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PubMed2004

The unintended impact of welfare reform on the medicaid enrollment of eligible immigrants.

BACKGROUND: During welfare reform, Congress passed legislation barring legal immigrants who entered the United States after August 1996 from Medicaid for five years after immigration. This legislation intended to bar only new immigrants (post-1996 immigrants) from Medicaid. However it may have also deterred the enrollment of legal immigrants who immigrated before 1996 (pre-1996 immigrants) and who should have remained Medicaid eligible. OBJECTIVES: To compare the Medicaid enrollment of U.S.-born citizens to pre-1996 immigrants, before and after welfare reform, and to determine if variation in state Medicaid policies toward post-1996 immigrants modified the effects of welfare reform on pre-1996 immigrants. DATA SOURCE/STUDY DESIGN: Secondary database analysis of cross-sectional data from 1994-2001 of the U.S. Census Bureau, Annual Demographic Survey of March Supplement of the Current Population Survey. SUBJECTS: Low-income, U.S.-born adults (N=116,307) and low-income pre-1996 immigrants (N=24,367) before and after welfare reform. MEASURES: Self-reported Medicaid enrollment. RESULTS: Before welfare reform, pre-1996 immigrants were less likely to enroll in Medicaid than the U.S.-born (OR=0.55; 95 percent CI, 0.51-0.59). After welfare reform, pre-1996 immigrants were even less likely to enroll in Medicaid. The proportion of immigrants in Medicaid dropped 3 percentage points after 1996; for the U.S.-born it dropped 1.6 percentage points (p=0.012). Except for California, state variation in Medicaid policy toward post-1996 immigrants did modify the effect of welfare reform on pre-1996 immigrants. CONCLUSIONS: Federal laws limiting the Medicaid eligibility of specific subgroups of immigrants appear to have had unintended consequences on Medicaid enrollment in the larger, still eligible immigrant community. Inclusive state policies may overcome this effect.

Adult↗

PubMed2005

Mental health in immigrant children in the Netherlands.

BACKGROUND: Background In the past decades, the ethnic diversity of the population in the Netherlands has rapidly grown. At present, approximately 10% of all people in the Netherlands belong to immigrant families that originate from a very large variety of non-Western nations. Although it is often assumed that migration has a stress-inducing effect, leading to heightened levels of mental health problems in both immigrant children and their parents, research into this group of children is very scarce in Europe. In this paper, we want to report on the mental health of immigrant children originating from non-Western countries enrolled in a large cohort study in the Netherlands. METHOD: A large sample of 11-year-old children in the Netherlands (n=2230) participated in the TRacking Adolescents' Individual Lives Survey (TRAILS). Approximately 10% of these children (n=230) belong to immigrant families originating from non-Western countries. Mental health problems were assessed using self-report measures (Youth Self-Report), using parent-report measures (Child Behaviour Check List) and using teacher report (Teacher Checklist for Psychopathology). In this paper, we report on the mental health problems of these children from all three perspectives (child, parent, teacher). In analysing the impact of immigrant status, the effect of gender and of socio-economic inequality was taken into account. RESULTS: According to self-report measures, mean level of mental health problems in immigrant children is comparable to that in non-immigrant children. Immigrant parents report higher problem rates for their daughters, in particular for internalising problem behaviours, social problems and attention problems, but not for their sons. In contrast, teachers perceive higher levels of externalising problem behaviour, but lower levels of anxious/depressed problems, social problems and thought problems in immigrant children. This last effect is most strongly found with respect to boys: teachers perceive less withdrawn/depressed problems, social problems, thought problems and attention problems in immigrant boys. CONCLUSIONS: Children from immigrant families do not appear to experience more problems than their non-immigrant peers. However, parents from immigrant families do report more problems in their daughters than non-immigrant parents, in contrast to teachers who perceive lower levels of internalising, social and thought problems in particular in boys, and higher levels of externalising problems in both immigrant boys and girls. In describing problem behaviour in immigrant children, the effect of diverging social contexts for and multiple perspectives on immigrant youth has to be taken into account.

Acculturation↗

PubMed2002

Behavioral risk factor and preventive health care practice survey of immigrants in the emergency department.

