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PubMed2004

Screening of immigrants and refugees for pulmonary tuberculosis in San Diego County, California.

STUDY OBJECTIVES: To evaluate the outcomes of a tuberculosis (TB) screening program for recent immigrants to San Diego County, CA, and to compare the demographic and clinical characteristics of pulmonary TB cases occurring in recently arrived foreign-born persons detected through this screening with those of similar cases found through routine surveillance. DESIGN: Retrospective review of computer databases and medical records. SETTING: Local public health department. PATIENTS: Recent immigrants and refugees classified as TB suspects in their country of departure and foreign-born patients with active TB detected through routine surveillance. RESULTS: Five hundred seventy-one of 658 immigrants and refugees (87%) of completed screening. Thirty-nine subjects (7%) were found to have active TB, and 433 subjects (76%) were found to have latent TB. A diagnosis of active TB was associated with age of 25 to 44 years (odds ratio, 3.6; 95% confidence interval, 1.1 to 11.6) and A (odds ratio, 25.7; 95% confidence interval, 1.3 to 512.2) or B1 classifications (odds ratio, 4.3; 95% confidence interval, 1.5 to 12.5). Cases detected through screening comprised 12% of all reported foreign-born persons with active TB. Compared to other recently arrived foreign-born persons with active TB, those detected through immigrant screening were more likely to be Asian and born in the Philippines and less likely to have advanced disease. CONCLUSIONS: Most immigrants and refugees classified as TB suspects by foreign screening completed the US screening process, which had a high yield for detecting active and latent TB. Only a minority of foreign-born persons (12%) with active TB were discovered through this program, however, and additional measures are needed to facilitate early case finding in other foreign-born populations.

Adolescent↗

PubMed2004

Different subjects: the health care system's participation in the differential construction of the cultural citizenship of Cuban refugees and Mexican immigrants.

This paper explores the public health system's differential construction of Mexican and Cuban immigrants' "deservingness" of citizenship benefits and its preparation of them for different roles in U.S. society. Civic institutions such as the public health care system are charged with inculcating normative behavior in immigrants and instilling in them different conceptions about their rights and responsibilities. Faced with limited resources under the implementation of Medicaid managed care, hospital administrators created new categories of "deserving" and "undeserving" immigrants based on neoliberal standards of individual responsibility and self-discipline. As a result, hospital policies construct different types of "cultural citizenship" for Cuban and Mexican immigrants, preparing the former to be active citizens and discouraging the latter from pressing demands on American civil institutions. I show that this negative construction of Mexican immigrants' moral worth leads to unmet health needs and poor health outcomes.

Cuba↗

PubMed1997

Effects of immigration on the incidence of congenital hypothyroidism.

OBJECTIVE: The incidence of congenital hypothyroidism (CH) has been shown to vary among different parts of the world. This could result from environmental or hereditary factors. Studies of other congenital diseases have shown that immigrants tend to retain the incidence of their country of origin while their children acquire the incidence of their new homeland, suggesting an environmental influence. This study aimed to assess the differences in the incidence of CH among immigrants from different parts of the world and to study the effects of immigration on its occurrence. METHODS: During the 9-year period between 1979 and 1987, 196 Jewish infants with primary CH were born in Israel; this constitutes an incidence of 1:3354 live births. We collected data from hospitals, endocrine pediatric clinics and the children's parents regarding the birth place of the parents and grandparents of those infants. These data were compared with the birth place of the parents and grandparents of all infants born in Israel during that period in order to learn about the incidence of CH among infants of different origins and to compare the incidence between children of parents born in Israel and those of immigrants of the same grandparental origin. RESULTS: CH incidence was lower among offspring of mothers and fathers of Israeli origin (1:4717 and 1:4255 live births respectively) and higher among those of African mothers (1:2950) and Asian fathers (1:2941). Parents of Asian or African origin, born in Israel have a lower incidence of CH-affected children compared with parents of the same origin born in their own continent. This trend is reversed for European and American parents, for whom being born in Israel is related to an increase in the CH incidence in their children. The difference in CH incidence between offspring of parents born in Israel and those of parents born in their original country was statistically significant (P < 0.05). In the different origin groups the gender of the parent did not influence significantly the incidence of CH. CONCLUSIONS: Environmental changes resulting from immigration can influence the incidence of congenital hypothyroidism.

