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PubMed1997

Health risks of immigration: the Yemenite and Ethiopian cases in Israel.

Immigration almost always involves major cultural changes in dietary, social and health-related beliefs and behaviour. Two years after the arrival of the earliest Yemenite immigration wave to Israel, about 30 years ago, the prevalence rate of diabetes in that population was almost nonexistent (approximately 0.06%), increasing to approximately 12% 25 years later. Obesity and hyperlipoproteinemia were not always correlated with diabetes. Ethiopians, mainly from the northern regions, first immigrated to Israel ten years ago. At that time, their prevalence rate of diabetes was 0-0.4%. Though it is too early to determine the overall prevalence rate in this population, 5-8% rates have been reported after up to 5 years in Israel. The objective of the present work was to study the effect of the diversity of ethnic food patterns and adaptability on the nutritional status of Ethiopian immigrants. Two groups were studied--teenagers and adults. After 2 and 18 months in Israel, adult Ethiopians who arrived in Israel in 1991 (n = 426) had an average body mass index (BMI) of 20-22 kg/m2, which was below western values; a waist:hip ratio (WHR) of 0.9 suggested abdominal fat accumulation. Fasting serum- glucose levels were within the norm, whereas insulin levels were high (24 micrograms/mL). Plasma triglycerides (TG) increased with age, from about 100 to 150 mg/dL, whereas cholesterol and lipoprotein levels remained stable and normal. The BMI of Ethiopian teenagers (n = 15) 5-7 years in Israel was similar to that found in adults. Fasting serum insulin levels were significantly lower in boys than in girls (approximately 16.6 vs approximately 18.6 microU/mL, respectively). Cholesterol values were significantly higher in girls than in boys (approximately 184 vs approximately 150 mg/dL); TG, high density and low density lipoprotein values were normal. These data indicate the existence of early signs of risk factors for diabetes, which may not manifest itself clinically unless provoked. Several causes, rendered detrimental by progress, could be setting the stage for early manifestation of risk factors for cardiovascular disease and diabetes. Of these, two are of pertinence to this work: a genetic endowment for low-energy output and the thrifty genotype, and maternal undernutrition.

Adolescent↗

PubMed2004

[Comparative study of infectious diseases in immigrant children from various countries].

INTRODUCTION: Immigrants have a higher risk of contracting some infectious diseases. The aim of this study was to determine and compare the morbidity profile of immigrant children according to their country of origin. MATERIAL AND METHODS: We performed a descriptive study of all immigrants aged less than 14 years old who attended the Tropical Medicine Unit of the Ramon y Cajal Hospital in Madrid between 1989 and 2001. RESULTS: A total of 170 children were included (73 % from Africa, 19 % from Latin America, and 5 % from Asia). Seventy-five percent had at least one infectious disease (78 % of Africans and 62 % of Latin Americans) and 27 % were co-infected (> 2 pathogenic agents). The proportion of healthy children was higher (p < 0.05) among Latin Americans (21 %) than among Africans (9 %). The most frequent infectious diseases were malaria (35 %), intestinal parasites (48 %), filariasis (23 %), and viral hepatitis (19 %). Malaria, filariasis and hepatitis were more frequent in Africans than in Americans (p < 0.05). Other helminthic infections (15 %) were more frequent in Americans. In both groups intestinal parasites and tuberculosis (6 %) were prevalent. Of the 36 (21 %) asymptomatic children, 53 % had at least one infectious disease. The most frequently diagnosed diseases in Africans were intestinal parasitosis (35 %), malaria (7 %), cured hepatitis B (15 %), filariasis (12 %) and superficial mycosis (4 %). The most frequent infectious diseases in Latin Americans were intestinal parasitosis (38 %) and visceral toxocariasis (25 %). CONCLUSIONS: Infectious diseases and co-infections are frequent in immigrant children, even in those who are asymptomatic. We propose screening of certain infectious diseases in these children according to their country of origin and their length of residence in Spain.

Adolescent↗

PubMed2007

Risk of schizophrenia in second-generation immigrants: a Danish population-based cohort study.