OBJECTIVE: To compare the demographic profiles, behavioral risk factors, and preventive health care practices of adult immigrant and non-immigrant patients while considering the effects of various socioeconomic variables. METHODS: This was a prospective survey administered at a large urban emergency department in New York City. Study subjects were adult immigrant patients presenting in an eight-week period in 1998. One non-immigrant control patient was recruited concurrently with every two immigrant patients. Differences between immigrants and non-immigrants were evaluated using the chi-square test. Multivariate logistic regression models were used to adjust for confounding variables. RESULTS: Eight hundred sixty-nine immigrant patients from 80 countries and 354 non-immigrant patients completed surveys. Immigrants were more likely not to have reached high school (28.9% vs 8.5%; p < 0.001), to have annual family incomes less than $20,000 (73.8% vs 64.5%; p < 0.01), and to have no health coverage (51.7% vs 30.8%; p < 0.001). Immigrant women were more likely never to have had a Papanicolaou test (16.1% vs 1.4%; OR 11.24, 95% CI = 2.70 to 46.8) and never to have performed a self-breast examination (20.8% vs 7.5%; OR 2.03, 95% CI = 1.29 to 3.20). Immigrants were more likely not to use condoms (63.4% vs 42.8%; OR 1.61, 95% CI = 1.20 to 2.15) and never to have visited a dentist (21.2% vs 7.8; OR 2.54, 95% CI = 1.60 to 4.04). Immigrants were more likely never to have received a purified protein derivative (PPD) skin test (30.3% vs 9.1%; OR 3.85, 95% CI = 2.56 to 5.80) and never to have received a tetanus immunization (48.1% vs 13.5%; OR 3.09, 95% CI = 2.17 to 4.42). These differences were independent of age, gender, marital status, employment, education, income, and health insurance status. When analyzing the immigrant group alone, region of origin, length of time in the United States, and English ability were significant independent predictors of higher-risk behavioral profiles and poor preventive health care practices. CONCLUSIONS: Differences exist between the socioeconomic profiles, behavioral risk profiles, and preventive health care practices of immigrant and non-immigrant patients presenting to a large inner-city municipal emergency department. Different populations within a heterogeneous group of immigrants have distinct health risks and public health needs.

Adult↗

PubMed2000

Social determinants of health in Canada's immigrant population: results from the National Population Health Survey.

As part of the Metropolis project--a large-scale investigation of immigration and integration, including well-being of immigrants in a number of areas of social life--in this paper we investigate the social determinants of health in Canada's immigrant population using Canada's National Population Health Survey (NPHS). Specifically, we examine differences in health status and health care utilization between immigrants and non-immigrants, immigrants of European and non-European origin, and immigrants of < 10 years and > 10 years' residence in Canada. We also examine social determinants of health care utilization and health status in immigrants and non-immigrants, and evaluate the utility of large-scale, national databases for these purposes. Our conceptual approach draws upon a 'population health' perspective, which suggests that the most important antecedents of human health status are not medical care inputs and health behaviours (smoking, diet, exercise, etc.), but rather social and economic characteristics of individuals and populations. We find no obvious, consistent pattern of association between socio-economic characteristics and immigration characteristics on the one hand, and health status on the other, in the NPHS data. This does not mean that socio-economic factors in Canada are not influential in shaping immigrants' health status. In fact, the results of the logistic regression models calculated for immigrants and non-immigrants on four outcome variables in this study suggest that socio-economic factors are more important for immigrants than non-immigrants, although in ways that defy a simple explanation. The complexity of immigrants' experiences, combined with the inherent limitations of cross-sectional survey data are discussed as major limitations to this kind of research.

Adult↗

PubMed1997

Measuring immigrant wage growth using matched CPS files.

Cross-sectional estimates of immigrant wage growth have painted an optimistic picture of the ability of immigrants to adapt to the U.S. labor market: Studies using cross-sectional data have generally found the wage growth of immigrants to exceed that of the native born. This optimistic picture of immigrant economic assimilation was challenged by the important finding that compared to earlier immigrant cohorts, recent immigrants started at much lower wages. As such, the high wage growth of immigrants relative to the native born measured in cross-sectional data may simply be the spurious result of declining immigrant earnings ability. In this paper, we match Current Population Survey samples so that the wages of individual immigrant and native-born men can be followed for one year. We find that the wage growth of immigrants does exceed that of the native born. The general finding of faster immigrant wage growth also holds when imposing the foreign-born geographic distribution upon natives, but not when imposing the native-born geographic distribution on the foreign born-a result consistent with some theories of immigrant assimilation. In each comparison, however, the actual wage growth of immigrants relative to natives is similar to the predictions of cross-sectional regressions. This similarity suggests that either there is no cohort quality bias in the cross-sectional estimates of immigrant wage growth, or that there has been a coincidental increase in immigrant wage growth as the entry wages of immigrants have fallen.