Adult↗

PubMed2004

"Who is sitting across from me?" Immigrant mothers' knowledge of parenting and children's development.

OBJECTIVE: Although parents' knowledge about child development and child rearing is relevant to pediatric practice, very little is known about immigrant parents' knowledge. To fill this gap in research, this study investigated parenting knowledge in 2 groups of mothers who had immigrated to the United States. DESIGN: Japanese and South American immigrant mothers of 2-year-olds completed a standardized survey of parenting knowledge and provided information about sociodemographic and infant health status. Their data were compared with European American mothers in the United States. RESULTS: Immigrant mothers scored approximately 70% on the evaluation of parenting knowledge, significantly lower than multigenerational US mothers. The majority of immigrant mothers did not know correct answers for 25% of the items, and their incorrect answers were mostly to questions about normative child development. CONCLUSIONS: Parents' knowledge is relevant to pediatricians' evaluations of the health and welfare of children as understood by their parents. Gaps in parenting knowledge have implications for clinical interactions with parents, child diagnosis, pediatric training, and parent education.

Acculturation↗

PubMed2003

Immigration: a potential time bomb under the Integration of Conservation and Development.

Integrated Conservation and Development Projects (ICDPs) aim to stimulate conservation without the previous negative experiences for local people, but pay little attention to their long-term impact such as immigration. The rehabilitation of the Logone floodplain in North Cameroon, the core activity of the Waza-Logone ICDP, has led to a 34% increase of sedentary fishermen and a multiple number of temporary fishermen. Whereas livestock pressure tripled, kob antelopes, a key floodplain species, have not increased, reducing their competitiveness. The virtual disappearance of wildlife in nearby Kalamaloué National Park (NP), due to advanced human encroachment forms, is therefore a bleak perspective for Waza NP. Examples from the Central African Republic (CAR), Galapagos, Nigeria and Zimbabwe also showed that in open-access systems, improvement in living standards (development) may stimulate immigration, jeopardizing the stability necessary in protected areas (conservation). Most ICDPs lack demographic monitoring, masking its possible immigration risk. To counter the immigration risk in Waza, a policy was formulated based on local stakeholder categorization and subsequent privileges, resulting in the voluntarily displacement of a village out of Waza NP. It is further recommended that ICDPs should be involved in regional land-use planning and discourage development activities that stimulate immigration.

Animals↗

PubMed1986

Mexican immigration and health care: a political economy perspective.

This paper examines the case of Mexican immigrants in the United States and their access to medical services within a political economy of health framework. Such an approach stresses that the provision of health care is independent of health factors per se and that access to health care is not equally distributed throughout a population. The first section reviews the three major concepts influencing medical anthropologists working within a political economy framework: the social origins of illness; the allocation of health resources; and fieldwork in Third World countries. The analysis then focuses upon the reasons for limiting immigrants' access to health care, followed by an examination of the socioeconomic characteristics of Mexican immigrants, including an undocumented immigration status, which limit their access to health care. Finally, the consequences of limited access to health services are suggested, including a low utilization of preventive health services resulting from the high cost of care combined with the immigrants' generally low income, lack of medical insurance and fear of using U.S. health services.

California↗

PubMed2006

The association between length of stay in Canada and intimate partner violence among immigrant women.

OBJECTIVE: We examined the prevalence of intimate partner violence (IPV) among recent (0-9 years) and nonrecent (>/= 10 years) immigrant women in Canada to determine whether differences in IPV were associated with length of stay in Canada. METHODS: We analyzed data from the 1999 General Social Survey, a national cross-sectional telephone survey. We used weighted logistic regression analysis to examine the effect of length of stay in Canada on IPV and controlled for socio-cultural and other factors associated with IPV. RESULTS: The crude prevalence of IPV was similar among recent and nonrecent immigrant women. However, after adjustment, the risk for IPV was significantly lower among recent immigrant women compared with nonrecent immigrant women. Country of origin, age, marital status, and having an activity limitation (physical/mental disability or health problem) also were associated with a higher risk for IPV. CONCLUSIONS: Our findings have important implications for both prevention and detection of IPV among immigrant women.

