survey consisting of 42,044 adult respondents. Logistic regression models use replicate weights to adjust for nonresponse and complex survey design. OUTCOME MEASURE: The outcome measure of this study was respondent reports that there was a time when they would have gotten better medical care if they had belonged to a different race or ethnic group. RESULTS: Seven percent of blacks and Latinos and 4% of Asians reported healthcare discrimination within the past 5 years. Immigrants were more likely to report discrimination than U.S.-born persons adjusting for race/ethnicity. For Asians, only the foreign-born were more likely than whites to report discrimination. For Latinos, increased perceptions of discrimination were attributable to sociodemographic factors for the U.S.-born but not for the foreign-born. Speaking a language other than English at home increased discrimination reports regardless of birthplace; private insurance was protective for the U.S.-born only. CONCLUSIONS: Immigration status should be included in studies of healthcare disparities because nativity is a key determinant of discrimination experiences for Asians and Latinos.

Adult↗

PubMed2005

HIV-related risk behavior among Hispanic immigrant men in a population-based household survey in low-income neighborhoods of northern California.

OBJECTIVES/GOAL: We compared risk behaviors and HIV testing between recent (in the U.S. <5 years) and established (in the U.S. >5 years) Hispanic immigrant men (N = 410). STUDY: This study was a population-based, cross-sectional survey of HIV/sexually transmitted disease markers and risk behaviors in men age 18 to 35 years residing in low-income census block groups in 3 northern California counties. RESULTS: Recent immigrants were less likely to currently have a main sexual partner (45.3% vs. 67.2%, P <0.01) and more likely to have ever used commercial sex workers (40.0% vs. 27.6%, P <0.01). Recent immigrants were less likely to receive medical care in the last 6 months (21.2% vs. 31.3%, P = 0.04) or had ever been HIV tested (26.0% vs. 43.3%, P <0.01). Established immigrants more likely reported unprotected sex, hallucinogen or ecstasy use. CONCLUSIONS: Recent Hispanic immigrants have less stable sexual partnerships and less health-seeking behavior, including HIV testing. Established immigrants report HIV test rates comparable to the national average.

Adolescent↗

PubMed2006

Genetic characterization of diverse HIV-1 strains in an immigrant population living in New York City.

New York City (NYC) is one of the original foci of the HIV-1 epidemic and has a greater number of AIDS cases than any other city in the United States. NYC also hosts the highest number of immigrants among the nation's cities: more than 2 million among a total population of 8 million. Such a high rate of immigration could act as a potential source for introducing and disseminating novel HIV-1 strains into the United States. Our current study focuses on the genetic characterization of HIV-1 strains circulating in an immigrant population in NYC. Of the 505 HIV-1-positive specimens obtained, 196 were available for viral sequencing from the C2 to V3 region of env. Phylogenetic analysis using maximum-likelihood and neighbor-joining methods demonstrated that non-B subtypes and circulating recombinant forms (CRFs) accounted for 43.4% (85 of 196 cases), whereas the remaining 56.6% (111 of 196) cases had viral variants similar to the typical North American subtype B virus. Of those non-B subtypes and CRFs, subtype A and CRF02 dominated (63.5% combined); other subtypes, including C, D, F1, G, CRF01_AE, and CRF06_cpx, were also detected. Two HIV-1 sequences do not cluster with any known subtypes or CRFs. Furthermore, the distribution of non-B subtypes and CRFs was consistent with the countries of origin, suggesting that many of the study subjects were likely infected in their home country before they entered the United States. Subtype B viruses identified in the immigrant population showed no significant differences from the typical North American B subtype, however, indicating that a significant proportion of the immigrants must have been infected after they came to the United States. Public health officials and physicians should be aware of the growing genetic diversity of HIV-1 in this country, particularly in areas with sizable immigrant populations.

Adolescent↗

PubMed2006

Relational experiences of partnered Japanese immigrant women with affect disorders.

AIM: This paper reports the findings of a study that explored characteristics of relationships of Japanese immigrant women partnered both intraculturally and interculturally, and analysed the role of Japanese culture in these relationships. BACKGROUND: Immigration can cause shifts in interpersonal structures with partners. When there are large discrepancies in gender roles and communication styles between the original and host cultures, the psychological impact on both partners may be significant. However, currently no empirical data are available to support this assumption. METHODS: Ten cases selected from the 68 medical records of Japanese-speaking women seen at a mental health clinic from September 2001 to September 2004 were analysed. All of the 10 women met DSM IV-TR criteria of major depressive disorder and were taking antidepressants. Half of the 10 women were in intimate intercultural partnered relationships and the remainder of the matched cases were in intracultural relationships at the time of treatment. The two cohorts were matched in age (36.2 and 43.2 years), length of stay in the United States of America (12 and 16.2 years), and length of treatment (1.2 and 1 years). The length of time of the sample in individual psychodynamic psychotherapy ranged from 20 to 317 hours, depending on the intensity of therapy. FINDINGS: Inductive data analysis revealed two themes: (1) Lack of awareness of differences in culturally bound communication by Japanese women in intercultural partnerships; (2) Lack of individuality in Japanese women in intracultural partnerships. Neither group appeared to consider relational aspects of partnership, or to make efforts to improve direct communication with their partners. CONCLUSION: The influence of Japanese culture on gender role and communication styles functions contrary to the mainstream Western culture of the United States of America. In the future, interpersonal elements of cultural differences between host and original cultures in immigration should be considered in research related to immigrants' mental health. This approach should lead to effective interventions to facilitate mental health among immigrants, and regardless of purposes of immigration or length of stay in a psychosocially foreign environment.