BACKGROUND: Urban birth, a risk factor for schizophrenia, is more frequent among second-generation immigrants. The aim of the current study was to determine whether the increased risk for schizophrenia found in second-generation immigrants is explained by the degree of urbanization of birthplace and/or factors related to parentage, such as geographic origin or history of residence abroad during upbringing. METHOD: Using data from the Danish Civil Registration System (CRS), we established a population-based cohort of 2.0 million Danes (persons born in Denmark). Schizophrenia in cohort members was identified by cross-linkage with the Danish Psychiatric Central Register. RESULTS: The relative risk of developing schizophrenia was 1.93 [95% confidence interval (CI) 1.79-2.08] and 2.96 (95% CI 2.49-3.51) among persons with one or both parents foreign-born respectively compared to native Danes. Adjustment for urbanization of birthplace and parental characteristics reduced these risks slightly. However, urbanization had a lesser effect in second-generation immigrants than in Danes. History of residence abroad was a risk factor for schizophrenia, regardless of whether parents were foreign-born or native Danes. CONCLUSION: The increased risk found in second-generation immigrants cannot be explained by urbanization or parental characteristics pertaining to age, mental illness, geographic origin or residence abroad during a child's upbringing.

Cohort Studies↗

PubMed2006

The rise and fall of the medical gaze: the political economy of immigrant medical inspection in modern America.

In this paper I examine the mass medical inspections of immigrants to the United States from the 1890s through the 1920s. I show how, framed as it was not only by nativism and eugenics but also by national industrial imperatives and priorities, scientific medicine served dual purposes. On the one hand, the medical exam was a tool for managing cultural and biological threats to the nation. There were regional variations in medical inspections that reflected the politics of race. On the other hand, the medical exam played an important role in the process of building an unskilled, highly mobile labor force. The industrial demands of the nation provided a rationale for drawing and absorbing millions of European immigrants into the labor force. It was thus a distinct product of the political economy of immigration. It was this second function that characterized the exam for the majority of immigrants entering the nation.

Asia↗

PubMed2006

Inoculating against barbarism? State medicine and immigrant policy in turn-of-the-century Argentina.

The border in turn-of-the-century Argentina was a place of heightened anxiety. State officials ignored the nation's vast land borders and focused on the port, located in the capital city of Buenos Aires, which attracted nearly six million European immigrants in the decades after 1870. Federal authorities were seeking to attract new immigrants and yet they were terrified that opening their gates would allow entry among the potential citizenry a new category of "toxins" dangerous to the national body. The authorities hired physicians as gatekeepers to identify desirable and undesirable traits that went beyond the definition of communicable disease. Science and medicine appeared to provide a means of legitimating a variety of attempts by the state to control the makeup of the population; in reality, the state's power to inspect immigrants for disease, racial toxins, social upheaval, and political instability was minimized by realistic decisions to open borders and by a weak and limited ability to control the influx of people. Alongside calls for immigrant selection there coexisted a strong trend in political discourse that sought to build a unified, homogenous national culture by accepting and assimilating the foreign masses. Both approaches, however, had similar goals--the material progress of the nation, the advancement of Argentina's "civilization," and the erasure of traces of "foreignness" among the new population.

Argentina↗

PubMed2006

Impact of immigration and HIV infection on tuberculosis incidence in an area of low tuberculosis prevalence.

The aim of this study is to assess the effects of immigration from countries with a high prevalence of tuberculosis (HPCs), of HIV/AIDS prevalence, and the ageing of the indigenous population, on tuberculosis distribution in a low-prevalence area (LPCs), the Piedmont Region of Italy. Tuberculosis incidence and HIV cases were identified by linking records from the surveillance systems. Overall, 640 tuberculosis cases were identified and crude annual incidence was found to be 17.3/100000. The incidence rate ratio for HIV infection as a risk factor for tuberculosis (11.4 and 51.9 among individuals from HPCs and LPCs respectively) was greater than that for immigration from HPCs (6.7 and 30.9 among HIV+ and HIV- individuals). Immigration accounted for a larger number of incident cases [population attributable risk % (PAR %): 31.8 and 52.8% among HIV+ and HIV- individuals] than did HIV infection (PAR %: 5.4 and 11.1% among individuals from HPCs and LPCs). Efforts should be made to identify and treat young immigrants from HPCs.

AIDS-Related Opportunistic Infections↗

PubMed1998

HBV and HCV infection among non-European Union immigrants in North-East Italy.