Acculturation↗

PubMed2002

Heterosis and outbreeding depression in descendants of natural immigrants to an inbred population of song sparrows (Melospiza melodia).

We studied heterosis and outbreeding depression among immigrants and their descendants in a population of song sparrows on Mandarte Island, Canada. Using data spanning 19 generations, we compared survival, seasonal reproductive success, and lifetime reproductive success of immigrants, natives (birds with resident-hatched parents and grandparents), and their offspring (F1s, birds with an immigrant and a native parent, and F2s, birds with an immigrant grandparent and resident-hatched grandparent in each of their maternal and paternal lines). Lifetime reproductive success of immigrants was no worse than that of natives, but other measures of performance differed in several ways. Immigrant females laid later and showed a tendency to lay fewer clutches, but had relatively high success raising offspring per egg produced. The few immigrant males survived well but were less likely to breed than native males of the same age that were alive in the same year. Female F1s laid earlier than expected based on the average for immigrant and native females, and adult male F1s were more likely to breed than expected based on the average for immigrant and native males. The performance differences between immigrant and native females and between F1s and the average of immigrants and natives are consistent with the hypothesis that immigrants were disadvantaged by a lack of site experience and that immigrant offspring benefited from heterosis. However, we could not exclude the possibility that immigrants had a different strategy for optimizing reproductive success or that they experienced ecological compensation for life-history parameters. For example, the offspring of immigrants may have survived well because immigrants laid later and produced fewer clutches, thereby raising offspring during a period of milder climatic conditions. Although sample sizes were small, we found large performance differences between F1s and F2s, which suggested that either heterosis was associated with epistasis in F1s, that F2s experienced outbreeding depression, or that both phenomena occurred. These findings indicate that the performance of dispersers may be affected more by fine-scale genetic differentiation than previously assumed in this and comparable systems.

Animals↗

PubMedDate not supplied

Immigrant suicide rates as a function of ethnophaulisms: hate speech predicts death.

OBJECTIVE: The purpose of this study was to determine whether suicide rates among ethnic immigrant groups were predicted by the ethnophaulisms, or the hate speech, used to refer to those ethnic immigrant groups. METHODS: Data were obtained for 10 European ethnic immigrant groups during the 1950s. These 10 European ethnic immigrant groups accounted for approximately 40% of all immigration into the United States during this time period. Both the suicide rates for these ethnic immigrant groups in the United States and suicide rates for those ethnic immigrant groups in their countries of origin were derived. The complexity and valence of ethnophaulisms used to refer to these ethnic immigrant groups were derived from the historical record of hate speech in the United States. RESULTS: Consistent with previous research, immigrant suicide rates were strongly correlated with origin suicide rates. As expected, the suicide rates for ethnic immigrant groups in the United States were significantly predicted by the negativity of the ethnophaulisms used to refer to those ethnic immigrant groups. This pattern was obtained even after taking into account the suicide rates for those ethnic immigrant groups in their countries of origin, and even after taking into account the size of those ethnic immigrant groups. CONCLUSIONS: This study found support for the expectation that suicide rates among ethnic immigrant groups would be predicted by the hate speech directed toward those ethnic immigrant groups.

Cause of Death↗

PubMedDate not supplied

Physical activity and immigrant status: evidence from the Canadian Community Health Survey.

