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Profile of a metropolitan North American immigrant suicidal adolescent population.

OBJECTIVE: Canadian immigrant adolescents have a lower suicide rate than their nonimmigrant peers. We conducted a hypothesis-generating analysis to determine whether this lower rate correlated with level of drug use and (or) with diagnostic and demographic characteristics of Canadian immigrant adolescents presenting to an emergency room for crisis assessment. METHOD: Known risk factors for suicide were compared among immigrant youth, North American youth, and a culturally mixed group of youth at baseline and at 6-month follow-up. RESULTS: The immigrant group was only differentiated by a lower rate of reported drug use. CONCLUSION: The lower rate of reported drug use at the time of crisis may contribute to the lower suicide rate among immigrants.

Adolescent↗

Adaption of recent Soviet Jewish immigrants and their children to Toronto.

This retrospective study examined the prevalence of depression and psychosomatic disorders among Soviet Jewish immigrants, and how such problems might have affected their children's adaptation. A 36-item English and Russian questionnaire was sent to 452 Soviet Jewish immigrants, requesting information on possible problems they or their children had had during the first three years after immigration. Ninety people responded, 78% of whom had children. Immigrants with depression and psychosomatic illness reported greater behaviour, academic, peer interaction, and child-parent difficulties in their children. Those who were married, were proficient in English, were professionals in the USSR and/or Canada and who had supportive friends, were more likely to adapt well. Because of the low response rate, the failure to validate the questionnaire, and the possible overrepresentation of professionals the findings are presented as preliminary pending further exploration. They are discussed for their relevance to the early identification of difficulties in immigrants and their children, and to the need for timely and informed intervention.

Acculturation↗

Adjustment and behaviour of Finnish and Southern European immigrant children in Stockholm. I. The teachers' assessment.

The adjustment and behaviour of immigrant schoolchildren were studied by means of teacher interviews. The material consisted of 50 Finnish and 37 southern European children. For comparison, 44 Swedish migrant children were also sampled. All had settled in the County of Stockholm three years prior to the study. Swedish children who had lived in the county for more than four years served as controls. In the teachers' opinions the immigrants as a whole had adjustment difficulties more often than the controls, but the proportion of children with such difficulties was no higher among the immigrant children. Compared with the controls the immigrant children showed a higher frequency of symptoms relating to a disordered self-esteem. The immigrant children were also considered to have a lower status and to be less trustworthy than the controls. The schooling of these children demands serious attention in order to prevent discrimination and to promote a feeling of personal worth among the children.

Adaptation, Psychological↗

Incidence of psychotic disorders in immigrant groups to The Netherlands.

BACKGROUND: Previous reports on the incidence of schizophrenia in immigrant groups to The Netherlands were based on hospital data. AIMS: To compare the incidence of psychotic disorders in the immigrant groups to that in natives. METHOD: Two-year first-contact incidence study in The Hague. RESULTS: The risks of schizophrenia, schizophreniform or schizoaffective disorder (DSM-IV criteria) were increased for subjects born in Morocco (gender and age-adjusted relative risk=4.5; 95% Cl 1.4-8.5), Surinam (relative risk=3.2; 1.8-5.7), The Netherlands Antilles (relative risk=2.9; 0.9-9.5) and other non-Western countries (relative risk=2.4; 1.3-4.7). This risk was also increased for Moroccans (relative risk=8.0; 2.6-24.5) and Surinamese (relative risk=5.5; 2.5-11.9) of the second generation. The risks for Turkish immigrants, first or second generation, and for immigrants from Western countries were not significantly increased. CONCLUSIONS: This study indicates that the incidence of schizophrenia is increased in several, but not all, immigrant groups to The Netherlands. It is possible that factors associated with a process of rapid westernisation precipitate schizophrenia in people who are genetically at risk.

Adult↗

Dysfunctional thinking patterns and immigration status as predictors of hearing protection device usage.