Adult↗

PubMed2007

Scale dependence of immigration rates: models, metrics and data.

1. We examine the relationship between immigration rate and patch area for different types of movement behaviours and detection modes. Theoretical models suggest that the scale dependence of the immigration rate per unit area (I/A) can be described by a power model I/A = i*Area(zeta), where zeta describes the strength of the scale dependence. 2. Three types of scaling were identified. Area scaling (zeta = 0) is expected for passively dispersed organisms that have the same probability of landing anywhere in the patch. Perimeter scaling (-0.30 > zeta > -0.45) is expected when patches are detected from a very short distance and immigrants arrive over the patch boundary, whereas diameter scaling (zeta = -0.5) is expected if patches are detected from a long distance or if search is approximately linear. 3. A meta-analysis of published empirical studies of the scale dependence of immigration rates in terrestrial insects suggests that butterflies show diameter scaling, aphids show area scaling, and the scaling of beetle immigration is highly variable. We conclude that the scaling of immigration rates in many cases can be predicted from search behaviour and the mode of patch detection.

Animals↗

PubMed1995

Preterm birth and low birthweight among children of Swedish and immigrant women between 1978 and 1990.

The aim of the study was to estimate the occurrence of low birthweight (LBW) and preterm birth among immigrant and Swedish women in Sweden. Eligible for analysis were all 1,270,407 singleton births in Sweden between 1978 and 1990 to mothers aged between 15 and 44 years, whose own country of birth was known. The mothers of the children were born in Sweden (88.2%), or had immigrated from Finland (4.4%), other Scandinavian countries (1.2%), Western Europe or North America (1.3%), Eastern Europe (1.8%), the Middle East and North Africa (1.7%), Central and South America (0.6%), Asia and the Pacific Islands (0.6%), or Sub-Saharan Africa (0.2%). Multiple logistic regression was used to model LBW and preterm birth categorical outcomes. Each immigrant group was compared with the Swedish group. Odds ratios (ORs) for LBW were 1.13 (95% CI 1.04, 1.22) for Asia and the Pacific Islands, 1.21 (1.05, 1.38) for Sub-Saharan Africa and 0.89 (0.86-0.93) for Finland. Odds ratios for preterm birth were 1.15 (1.08-1.23) for immigrants from Asia and the Pacific Islands and 1.08 (1.04, 1.13) for immigrants from Eastern Europe. Remarkably small differences were found between immigrant women and native Swedish women.

Adolescent↗

PubMed2006

Are food intolerances and allergies increasing in immigrant children coming from developing countries ?

There are not available data concerning the occurrence, the clinical features and the environmental risk factors for food intolerances and allergies in immigrant children. The aim of the study was to evaluate rates, distribution, clinical features and environmental risk factors for food intolerances and allergies in immigrant children. Hospital records of 4,130 patients with celiac disease (CD), cow milk protein intolerance (CMPI) and food allergies (FA) diagnosed in 24 Italian Centres from 1999 to 2001 were retrospectively reviewed, comparing immigrant patients with Italian ones. 78/4,130 (1.9%) patients were immigrant: 36/1,917 (1.9%) had CD, 24/1,370 (1.75%) CMPI and 18/843 (2.1%) FA. They were evenly distributed across Italy and their native areas were: East Europe (23/78), Northern Africa (23/78), Southern Asia (14/78), Saharan and Sub-Saharan Africa (9/78), Southern America (4/78), Far East (3/7), Middle East (2/78). Despite differences in their origin, the clinical features of immigrant children were similar to the ones of Italian patients and among each ethnic group. The majority of them were born in Italy (57/78) or have been residing in Italy since several years (19/78). All of them had lost dietary habits of the native countries and had acquired those of the Italian childhood population. Food intolerances and allergies are present also in children coming from developing countries, and paediatricians will need to have a full awareness of them because the number of immigrant children in Italy is quickly increasing. The clinical features of food intolerances and allergies appear the same in each ethnic group, despite differences in races. Sharing of dietary habits with the Italian childhood population seems to be an important environmental risk factor.

Adolescent↗

PubMed2004

Prevalence of gastroesophageal reflux disease in immigrants living in the Zaanstreek region in the Netherlands.

Racial differences in the incidence of reflux disease are reported but data on differences in ethnicity are rare. A study was undertaken to assess the prevalence of reflux disease, defined as the presence of reflux esophagitis, in immigrants and correlate the results with native inhabitants living in the same region. Consecutive patients with hiatus hernia and defective lower esophageal sphincter closure as well as reflux esophagitis were included. A large population of people of Turkish descent and a small contingent of people from northern Africa and the Middle East were studied separately. Reflux disease was diagnosed in 4165 patients. One hundred and sixty-seven (4%) were of Turkish descent, and 26 (0.6%) originated from Africa and the Middle East. Reflux disease occurred significantly less often in immigrants, 24% versus 55.5% (P < 0.0001). There was no difference relating to gender in the presence of reflux disease in native Dutch patients, while the number of men in the immigrant group with the condition was significantly higher than women; 51% versus 72%, respectively (P < 0.0001). The majority of immigrants only suffered from mild reflux esophagitis (P < 0.001). Immigrants with reflux disease are significantly younger than native Dutch patients, mean age 42 years versus 57 years, respectively (P < 0.0001). Reflux disease is less prevalent in immigrants, mostly people of Turkish descent. If the condition is present in this population, the majority of patients is male and belongs to the younger age cohorts.

Adult↗