The status of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection among non-European Union (non-EU) immigrants in North-East Italy was evaluated. Among the 1683 individuals tested the prevalence of HBsAg was 8.9% (150 subjects) and of HBV antibodies (anti-HBc with/without anti-HBs) was 38.9% (654 subjects). The distribution of HBV serological markers showed significant differences according to region of origin; the highest prevalence of infection (76.9%) and carriage (16.1%) was found in immigrants from sub-Saharan Africa. Among the 933 individuals screened for HCV infection, prevalence of antibody was much lower (0.9%) than that observed in the Italian general population (3.2-12.6%). The large number of HBV carriers among immigrants could increase the number of new adult infections due to life-style habits or professional risks in the host population. In contrast, the risk of HCV spread from non-EU immigrants is very low.

Adolescent↗

PubMed1999

Generational differences in psychosocial adaptation and predictors of psychological distress in a population of recent Vietnamese immigrants.

While first-wave Vietnamese immigrants adapted well to life in the United States, subsequent immigrants have had greater adjustment difficulties, including more evidence of psychological distress. This study aimed to analyze psychosocial adaptation differences among three generations of recent Vietnamese immigrants, as well as to examine predictors of mental distress in the sample as a whole. A community sample of 184 recent Vietnamese immigrants, categorized as either elderly, middle-aged, or young adults, was assessed for levels of psychological distress, including depression, anxiety, and PTSD, as well as family conflict, dissatisfaction with life in the U.S., acculturation and biculturalism, social support, coping, and premigratory stressors. Young Vietnamese adults were most acculturated, most bicultural, and reported themselves as healthiest and least depressed. They were most often working, least often on welfare, and had the highest family income. However, they also reported most dissatisfaction with their current lives in the U.S. and most family conflict. Regression analysis explaining approximately one-quarter of the variance in mental distress implicated current dissatisfaction with and lack of adjustment of life in the United States, as well as greater acculturation and increased family conflict. Although young adults scored significantly higher than other generations on most of the risk factors for psychological distress, they appeared to be buffered against poorer mental health outcomes by factors of generation and perceived positive overall well-being. In terms of testing a predictive model of psychological distress, this study found current adjustment factors significantly more important in determining mental health outcomes than premigratory stressors such as war-related traumas.

Acculturation↗

PubMed1999

Adverse birth outcomes among native-born and immigrant women: replicating national evidence regarding Mexicans at the local level.

OBJECTIVES: For almost two decades, the literature has consistently described an epidemiologic paradox relating to better birth outcomes among high-risk groups, particularly new immigrants from Mexico and Southeast Asia. We hypothesize that regardless of their sociodemographic profile, Mexican immigrants will exhibit lower rates of low birth weight and preterm deliveries than native-(U.S.) born women of Mexican origin, non-Hispanic White and Black women, and Puerto Rican Women. METHODS: We studied 57,324 live-born singleton infants born to residents in the city of Chicago in a linked data set of 1994 birth-death records. Multivariate logistic regression was used to analyze race/ethnicity differentials in two pregnancy outcome measures, low birth weight and preterm birth. RESULTS: Overall better birth outcome is related to maternal immigrant status regardless of race/ethnic groups. Immigrant Mexican women had a significantly lower risk of both low birth weight [adjusted odds ratio (AOR): 0.78, 95% confidence interval (CI) 0.66-0.91] and preterm births (AOR: 0.75, 95% CI 0.65-0.86) and were at 28% and 33% lower risks of delivering a low birth weight infant or a premature infant, respectively, than non-Hispanic White women.

Adolescent↗

PubMed1999

Birth outcomes of immigrant women in the United States, France, and Belgium.

OBJECTIVES: To compare maternal characteristics and birth outcomes of Mexico-born and native-born mothers in the United States and those of North African mothers living in France and Belgium to French and Belgian nationals. METHODS: We examined information from single live birth certificates for 285,371 Mexico-born and 3,131,632 U.S.-born mothers (including 2,537,264 U.S.-born White mothers) in the United States, 4,623 North African and 103,345 Belgian mothers in Belgium, and a French national random sample consisting of 632 North African and 11,185 French mothers. The outcomes were mean birthweight, low birthweight, and preterm births. Differences between native/nationals and foreign-born mothers in each country were assessed in bivariate and multivariate analyses controlling for maternal risk factors. RESULTS: The adjusted odds for low birthweight were lower for immigrants than native/nationals by 32% in the United States, by 32% in Belgium, and by 30% in France. The adjusted odds for preterm births were lower for immigrants compared with native/nationals by 11% in the United States and by 23% in Belgium. In France, the odds for preterm births were comparable for immigrants and naturalized mothers. Infants of immigrant mothers also had higher mean birthweights in all three countries. CONCLUSION: Despite their disadvantaged status, Mexico-born and North African-born women residing in the United States, France, and Belgium show good birth outcomes. These cannot be explained solely by traditional risk factors. Protective factors and selective migration may offer further clues.