BACKGROUND: The immigrant population in Canada is diverse and growing, yet little is known about their physical activity behaviour and how it changes as they adapt to a Canadian lifestyle. This study extends the surveillance of physical activity in Canada to include the influence of time since immigration within and between ethnic groups. METHODS: Pooled data from cycles 1.1 (2000/01) and 2.1 (2003) of the cross-sectional Canadian Community Health Survey (ages 20-64 y; N = 171,513) were used for this study. Weighted prevalences of self-reported leisure-time physical activity (> or = 3 kcal x kg(-1) x day(-1) (kkd)) were calculated, and unadjusted and adjusted (age, income, education, BMI) multiple logistic regression models were used to quantify the odds of being physically active (PA) (> or = 3 kkd) by time since immigration (recent immigrant < or = 10 yrs, immigrant >10 yrs, non-immigrant) within and between ethnic groups (White referent group). RESULTS: The prevalence of recent immigrants (< or = 10 yrs) being PA (> or = 3 kkd) by ethnicity was: White (21%), Other (19%), Black (19%), Latin American (17%), West Asian/Arab (16%), East/Southeast Asian (14%), South Asian (11%). Recent immigrant Black men and White women had the highest prevalence of being PA (M = 27%, F = 18%) while South Asian men and women had the lowest prevalence (M = 14%, F = 9%). There is a gradient in the prevalence of being PA with recent immigrants (16%) < immigrants (20%) < non-immigrants (24%). Ethnic differences in the prevalence of being PA by time since immigration show similar patterns for men and women. Controlling for age, income, education and BMI had only small effects on the odds of being physical active across ethnicities and immigrant status. CONCLUSION: These results suggest that physical activity levels vary according to immigrant status and self-ascribed ethnicity in Canadian adults. Strategies to promote physical activity and prevent physical inactivity should consider both ethnicity and time since immigration.

Adult↗

PubMed2006

Community unemployment and immigrants' health in Montreal.

This research examines the relationship between community unemployment and the physical and mental health of immigrants in comparison to non-immigrants in Montreal under the hypothesis that high unemployment in the community may generate more negative effects on the health of immigrants than on non-immigrants. Possible gender differences in these associations are also examined. Montreal residents were studied via multilevel analysis, using both individual survey data and neighbourhood data from 49 police districts. Individual-level data were excerpted from a 1998 health survey of Montreal residents, while neighbourhood data originated from survey data collected in the 49 Montreal police districts and the 1996 Canadian Census. The associations between community unemployment and self-rated health, psychological distress and obesity are examined, and hypotheses regarding the modifying mechanisms via which male and female immigrants may run a greater risk of poor health than non-immigrants when living in areas of high unemployment were tested. Between neighbourhoods, variations in the three health outcomes were slight, and differences in health were not associated with differences in community unemployment. The associations between community unemployment and health varied according to immigration status. At the individual level, immigrants do not differ from non-immigrants with respect to the three health indicators, except that second-generation males are slightly heavier. However, when living in areas of high unemployment, immigrants tend to report poor physical and mental health in comparison to non-immigrants. Among first-generation immigrants, community unemployment was associated with psychological distress. Among second-generation immigrants, the probability of obesity and poor self-rated health increased significantly for those living in areas with high unemployment, but these associations reached statistical significance only for men. Findings among first-generation immigrants are interpreted with respect to the effects of possible discrimination in areas with low job availability. Among second-generation men, poor physical health and obesity may be the result of poor health habits stemming from perceived lack of life opportunities.

Adolescent↗

PubMed2004

Examining the healthy immigrant effect in mid- to later life: findings from the Canadian Community Health Survey.

Recent studies have established that a healthy immigrant effect operates in Canada-immigrants are generally healthier than Canadian-born persons-but that this effect tends to diminish over time, as the health of immigrants converges to the Canadian norm. Although this effect has been examined by place of birth, language, marital status, socio-economic status, charter-language ability, and category of immigrant status in Canada, less is known about the healthy immigrant effect at different stages of the life course, particularly in mid- to later adulthood, stages at which there is an increased likelihood of decline in physical and mental health status. This study examines how age at immigration affects the health of mid- to later-life immigrants, compared to Canadian-born persons, using data from the 2000-2001 Canadian Community Health Survey. These data indicate that the healthy immigrant effect applies to later mid-life immigrants; that is, new immigrants-those who immigrated less than 10 years ago-aged 45 to 64 have better health than their longer-term counterparts-those who immigrated 10 or more years ago-whose health status is similar to that of Canadian-born persons. Interestingly, a different picture emerges in old age (65 years and over), where recent immigrants have poorer overall health compared to Canadian-born persons. When a number of socio-demographic, socio-economic, and health behaviour factors are controlled, however, this disadvantage largely disappears. The findings are discussed in terms of their implications for Canadian health care policy and program planning for immigrants in the latter stages of the life course.

Age Factors↗

PubMed2005

The effect of immigrant generation on smoking.