BACKGROUND: There is limited research on the role of dysfunctional/irrational thinking processes and immigration status on hearing protection device (HPD) usage. PURPOSE: The aim of the study is to investigate the effects of low frustration tolerance (LFT) and immigration status on HPD usage among employees exposed to hazardous industrial noise. METHODS: A total of 117 Israeli-borns and 80 new immigrants from former Soviet Union completed a questionnaire. The association between HPD usage and barriers to action, self-efficacy, and LFT (accounting for age, years of exposure, and immigration status) were assessed using ordered logistic regression models. RESULTS: LFT was associated negatively (adjusted odds ratio [OR]=.25, 95%; confidence interval [CI]=.15-.41) with HPD usage. Self-efficacy was a modifier (adjusted OR=1.47, 95%; CI=1.34-1.63): the higher the self-efficacy for a given LFT level, the higher the extent of HPD usage. Immigration status was not a significant predictor. CONCLUSIONS: HPD usage is associated with both rational and irrational motivations. The role of LFT in hearing protection should be further investigated.

Adult↗

Health practices among Russian and Ukrainian immigrants.

Since 1990, due to political and legislative changes, immigration from the former Soviet Union to the United States has increased significantly. Population reports from 1988 indicate that there were approximately 406,000 Soviet immigrants in the United States at that time. This number is expected to increase due to the Immigration Reform Act of 1990, which raised the Soviet refugee ceiling to 50,000 per year. Currently, very little is known about the health status and health practices of this population, although some published data indicate that life expectancy and infant mortality rates compare poorly with those of the general population in the United States. Although the former Soviet republics experienced universal health care coverage, there was little emphasis on promoting a healthy lifestyle. Heavy cigarette use, high alcohol intake, poor dietary intake, little attention to physical fitness, and crowded living conditions have been described. Environmental pollution and poor occupational safety are common and have contributed to the health problems of the population. As the influx of immigrants continues, the consequences of these health conditions will impose a burden on health care services in this country. As with any immigrant group, an understanding of the potential health conditions and cultural values can facilitate appropriate medical care. This research was conducted to explore these issues. Interviews and a physical assessment were conducted with 30 adults from the former Soviet Union. The major health problems identified included various dental conditions requiring treatment, obesity, and the absence of basic health screening measures such as cholesterol testing, high blood pressure screening, Pap smears, and mammograms. The authors also identified a need for translators and for education regarding preventative self-care, such as breast self-examinations.

Adult↗

Immigrant workers: health, law, and public policy.

Immigrant workers are a large segment of the lower echelon of the U.S. labor force, and as many as 3.6 to 6 million of these workers and their families are living in the U.S. illegally. This paper examines who the recent immigrants are: explains why their current situation in the U.S. is an important public health matter; discusses the ethical and policy issues stemming from their health needs and from illegal status; and concludes with a brief look at some implications of the Simpson-Mazzoli Immigration and Reform Act, currently before Congress. The paper suggests that the illegal status of undocumented workers intensifies their health risks; that the immigrants' responsibility for budget short-falls in public services is not as clearcut as frequently assumed; and that legislation aimed at regulating the status of immigrant workers in the U.S. is unlikely to solve many of the central problems.

Cultural Diversity↗

Health status and health care of immigrants in Canada: a longitudinal analysis.

OBJECTIVES: This paper focuses upon health status, need for care, and use of health care from 1994/95 to 2000/01 in the Canadian foreign-born population. METHODS: Using Statistics Canada's longitudinal National Population Health Survey, descriptive and survival analyses are used to explore immigrant health status and health care. RESULTS: The health status of immigrants quickly declines after arrival, with a concomitant increase in use of health care services. However, survival analysis of the risk of a change to poor health indicates no difference between immigrants and the native-born. Similarly, there is no difference in the risk of hospital use between the two populations. CONCLUSIONS: The health status of recent immigrant arrivals is observed to decline towards that of the native-born population, while health care utilization increases. However, increased use may not be sufficient to offset declines in health, meaning that need for health care within the immigrant population may be unmet.

Adult↗

Health status and health care utilization among New York City home attendants: an illustration of the needs of working poor, immigrant women.