Adolescent↗

PubMed1999

The influence of American urban culture on the development of normative beliefs about aggression in Middle-Eastern immigrants.

The effects of a community's culture on children's and adolescents' normative beliefs about the appropriateness of aggression were examined. One hundred forty-seven high school students and 103 fourth graders participated in a survey of normative beliefs; 69 high school and 44 elementary school students were of Middle-Eastern background. Although there were no differences in the beliefs of immigrant and nonimmigrant fourth graders, adolescents born in the United States were more accepting of aggression than those who immigrated from the Middle East. Moreover, adolescents who immigrated to the U.S. at age 12 or later were less accepting of aggression than those who immigrated prior to age 12.

Acculturation↗

PubMed2004

Transnational ties and mental health of Caribbean immigrants.

Immigration scholars have demonstrated the increasing importance of transnational activities among contemporary immigrants. While much of the previous research has emphasized social and economic outcomes, very little attention has been paid to psychological well-being or mental health. Using a community sample of West Indian immigrants, we developed an empirical measure of the nature and frequency of transnational practices. The resulting Transnationalism Scale is examined for psychometric properties using an exploratory principal components factor analysis, and bivariate correlations with pre-existing measures of psychological well-being, perceived social support, and ethnic identity. Results reveal five factors, some of which are significantly correlated with measures of psychological well-being, social support, and ethnic identity. Findings suggest that transnationalism, as a construct, is a valid measure for this population. We argue that transnational ties shape various aspects of immigrants' lives.

Acculturation↗

PubMed2004

Immigrant parents and their emigrant adolescents: the tension of inner and outer worlds.

This article examines different experiences of immigrant parents and their children in transit between the parents' ethnic world and American culture through three clinical cases: a 16-year-old male, whose mother is Persian and father East Indian and who presents with depression and lack of focus; an 18-year-old girl, whose mother is Nigerian and father African American and who was reporting depressive symptoms and confusion about sexual identity; and an 18-year-old depressed male from an Assyrian Iraqi background whose parents both are from Northern Iraq, but have lived in the United States for 20 years. Adolescents of immigrant families have much more complicated tasks during this phase of their development to establish a future sense of self-identity. A well-consolidated sense of self-identity is more complicated for these types of multiethnic immigrant families. The adolescents must rely on parental ego functions and their coherent sense of identity to weather this stage of their turbulent experience. In their strong fantasy framework, these adolescents strive to belong to their new peer groups, in which parents do not belong, particularly when the immigrant parents present a variety of different social and cultural values discordant to the contemporary culture. The cases suggest that both positive and negative aspects of ethnic identification become diluted during adolescence, when identification with parental mores occurs.

Adolescent↗

PubMed2004

Marriage in the context of immigration.

Two very important life events, marriage and immigration, often take place in close relation to one another. It is common, for example, for a couple to marry and emigrate together or for a recent immigrant to marry a native of the new country. In addition to addressing the effect of culture on marriage, the article discusses how these two life events parallel each other and how they interact with each other. In both marriage and immigration, the individual must mourn the loss of old objects and make a commitment to new objects. The personal choices made and reactions to those choices are attempts to meet intrapsychic needs, sometimes normal and sometimes pathological. In addition, both marriage and immigration create intrapsychic needs that the other may be used to fill. A clinical example illustrates these points.

Culture↗

PubMed2002

Cancer risks in childhood and adolescence among the offspring of immigrants to Sweden.