Immigrants to the US are not only an increasingly significant demographic group but overall they also have lower socioeconomic status (SES) than the native-born. It is known that tobacco use is a major health risk for groups that have low SES. However, there is some evidence that tobacco use among certain immigrant groups is lower than among the respective native-born ethnic group, and that immigrant assimilation is positively related to tobacco use. We investigated the relationship between immigrant generation and daily smoking, using the Tobacco Use Supplement of the Current Population Survey (TUS-CPS), 1995-96, a national data set representative of the US general and immigrant populations. Our multivariate logistic regression analysis of the relationship between immigrant generation and daily smoker status (n = 221,798) showed that after controlling for age, gender, race/ethnicity, SES variables (i.e. equivalized household income, education, occupation), and central-city residence, the odds of being a daily smoker were highest among US-born individuals of US-born parents (reference group) and lowest among foreign-born individuals (95% CI: 0.54-0.62). Being a second-generation immigrant (i.e. US born) with two immigrant parents also conferred a protective effective from smoking (95% CI: 0.64-0.77). However, having only one foreign-born parent was not protective against smoking. Testing for interaction effects, we also found that being foreign born and being second generation with two immigrant parents were especially protective against smoking among females (vis-à-vis males); racial/ethnic minorities (vis-à-vis whites); and low-income individuals (vis-à-vis high-income individuals). We discuss possible mechanisms that may explain the protective effect against smoking of being foreign born and being second generation with two immigrant parents, including differences in the stage of the tobacco epidemic between immigrants' countries of origin and the US, the "healthy immigrant effect", and anti-smoking socialization in immigrant families.

Adolescent↗

PubMed2005

Diverticulosis of the colon is rare amongst immigrants living in the Zaanstreek region in the Netherlands.

BACKGROUND: Data on prevalence of diverticulosis related to ethnicity or race in the Western world are very sparse. A cross-sectional study was done in patients undergoing endoscopy of the colon in order to assess the prevalence of diverticulosis and relate the presence to ethnicity. METHODS: An analysis was undertaken of the endoscopy reports from all consecutive patients undergoing endoscopy of the colon. As a reference group all patients in whom no abnormalities were detected were used. In the Zaanstreek region a large population of immigrants, mostly of Turkish descent, is present. These immigrants were studied separately. RESULTS: In a period of 12 years 3004 patients were diagnosed with diverticulosis. Of these 2975 were authentic Dutch. The remainder 29 patients were immigrants. Diverticulosis was diagnosed significantly more often in immigrant men (P < 0.0001). Immigrants with diverticulosis were significantly younger than the authentic Dutch, P < 0.001. There was no major difference in representation of immigrants with diverticular disease in different age cohorts. The reference group consisted of 3356 patients. In this group 2998 patients were authentic Dutch, while 358 patients were immigrants. There was no difference in numbers of men and women amongst the immigrants. Of the patients with a normal colon and rectum 11% is immigrant. In the group of patients with diverticulosis only 0.9% was immigrant. CONCLUSION: This study clearly shows that prevalence of diverticular disease is very low in immigrants. The majority of these immigrants are of Turkish descent. In addition, the majority of immigrants with diverticulosis was male.

Adult↗

PubMedDate not supplied

Immigrant status and unmet health care needs.

OBJECTIVES: To compare whether unmet health needs differ between immigrants and non-immigrants, and examine whether help-seeking characteristics account for any unmet needs disparities. METHODS: The data are from the Canadian Community Health Survey Cycle 1.1, conducted by Statistics Canada in 2000-2001. The study sample includes 16,046 immigrants and 102,173 non-immigrants aged 18 and older from across Canada. The study employs logistic regression models to examine whether help-seeking behaviours explain unmet needs differences. RESULTS: Logistic regression analysis indicates that immigrants have a 12% (95% CI: 6-18) lower all-cause unmet needs risk (odds ratio) than non-immigrants after controlling for differences in help-seeking characteristics. The unmet needs risk among long-term immigrants (15 years of residence and more), however, is similar to non-immigrants after considering these characteristics. We found differences between immigrants and non-immigrants in reasons for unmet needs, with more immigrants believing that the care would be inadequate, not knowing where to access health care, and having foreign language problems. CONCLUSIONS: The Canadian health care system delivers sufficient health care to immigrants, even though the poverty rate and proportion of visible minorities are comparatively higher within this subpopulation. Nonetheless, these results indicate that some immigrant-specific health care access barriers may exist.

Adolescent↗

PubMed2006

[Patterns of contact with general practice in the daytime by guest workers with immigrant and refugee background in Copenhagen municipality, 1998].

