Unravelling the ‘immigrant health paradox’: ethnic maintenance, discrimination, and health behaviours of the foreign born and their children in England

Renee Luthra,Alita Nandi,Michaela Benzeval

doi:10.1080/1369183x.2018.1539287

Renee Luthra, Alita Nandi + Show 1 more

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https://doi.org/10.1080/1369183x.2018.1539287

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Abstract

ABSTRACTThis paper uses data from Understanding Society, a large representative survey of UK with an ethnic minority boost sample, to test the association between ethnic maintenance, discrimination and health behaviours, among both foreign born and UK born ethnic minorities. We model the probability of smoking and alcohol consumption on (a) ethnic maintenance measured as a function of friendship composition, religiosity, and ethnic identity; and (b) exposure to discrimination as evidenced by self-reports of ethnic and racial harassment in public places. We find that even after controlling for other structural inequalities in income, education, and geography, there is a positive association between ethnic and racial harassment and smoking for ethnic minority women. We also find that ethnic minority men and women who report stronger ethnic maintenance are less likely to binge drink. While we find similar results for ethnic minority women and smoking, we find no such relationship for ethnic minority men.

Highlights

This paper contributes to a burgeoning literature on the existence of an ‘immigrant health paradox’ which has been well established in many immigrant receiving countries: after adjusting for socioeconomic status, the foreign born generally have lower mortality than the native born, this initial advantage disappears with increasing time in the receiving country and across generations
Even after including these controls, which are correlated with ethnic maintenance, women who have no religion and lower religious attendance, who have fewer co-ethnic friends, and who experience ethnic and racial harassment are more likely to smoke than women with stronger ethnic attachment and do not experience harassment. While these results demonstrate that ethnic maintenance and harassment are both associated with smoking for minority women in England, generational differences in ethnic maintenance and harassment do not seem to explain the differences in smoking behaviour between the UK and foreign born
Binge drinking In our model above we found that most forms of ethnic maintenance reduce the probability of binge drinking, in a more consistent manner than for smoking, which is what we anticipated given the cultural norms present in most origin countries (Hypothesis 4)

Summary

Introduction

This paper contributes to a burgeoning literature on the existence of an ‘immigrant health paradox’ which has been well established in many immigrant receiving countries: after adjusting for socioeconomic status, the foreign born generally have lower mortality than the native born, this initial advantage disappears with increasing time in the receiving country and across generations. The burgeoning literature on the immigrant health paradox (IHP) began with the discovery of a more specific ‘Latino mortality paradox’ in the USA (Abraído-Lanza, Echeverría, and Flórez 2016; Abraido-Lanza et al 1999): relative to non-Latino whites, Latinos have a worse socioeconomic profile but a lower mortality rate, representing an epidemiological paradox. This advantage seemed to decline the longer Latinos resided in the United States and over generations. This finding of lower mortality among immigrants in the UK has been confirmed with more recent data from the mid-2000s (Kennedy et al 2015; Wallace and Kulu 2014)

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