Adolescent↗

PubMed2006

Health status and health service access and use among children in U.S. immigrant families.

OBJECTIVES: We examined the health status and patterns of health care use of children in US immigrant families. METHODS: Data from the 1999 National Survey of America's Families were used to create 3 subgroups of immigrant children: US-born children with noncitizen parents, foreign-born children who were naturalized US citizens, and foreign-born children with noncitizen parents. Chi-square and logistic regression analyses were used to examine relationships between immigrant status and health access variables. Subgroup analyses were conducted with low-income families. RESULTS: Foreign-born noncitizen children were 4 times more likely than children from native families to lack health insurance coverage and to have not visited a mental health specialist in the preceding year. They were 40% and 80% more likely to have not visited a doctor or dentist in the previous year and twice as likely to lack a usual source of care. US-born children with noncitizen parents were also at a disadvantage in many of these aspects of care. CONCLUSIONS: We found that, overall, children from immigrant families were in worse physical health than children from non-immigrant families and used health care services at a significantly lower frequency.

Adolescent↗

PubMed2006

Immigration-related factors and mental disorders among Asian Americans.

OBJECTIVES: We examined lifetime and 12-month rates of any depressive, anxiety, and substance abuse disorders in a national sample of Asian Americans. We focused on factors related to nativity and immigration as possible correlates of mental disorders. METHODS: Data were derived from the National Latino and Asian American Study, the first national epidemiological survey of Asian Americans in the United States. RESULTS: The relationships between immigration-related factors and mental disorders were different for men and women. Among women, nativity was strongly associated with lifetime disorders, with immigrant women having lower rates of most disorders compared with US-born women. Conversely, English proficiency was associated with mental disorders for Asian men. Asian men who spoke English proficiently generally had lower rates of lifetime and 12-month disorders compared with nonproficient speakers. CONCLUSIONS: For Asian Americans, immigration-related factors were associated with mental disorders, but in different ways for men and women. Future studies will need to examine gender as an important factor in specifying the association between immigration and mental health.

Adolescent↗

PubMed2006

Use of mental health services and subjective satisfaction with treatment among Black Caribbean immigrants: results from the National Survey of American Life.

OBJECTIVES: We examined the use rates and correlates of formal psychiatric services among the US-born and immigrant Caribbean Black population. METHODS: We compared overall mental health service use in samples of Caribbean Blacks and African Americans and examined the within-sample ethnic variation among Caribbean Blacks, including for ethnic origin (Spanish Caribbean, Haiti, and English Caribbean), nativity status (those born in or outside the United States), number of years spent living in the United States, age at the time of immigration, and generational status. RESULTS: African Americans and Caribbean Blacks used formal mental health care services at relatively low rates. Among Caribbean Blacks, generational status and nativity showed the greatest effects on rates of reported use, satisfaction, and perceived helpfulness. Of those study participants who met the criteria for disorders as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, about one third used formal mental health care services. The US-born subjects were more likely to receive care than were first-generation immigrants. CONCLUSIONS: Our study underscores the importance of ethnicity, immigration, and migration-related factors, within racial categorization, as it pertains to the use of mental health services in the United States. Our findings suggest that timing of migration and generational status of Caribbean Black immigrants and ancestry groups contribute to important differences in rates and sources of use, relative satisfaction, and perception of helpfulness, with regard to formal mental health services.

Adolescent↗

PubMed2002

Poverty, family process, and the mental health of immigrant children in Canada.