INTRODUCTION: Little is known about immigrants' contact with the Danish health system. The aim of this study was to compare the pattern of contact with general practitioners of guest workers, refugees and non-immigrants in Copenhagen. MATERIALS AND METHODS: 2.04 daytime contacts (home visits, clinic consultations and telephone consultations) by 423,202 inhabitants during the year 1998 as recorded in the National Patient Registry were merged with information about citizenship and place of birth in the Danish Central Office of Civil Registration. The contacts were described by the average number of contacts per person at risk per year. The differences between non-immigrants and immigrants were analyzed using Poisson regression. RESULTS: Immigrants and non-immigrants showed nearly the same sex- and age-dependent contact pattern. Immigrant children (1-18 years) and older people (60+ years) had a lower contact rate than non-immigrants in the same age groups. The 19- to 59-year-old guest worker women and men had 3% and 5% higher contact rates and the refugee women and men 2% and 17% higher contact rates, respectively, than non-immigrants in the same age group. The percentage of telephone consultations was lower for immigrants and the clinic consultation rate higher than for non-immigrants. CONCLUSION: There are sex- and age-specific differences between immigrants and non-immigrants. If equity is a goal in public health care, we should know more about its actual use. More complex research designs are needed, as well as theoretical studies, to shed light on these issues.

Adolescent↗

PubMed1995

[Tuberculosis among immigrants in Japan--epidemiological, clinical and sociological features, and the future of control].

Case of tuberculosis among immigrants in Japan have been increasing recently as the entry of the foreigners increases. The 1993 national survey showed that the number of the newly registered tuberculosis patients among immigrants (new comers) was 593 (1.2% of total patients) in 1992. Though their proportion among all patients is still yet small, immigrant cases show remarkable disparity in geographical and age distribution. Immigrant patients present various challenges in the control of tuberculosis, with higher rates of defaulter in treatment and drug resistance. This study analysed the characteristics of the problems with various data and made recommendations for the future control programme. Epidemiologically, the mean tuberculosis incidence during the period from 1987 to 1992 was estimated for the population of each country of origin. The rate for the whole immigrants was between 58.1 and 76.7 per 100,000, which was 2 to 5 times of the rate (i.e. 39) for Japan in 1992. The trend of the incidence after the arrival in Japan by year cohort was also estimated. It was found that the shorter the stay, the higher the incidence. Future estimate of tuberculosis incidence in immigrants was made based on the assumptions of the population in and out flows. In 2005, the number of new immigrant patients will be between 1169 and 846, representing 3.4% to 2.5% of all tuberculosis patients expected a decade hence. By reviewing the clinical data and chest radiogrphy of 157 immigrant patients currently diagnosed in Tokyo area, the attack timing of the disease for each patient was estimated. Nearly half the patients who would be diagnosed later was estimated to have some abnormal shadows on chest radiography before arrival in Japan, while the other half or at least 30% developed tuberculosis after arrival. These indicate the importance and the limitations of screening by chest radiography at the early stage of arrival. The clinical status and treatment compliance were better among the legal immigrants such as Japanese language school students that the over-stay (illegal) immigrants. The extra-pulmonary cases consisted only 7% of the total disease, which was similar to the whole patients in Japan. The perception and knowledge about tuberculosis and tuberculosis services among immigrants was found some different from those among Japanese. With the data analysed above and the information on the policy and guidelines in other countries, it is recommended that guidelines for improved Case-finding and treatment of tuberculosis among immigrants need to be developed in Japan, and pilot trials at local level should be instituted. For surveillance for tuberculosis in immigrants a standardized information system must be developed.

Adult↗

PubMed2000

The genetic contribution of single male immigrants to small, inbred populations: a laboratory study using Drosophila melanogaster.

This study examined the genetic contribution of single male immigrants to small, inbred laboratory populations of Drosophila melanogaster. Genetic contribution was assessed by measuring the relative frequency of immigrant marker alleles in the first and second generations after immigration, while controlling for any selection effects at the marker locus, and for the experience of male immigrants. When immigrants were outbred, the mean frequency of the immigrant allele was significantly higher than its initial frequency, in both the first and second generations after immigration. There was no significant change in allele frequency for populations receiving inbred immigrants. The increase in allele frequency for outbred immigrants was attributed to an initial outbred vigour fitness advantage of immigrant males over resident males experiencing inbreeding depression. Hybrid vigour of immigrant progeny and the rare-male effect did not have a statistically significant role in the fitness advantage of the immigrant allele. The results suggest that inbreeding may have a considerable impact on the contribution of immigrants to the genetic diversity of populations.