In this paper, the health needs and health care utilization patterns of home attendants and their families have been studied as an illustration of those likely to be found among working poor, immigrant women and their children. Despite tremendous growth in the number of immigrants, studies to date provide only limited information regarding the specific health needs and patterns of health care utilization among such women and their children. As part of a longitudinal study on the impact of insurance on health status and health care utilization, 387 female, immigrant home attendants were interviewed. Data were also gathered on 355 of their minor children. These women and children were found to be less likely than other Americans to make use of basic health services, despite the fact that they are more likely to indicate fair or poor health status. This is true even in comparison to poor or uninsured Americans. Immigrant attendants in fair or poor health report an average annual visit rate of 4.1 ambulatory care visits for themselves and 2.2 for their children, as compared to 8.4 for poor adults and 4.4 for poor children in national samples. These findings illustrate the likelihood that poor, immigrant women make limited use of American medical care, and face barriers to health care that appear even greater than those faced by the uninsured and the poor.

Adult↗

Use of home care services by elderly Chinese immigrants.

Using the Anderson Service model, this study examined the level and predictors of using selected home care services by elderly Chinese immigrants in Canada. Data from 1,537 randomly selected Chinese immigrants aged 65 years and older were used. Only 5.2% of participants reported using home care services. Being older, living alone, having a post-secondary education, immigrating from Hong Kong or Southeast Asia, having a higher level of agreement with Chinese health beliefs, higher social support, and poorer physical and mental health were predictors for home care service use among elderly Chinese. The probability of using homecare services lessens with increased self-rated financial adequacy. These findings point to the need for service providers to address the gap in use of home care between elderly Chinese immigrants and overall elderly Canadians through promoting appropriate use of home care among elderly Chinese immigrants.

Aged↗

Drug abuse, risks of infectious diseases and service utilization among former Soviet Union immigrants: a view from New York City.

Based on the high rates of injection drug use and infectious disease such as HIV, HCV and tuberculosis in their home country, immigrants from the Former Soviet Union (FSU) comprise a high-risk population in the United States. Yet, little is known about their drug abuse and health problems relative to other immigrant populations like Hispanics. The objectives of this exploratory study were to identify disease risk behavior, and utilization of and barriers to treatment services among drug using immigrants from the FSU. Focused interviews were conducted with 27 public officials and administrators in New York City. This study found that FSU immigrants tend to have culturally unique drug abuse patterns and behavior, such as rapid transition to injection drug use, and suspicion and avoidance of traditional drug treatment approaches. The findings of this exploratory study point to the need for further research and the need to take immediate steps to promote culturally appropriate treatment and prevention services that can address the spread of harmful behavior that threatens the public health of FSU immigrants and others.

Adult↗

Factors affecting the adjustment to disability for new immigrants.

Factors such as self-esteem, social support, and perceived social discrimination are associated with the acceptance of disability. A new immigrant may face unique barriers to health care, including cultural differences between the patient and provider, language/communication issues, and discrimination. However, little research is available that identifies barriers specific to new immigrants relating to disability. This is an exploratory descriptive pilot study using a phenomenological approach. The investigator interviewed two "new" immigrants with an acquired disability. A "new" immigrant is defined as an individual who was born outside of the United States, whose parents were born outside of the United States, and who relocated across international borders to live in this country. The participants reported on perceived barriers to the adjustment to a disability. Strategies to consider in the care of the immigrant patient are described.

Adaptation, Psychological↗

The educational enrollment of immigrant youth: a test of the segmented-assimilation hypothesis.

An analysis of 1990 census data on the educational enrollment of 15- to 17-year-old immigrants to the United States provides partial support for predictions from both the segmented-assimilation hypothesis and the immigrant optimism hypothesis. Most immigrant adolescents, especially from Asia, are as likely as their native-born peers to be enrolled in high school, or more so. The "at-risk" immigrant youths with above-average levels of nonenrollment that are not reduced with longer exposure to American society are primarily of Hispanic Caribbean origins (from Puerto Rico, the Dominican Republic, and Cuba). Recent Mexican immigrants who arrived as teenagers have nonenrollment rates over 40%, but Mexican youths who arrived at younger ages are only somewhat less likely to be enrolled in school than are native-born Americans.

Acculturation↗

Immigration and males' earnings inequality in the regions of the United States.