OBJECTIVES: This study examined the differential effects of poverty on the mental health of foreign-born children, Canadian-born children of immigrant parents, and children of non-immigrant parents. METHODS: Secondary analysis of data from a national Canadian study of children between 4 and 11 years of age was conducted. RESULTS: Compared with their receiving-society counterparts, foreign-born children were more than twice as likely to live in poor families, but they had lower levels of emotional and behavioral problems. The effect of poverty on children's mental health among long-term immigrant and receiving-society families was indirect and primarily mediated by single-parent status, ineffective parenting, parental depression, and family dysfunction. In comparison, the mental health effect of poverty among foreign-born children could not be explained by the disadvantages that poor families often suffer. CONCLUSIONS: Poverty may represent a transient and inevitable part of the resettlement process for new immigrant families. For long-stay immigrant and receiving-society families, however, poverty probably is not part of an unfolding process; instead, it is the nadir of a cycle of disadvantage.

Affective Symptoms↗

PubMed2003

Restrictions on undocumented immigrants' access to health services: the public health implications of welfare reform.

The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 greatly restricts the provision of many federal, state, and local public services to undocumented immigrants. These restrictions have prompted intense debates about the provision of free and discounted primary and preventive health care-services and have placed significant burdens on institutions that serve large undocumented immigrant populations. Intended to serve as a tool for reducing illegal immigration and protecting public resources, federal restrictions on undocumented immigrants' access to publicly financed health services unduly burden health care providers and threaten the public's health. These deleterious effects warrant the public health community's support of strategies designed to sustain provision of health services irrespective of immigration status.

Documentation↗

PubMed2005

Somatization in primary care: a comparative survey of immigrants from various ethnic groups in Rome, Italy.

OBJECTIVES: Those responsible for interviewing immigrants in primary care settings often underestimate the importance of somatic symptoms arising from psychological distress. This study investigates the current prevalence of somatization in immigrants, and evaluates the comparative rates of somatic complaints in four ethnic groups (Caucasians, Asians, South/Center Americans, and Africans). METHODS: We studied the 301 consecutive outpatients (aged between 16 and 70 years) attending the "Caritas" primary care unit for immigrants in Rome (Italy) from January to December 2003, all of whom completed the 21-item version of the Bradford Somatic Inventory (BSI-21). Patients scoring 14 or more on the BSI-21 were considered at risk for somatization. RESULTS: The current prevalence of somatization was 35.2%; 62.3% of the somatizers were women. A multiple regression analysis adjusting for the possible confounding effects of sex, age, education, and months of stay in Italy showed that South/Central Americans had significantly higher somatization scores than the other three groups. CONCLUSIONS: These findings suggest a high probability of somatization syndromes in immigrant patients. South/Central Americans tend to somatize more than other ethnic groups. A psychosomatic approach may be useful for immigrants in primary care settings.

Adolescent↗

PubMed2000

Subjective quality of life of Polish, Polish-immigrant, and Polish-American elderly.

This study compared the subjective quality of life of elderly Poles living in Poland, and Polish immigrants and Polish-American ethnics living in Chicago. The article is a secondary data analysis of a study that replicated an earlier study conducted in Poland. The study uses three measures of quality of life used in the earlier study-self assessments of health, initiative, and fulfillment of plans and wishes-and develops a composite measure. The results showed that Polish-American ethnic elderly had significantly better subjective quality of life than Polish-immigrant elderly, and Polish-immigrant elderly had significantly better subjective quality of life than elderly Poles in Poland. These conclusions lend support to the idea the U.S.-born elderly people and elderly immigrants to the United States have access to an American cultural construct of "vital aging." However, immigration is also a risk factor worthy of being added to the traditional "triple jeopardy."

Acculturation↗

PubMed2003

Outcome of pregnancy among immigrant women with diabetes.

