The Weight of Migration: Reconsidering Health Selection and Return Migration among Mexicans.

Arline T. Geronimus,Aresha M. Martinez-Cardoso

doi:10.3390/ijerph182212136

Abstract

While migration plays a key role in shaping the health of Mexican migrants in the US and those in Mexico, contemporary Mexican migration trends may challenge the health selection and return migration hypotheses, two prevailing assumptions of how migration shapes health. Using data from the Mexican Family Life Survey (2002; 2005), we tested these two hypotheses by comparing the cardiometabolic health profiles of (1) Mexico–US future migrants and nonmigrants and (2) Mexico–US return migrants and nonmigrants. First, we found limited evidence for health selection: the cardiometabolic health of Mexico–US future migrants was not measurably better than the health of their compatriots who did not migrate, although migrants differed demographically from nonmigrants. However, return migrants had higher levels of adiposity compared to those who stayed in Mexico throughout their lives; time spent in the US was also associated with obesity and elevated waist circumference. Differences in physical activity and smoking behavior did not mediate these associations. Our findings suggest positive health selection might not drive the favorable health profiles among recent cohorts of Mexican immigrants in the US. However, the adverse health of return migrants with respect to that of nonmigrants underscores the importance of considering the lived experience of Mexican migrants in the US as an important determinant of their health.

Highlights

IntroductionAmong people of Mexican descent in the United States (US), nativity and generational status are consistently associated with adiposity, diabetes, and cardiometabolic health
Among people of Mexican descent in the United States (US), nativity and generational status are consistently associated with adiposity, diabetes, and cardiometabolic health.In general, recent Mexican immigrants present with lower levels of cardiometabolic risk factors and adverse outcomes in comparison to their US-born Mexican American counterparts and, in some cases, non-Latino US-born Whites [1]
The Mexico–US migration flow represents one of the largest global migration flows, and Mexican migrants account for the largest immigrant-origin group in the US [41]

Summary

Introduction

Among people of Mexican descent in the United States (US), nativity and generational status are consistently associated with adiposity, diabetes, and cardiometabolic health. Recent Mexican immigrants present with lower levels of cardiometabolic risk factors and adverse outcomes in comparison to their US-born Mexican American counterparts and, in some cases, non-Latino US-born Whites [1]. Advantageous cardiometabolic health among recent Mexican immigrants is one example of what has been coined the Latino/Hispanic or immigrant health paradox, where despite their considerable social and economic vulnerabilities, immigrants have lower rates of mortality, adverse birth outcomes, and cardiovascular mortality risk than US-born Mexican Americans [4,5,6]. Health selection, return migration, and acculturation hypotheses are proposed to explain the disparate health outcomes between Mexican immigrants and US-born Mexicans and between recent and long-stay Mexican immigrants. Research that compares the health of immigrants and that of US-born may be mis-specified

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