In this paper I investigate the impact of recent immigration on males' earnings distributions in the major regions of the United States. I use six counterfactual scenarios to describe alternative regional skill distributions and wage structures for the population of natives and long-term immigrants in the absence of recent immigration. I find that immigration over the last three decades can account for a substantial portion of the variation in inequality across the regions. Recent immigration has contributed moderately to national growth in males' earnings inequality, primarily by changing the composition of the population.

Emigration and Immigration↗

Do amnesty programs reduce undocumented immigration? Evidence from IRCA.

This article examines whether mass legalization programs reduce future undocumented immigration. We focus on the effects of the 1986 Immigration Reform and Control Act, which granted amnesty to nearly 2.7 million undocumented immigrants. We report that apprehensions of persons attempting to cross the U.S.-Mexico border illegally declined immediately following passage of the law but returned to normal levels during the period when undocumented immigrants could file for amnesty and the years thereafter. Our findings suggest that the amnesty program did not change long-term patterns of undocumented immigration from Mexico.

Crime↗

A decomposition of trends in poverty among children of immigrants.

Poverty levels among all children in the United States have tended to fluctuate in the past 30 years. However, among the children of immigrants, child poverty increased steadily and rapidly from about 12% in 1970 to 33% in the late 1990s before declining to about 21% in 2000. Using 1970, 1980, 1990, and 2000 Public Use Microdata Samples data, we identified key factors that underlie the fluctuations in immigrant child poverty from 1969 to 1999 and the divergence from children of natives. We found that roughly half the absolute increase in immigrant child poverty can be linked to changing conditions in the U.S. economy that make it more difficult to lift a family out of poverty than 30 years ago. These changes occurred disproportionately among children of parents with lower levels of education, employment, and U.S. experience but not among racial/ethnic minorities. Poverty risks among various racial and ethnic groups converged over time. The relative increase in poverty for immigrant versus native children owes largely to the divergence between immigrant and native families in racial/ethnic composition, parental education, and employment.

Adolescent↗

Making it in America: high school completion by immigrant and native youth.

Using data from the National Longitudinal Study of Adolescent Health (Add Health), we find that first-generation youth of Hispanic, Asian, and African heritage obtain more education than their parents, but the second generation and third or higher generations lose ground. Differences in dropout rates by race-ethnicity and immigrant generation are driven by differences in human, cultural, and social capital. Low levels of family human capital, school social capital, and community social capital place the children of immigrants at risk of dropping out. However, cultural capital and immigrant optimism buffer first-generation Hispanic youth and the children of Asian immigrants from the risk of dropping out of high school. While human and social capital resources improve with immigrant generation, cultural capital diminishes.

Acculturation↗

Epidemiology and ethnic distribution of multidrug-resistant tuberculosis in southern Israel, 1992-1997: the impact of immigration.

STUDY OBJECTIVES: To assess the incidence of tuberculosis in the native and immigrant populations of southern Israel in the period between 1992 and 1997, and to study the prevalence of drug resistance overall and among these subpopulations in the region in order to create guidelines for empirical antituberculous treatment in this region. DESIGN: A retrospective population-based study. SETTING: The southern district of the country and its tertiary-care hospital. PATIENTS: All new culture-proven tuberculosis cases diagnosed in adults residing in the Negev region during the study period. Patients were classified into four groups according to ethnic origin and immigration date. RESULTS: During the study period, 249 new cases involving 249 patients were recorded. Immigrants from the former Soviet Union (IFSU) were significantly younger and of male gender, and the incidence among this group rose sharply. IFSU had higher rates of resistance to any drug or drug combination. Isoniazid resistance rates were 16% overall and 32% among IFSU. Resistance to any drug was observed in 29% overall and 50% of isolates among IFSU. Multidrug-resistant tuberculosis was observed in 8.5% and 17%, respectively. CONCLUSIONS: The population of southern Israel carries very high rates of drug-resistant tuberculosis, mandating quadruple empiric treatment. IFSU should be regarded as having multidrug-resistant tuberculosis until proven otherwise, and empiric therapy with at least five drugs should be considered. This report demonstrates the influence of immigration on the incidence of tuberculosis, and the great value of local surveillance of population-specific resistance rates in an immigrant society, in order to optimize drug treatment and prevent the dissemination of resistant strains.

Adult↗