OBJECTIVE: We studied outcome of pregnancy among immigrant women with diabetes. The women came from regions of the world with high incidence of impaired glucose tolerance and type 2 diabetes. Prevalences, secular trends, and sociodemographic risk factors of diabetes were also explored. RESEARCH DESIGN AND METHODS: Data from the Medical Birth Registry of Norway on all births from 1988 to 1998 for mothers born in South Asia and North Africa (11,268) and Norway (601,785) were analyzed. RESULTS: The prevalence of pregestational diabetes among the immigrants was 8.9/1,000 births, which was more than twice the rate among ethnic Norwegians (3.6/1,000). Time trends indicated increasing prevalences in both groups. Among the immigrants, diabetes was closely associated with maternal age. Maternal diabetes was associated with a significantly increased risk of pregnancy complications in both study groups. Increased risks were found for low birth weight, macrosomia, preterm birth, preeclampsia, and cesarean sections. Among ethnic Norwegians, maternal diabetes conferred a significantly increased risk of infant perinatal death (odds ratio 2.00, 95% CI 1,44-2.77). In the sample of immigrant women with predominantly type 2 diabetes, maternal diabetes was not significantly associated with perinatal death or congenital malformations in the offspring. CONCLUSIONS: The high prevalence of diabetes among immigrants from South Asia and North Africa represents a challenge for health care providers. To prevent adverse pregnancy outcomes and later cardiovascular and renal morbidity among these groups, early diagnosis of diabetes, adequate metabolic control, and relevant preventive measures are warranted.

Adult↗

PubMedDate not supplied

Mental health risks and problems encountered by illegal immigrants.

This article documents the emotional difficulties associated with the illegal Irish immigrant experience. Demographic data were collected and in-depth interviews were conducted with 17 Irish immigrants (13 had experiences as illegal immigrants and 4 were expert observers but did not have personal or first-hand experience on the topic). Content analysis of interview data documented positive and negative aspects of the illegal immigrant experience. Positive aspects included opportunity for adventure and the monetary benefit of illegal work. Negative aspects included difficulty finding satisfactory work, exploitation by employers, uncertainty about the future, vulnerability and fear over being apprehended and deported, and restrictions in numerous spheres of activity, including limited freedom to return home to visit family and friends. The findings sensitize mental health professionals to the difficulties experienced by illegal immigrants and provide direction for clinical interventions with this high-risk group.

Adaptation, Psychological↗

PubMedDate not supplied

Time since immigration and excess body weight.

OBJECTIVES: To examine the relationship between time since immigration and excess body weight. METHODS: Secondary data analysis of a cross-sectional survey of 19,600 Canadians. RESULTS: The prevalence of excess weight (BMI > 25) increases with time since immigration for both men and women. After controlling for birthplace, socio-demographic, lifestyle and health correlates, only female immigrants (less than five years) are significantly less likely to have BMI scores greater than 25 kg/m2 compared to those born in Canada. Stratified analyses, however, revealed similar findings for Asian men who had immigrated less than five years prior to the survey. DISCUSSION: Our results suggest that length of time since immigration is an important risk factor for excess weight. Further research with longitudinal data, more reliable measures of ethnicity and anthropometric measures of weight are required to confirm these initial findings.

Adult↗

PubMed1998

The perceived life stressors among elderly Chinese immigrants: are they different from those of other elderly Americans?

This is a descriptive study examining the perceived life stressors among elderly Chinese immigrants and comparing their stressors to those experienced by other elderly Americans. Lazarus and Folkman's stress theory and Roy's adaptation model were used as the theoretical basis for this study. Based on this framework, it was predicted that elderly Chinese immigrants would report more life stressors than elderly Americans, because they experience a changing cultural environment along with the aging process. The sample was a convenience sample of 30 elderly people from two Chinese churches in one northeastern metropolitan city. Participants were asked to describe a stressful event that they had experienced within the past month. Data were collected by a bilingual (Chinese and English) interviewer using open-ended questions. The research design was based on Manfredi and Pickett's (1987) research exploring the stressors among elderly Americans, and those research results provide the comparison data for this study. The findings suggest that the amount and sources of stress reported by elderly Chinese immigrants are different from those reported by other elderly Americans. Additional studies are needed to identify the coping strategies used by elderly Chinese immigrants. These findings have implications for gerontologists, policy makers, community healthcare providers, and the Chinese immigrant population.

Adaptation, Psychological↗