Alleles↗

PubMed2001

Point prevalence of schizophrenia in immigrant groups in Rotterdam: data from outpatient facilities.

OBJECTIVE: Reports of an increased incidence of schizophrenia in some immigrant groups to The Netherlands are based exclusively on hospital data. THE AIMS OF OUR STUDY WERE: 1) to determine the treated point prevalence of schizophrenia at outpatient mental health services in Rotterdam and to compare the results for immigrants to those for natives; and 2) to compare groups born in The Netherlands and immigrant groups in terms of the proportions of patients with a previous hospital admission. METHOD: We included all patients aged between 20 and 64 who were treated for a non-affective psychosis at any of the outpatient mental health services in Rotterdam on October 1, 1994. The mental health professionals responsible reported on the socio-demographic and clinical characteristics of each patient. RESULTS: Seven hundred and thirteen patients with a diagnosis of schizophrenia (DSM-III-R) were identified (rate: 2.1 per 1000). The (treated) prevalence of schizophrenia in male immigrants from Surinam and Morocco and in female immigrants from Surinam, the Netherlands Antilles and Cape Verde was significantly higher than that in their native-born counterparts (odds ratios between 2 and 3). The (treated) prevalence was not significantly higher in immigrants from Turkey, female immigrants from Morocco or male immigrants from the Antilles. Proportions of patients with a previous hospital admission were similar in each ethnic group (81-93%). CONCLUSION: These findings are generally in line with earlier studies, based on the Dutch psychiatric registry, which has reported an increase in the (treated) incidence of schizophrenia in immigrants from Surinam and the Netherlands Antilles and in male immigrants from Morocco, and no increase in the (treated) incidence in immigrants from Turkey or female immigrants from Morocco.

Adult↗

PubMed1995

Breast cancer mortality among immigrants in Australia and Canada.

BACKGROUND: By moving between geographic regions with differing levels of breast cancer risk, migrant populations of women provide a unique opportunity to examine the impact of exposure to new environments and lifestyles on breast cancer risk. Breast cancer incidence and mortality rates for the majority of migrant groups originating from countries with low breast cancer risk have been found to increase toward the rates observed in destination countries with populations at higher risk for this disease. Because very little information exists on migrants from high- to low-risk countries, it is not known whether rates for these groups decrease or whether migrant groups generally experience increases in breast cancer rates. PURPOSE: To address these questions, we determined the breast cancer mortality rates for women from both lower and higher risk countries who had immigrated to Australia and Canada and compared these rates with those exhibited by the population in the origin country and by the destination native-born population. METHODS: Individual mortality records covering the years 1984 through 1988 and 1986 census data for Australia and Canada were obtained. Direct age-standardized mortality rates and rate ratios (and their 95% confidence intervals) were calculated for immigrant groups in Australia and Canada. Age-standardized rate ratios by length of residence in Australia were calculated. Weighted regression analyses of observed and expected mortality changes were performed. RESULTS: In Australia, the mortality rates for 12 (75%) of 16 immigrant groups from lower risk countries and 10 (71.4%) of 14 groups from higher risk countries shifted toward the rate of native-born Australians. In Canada, the rates for 12 (60%) of 20 immigrant groups from lower risk countries and four (80%) of five groups from higher risk countries converged to the rate of native-born Canadians. Overall, the extent of convergence (shift of immigrant's mortality rate in origin country toward rate of native-born population) was 50% for immigrants in Australia and 38% for immigrants in Canada. Although there was not a consistent pattern of convergence with length of residence in Australia, after 30 or more years, the mortality rates of 15 (83.3%) of 18 immigrant groups had shifted toward the rate of the native-born Australians. Because of the small number of deaths in many of the immigrant groups studied, the observed differences in the breast cancer mortality age-standardized rates between the origin country and immigrant group, although often substantial, were seldom statistically significant. CONCLUSIONS: Breast cancer mortality rates among women in the majority of immigrant groups shifted from the rate observed in their country of origin toward the rate of the native-born population in the destination country. IMPLICATIONS: These findings indicate that environmental and lifestyle factors associated with the new place of residence influence the breast cancer rates of immigrants and also suggest that, since most migrants migrate as adults, the risk of breast cancer can be altered in later life.

Adult↗