We used the nation-wide Swedish Family-Cancer Database to analyse the risk of nervous system tumours, leukaemia and non-Hodgkin's lymphoma in age groups 0-4 and 0-19 years among Swedish-born offspring of immigrants. The study included 850 000 individuals with an immigrant background, including European, Asian and American parents. We calculated standardised incidence ratios for the above three malignancies using Swedish offspring as a reference. Subjects were grouped by region or by selected countries of parental origin. No group differed significantly from Swedes in the occurrence of nervous system neoplasm or leukaemia. Offspring of Yugoslav fathers (SIR 2.27) and Turkish parents were at increased risk of non-Hodgkin's lymphoma. The highest risk was noted for non-Hodgkin's lymphoma among young offspring (0-4 years) of two Turkish parents (6.87). The currently available limited data on rates for childhood non-Hodgkin's lymphoma in these countries do not explain the risk in the offspring of immigrants. Yugoslavs and Turks are recent immigrant groups to Sweden, and their offspring have been subject to much population mixing, perhaps leading to recurring infections and immunological stimulation, which may contribute to their excess of lymphomas.

Adolescent↗

PubMed2003

Incidence of fetal macrosomia and birth complications in Chinese immigrant women.

OBJECTIVE: To compare rates of fetal macrosomia (birthweight > 4000 g) and birth complications in both Chinese women immigrants and Caucasian women for two time periods: 1992 and 1999-2000. POPULATION: Chinese women immigrants and Caucasian women attending the Royal North Shore Hospital and Hornsby Ku-Ring-Gai Hospital in Sydney's northern health region. METHODS: Data used were extracted from the Northern Suburbs Area Health Service OBSTET database. Significance of trends were assessed using chi2 test. RESULTS: The results show a rise in macrosomic babies born to Chinese immigrants from 4% of total Chinese births in 1992 to 9.8% in 1999-2000 (P = 0.02). There was no significant difference in the rate of macrosomia among Caucasian women with respective rates of 11 and 14% for the same periods. The incidence of post-partum haemorrhage increased significantly in both Chinese immigrants and Caucasian women (P < 0.001). CONCLUSION: Australia has a multicultural population and yet the normal ranges defined for many obstetric investigations do not adjust for ethnicity. The application of values derived from a Caucasian population to other ethnic populations may be inappropriate and conceal important pathologies.

Birth Weight↗

PubMed1999

Predictors of loneliness in elderly Korean immigrant women living in the United States of America.

The purpose of this study was to examine the predictors of loneliness in elderly Korean immigrant women. The sample was derived from a larger study designed to examine loneliness in elderly Korean immigrants. Subjects were 110 elderly Korean immigrant women who were at least 60 years of age and lived in a large metropolitan city area in the United States of America. Data were collected by telephone interview using the Revised University of California Los Angeles (UCLA) Loneliness Scale (RULS), Social Support Questionnaire, Ethnic Attachment Questionnaire and Instrumental Activities of Daily Living (ADL) Scale. Measures were prepared using translation and back-translation procedures. Results indicate that elderly Korean immigrant women were more lonely than those found in other studies. Satisfaction with social support, social network size, ethnic attachment and functional status were predictive variables of loneliness. Satisfaction with social support was the largest predictor of loneliness in elderly Korean women. Marital status was not a predictor of loneliness.

Aged↗

PubMed2002

Immigrant women's views about care during labor and birth: an Australian study of Vietnamese, Turkish, and Filipino women.

BACKGROUND: Few studies of immigrant women's views of maternity care in their new homelands have been conducted. In Victoria, Australia, approximately 1 woman in 7 giving birth was born overseas in a non-English speaking country. This paper examines the views of three groups of immigrant women about the care they received in hospital for the birth of their babies and compares the findings with a population-based statewide survey. METHODS: Mothers in a New Country was a study of 318 Vietnamese, Turkish, and Filipino women interviewed about their maternity care experiences by bicultural interviewers 6 months after giving birth in Melbourne, Australia. The interview schedule was adapted from the 1994 Victorian Survey of Recent Mothers, a population-based postal survey of 1336 women. RESULTS: Of the 3 groups, 27 percent of Vietnamese, 48 percent of Turkish, and 39 percent of Filipino women reported their care during labor and birth as "very good," figures significantly lower than for the statewide survey, in which 61 percent of women experiencing similar models of care described their care as "very good." This significant differential in views about care was also present for many individual aspects of care. In the current study of mothers in a new country, comments about aspects of care with which women were particularly happy and unhappy highlighted their appreciation of care that was safe, kind, supportive, and respectful, and conversely, illustrated how distressed women were when care failed to meet these basic standards. CONCLUSIONS: What immigrant women wanted from their maternity care proved to be extremely similar to what Australian-born women--and women the world over--want. Unfortunately, immigrant women were much less likely to experience care that gave them what they wanted.

Adult↗