First-generation Immigrant Women Research Articles

Hypertension in Pregnancy Among Immigrant and Swedish Women: A Cohort Study of All Pregnant Women in Sweden.

Little is known about risks of hypertensive disorders of pregnancy in both first- and second-generation immigrant women in Europe and other Western countries; such knowledge may help elucidate the influence of genetic versus social factors on such risks. We aimed to study both first- and second-generation immigrant women for the presence of all types of hypertension (preexisting hypertension, gestational hypertension, preeclampsia, and eclampsia) during pregnancy. A cohort study was conducted using data derived from the Swedish National Birth Register, the National Patient Register, and the Total Population Register. We used Cox regression analysis to compute hazard ratios (HRs) and 99% CIs while adjusting for sociodemographic factors and comorbidities. The first-generation study included a total of 1 084 212 deliveries and 68 311 hypertension cases, and the second-generation study included 989 986 deliveries and 67 505 hypertension cases. The fully adjusted HR (with 99% CI) for hypertension in pregnancy among first-generation immigrant women was 0.69 (0.66-0.72), and among second-generation immigrant women, it was 0.88 (0.86-0.91), compared with Swedish-born women with 2 Swedish-born parents. Women born in Finland or with parent(s) from Finland had higher risks, with fully adjusted HRs (99% CIs) of 1.30 (1.18-1.43) and 1.12 (1.07-1.17), respectively. Both first- and second-generation immigrant women had overall lower risks of hypertension in pregnancy compared with other Swedish women. However, the risk reduction was less pronounced in second-generation compared with first-generation immigrant women, suggesting that environmental factors in Sweden may have an important influence on risk of hypertension during pregnancy.

Diabetes risk during pregnancy among second-generation immigrants: A national cohort study in Sweden

Background and aimsGestational diabetes is more common in many first-generation immigrant women in Europe and other Western countries. Less is known about second-generation immigrant women; such knowledge is needed to understand generational influences on diabetes risk. We aimed to study second-generation immigrant women regarding the presence of all types of diabetes during pregnancy. Methods and resultsA cohort study was conducted using the Swedish National Birth Register, the National Patient Register, and the Total Population Register. We used Cox regression analysis to compute hazard ratios (HRs) and 99% confidence intervals (99% CI) for any diabetes during pregnancy and specific subtypes (gestational diabetes, pre-existing diabetes type 1, pre-existing diabetes type 2) in second-generation immigrant women compared with Swedish-born women with two Swedish-born parents while adjusting for sociodemographic factors, family history of diabetes, body mass index, smoking habits, and comorbidities. The study population included a total of 989,986 deliveries and 17,938 diabetes cases. The fully adjusted HR (with 99% CI) for any type of diabetes during pregnancy among second-generation immigrant women was 1.11 (1.05–1.18). Higher risks were found in women with parents from Africa, Asia, or Eastern Europe, as well as Denmark. A lower risk for pre-existing type 1 diabetes was found overall and for women with parents from most geographic regions. ConclusionIn this national cohort study, the risk of all types of diabetes during pregnancy was increased in second-generation immigrant women. Diabetes prevention and treatment is especially important in these women both before and during pregnancy.

‘Pushing or excluding the immigrants wouldn’t help in the learning process, you know’: an intersectional analysis of immigrant women’s higher education experiences

ABSTRACT Despite the diversity and inclusion efforts of higher education institutions, immigrant and minority students frequently experience marginalisation that adversely affects their academic progress. In this article, we examine the under-researched population of immigrant women in Icelandic universities. Drawing on the intersectionality perspective, we focus on how sociocultural differences shape immigrant women’s educational experiences. We explore how power relations and institutional whiteness play roles in either privileging or marginalising particular student populations. The data come from life-story interviews with 16 first-generation immigrant women from Africa, Asia, Europe and South America. We use thematic analysis to show how immigrant women face academic challenges and marginalisation in the forms of othering and (in)visibility based on gender, race, language and religion. Nevertheless, they demonstrate personal agency for their academic progress. The findings underline how discussions on (in)equity in Icelandic higher education would benefit from an intersectional approach.

Incidence of head and neck cancer among first-generation immigrants and their children in Finland

IntroductionLimited data exist regarding head and neck cancer (HNC) burden among immigrants who may have distinct characteristics, and hence different incidence rates from the general population. Variations in behavioral habits, cultural lifestyle, or diet may cause variations across different subgroups.MethodsThe whole immigrant population of Finnish residents born abroad, and their children were retrieved for the years 1970–2017. First-generation immigrants are defined as individuals born abroad, excluding their children (even if born abroad). The study comprised 0.5 million first-generation immigrants and 0.3 million children, contributing to 6 million and 5 million person-years of follow-up, respectively. Standardized incidence ratios (SIR) and excess absolute risk (EAR) per 100,000 person-years at risk were calculated to quantify the risk of HNC among immigrants relative to the general Finnish population.ResultsThe overall risk of any HNC was not increased among first-generation male immigrants (SIR 1.00, 95% CI: 0.88–1.15), but significantly elevated for cancer of the pharynx (SIR 1.56, 95% CI: 1.22–1.95), and larynx (SIR 1.38, 95% CI: 1.02–1.83) and decreased for lip (SIR 0.38, 95% CI: 0.20–0.67). The increased risk of pharyngeal cancer was highest among male immigrants from Asia Pacific (SIR 4.21, 95% CI: 2.02–7.75). First-generation immigrant women had a significantly reduced risk of any HNC (SIR 0.45, 95% CI: 0.37–0.55), which remained even after stratification by site. We observed no increased risk of any HNC among the children of first-generation immigrants.ConclusionHealthcare professionals need to recognize the groups at higher HNC risk. Efforts to address the main etiological risk factors, such as smoking, are needed among the selected immigrant populations, that haven’t yet reached similar decreasing trends, as in for example smoking, as the main population.NOVELTY AND IMPACTCurrently, globally, over 280 million people live outside their country of birth. Limited data exist regarding head and neck cancer (HNC) burden among immigrants who may have distinct characteristics and hence different incidence rates from the general population. Immigrant studies can provide novel data by shedding light on risk alterations and the pace of acculturation of different populations.

Experiencing ‘nikah Captivity’ in the West

Abstract Based on interviews with Muslim minority women and Islamic authorities, this article proposes a step-based model for understanding Muslim divorce processes in diaspora. Such processes are highly dependent on individual women’s embedding in gendered geographies of power: The analysis shows that second-generation immigrant women generally are quite easily able to put a full end to unwanted marriages. In contrast, first-generation immigrant women may end up living in yearlong ‘nikah captivity’, unable to have their nikahs (their ‘Muslim marriages’) dissolved, even though they have obtained a divorce under Danish law. When (ex)husbands keep (ex)wives in such nikah captivity, it can be regarded as a type of post-separation violence, facilitated by the migration-induced separation of Muslims from Islamic institutions.

Pregnancy related cultural food practices among Pakistani women in the UK: a qualitative study

Background Food practices are influenced by cultural traditions which continue to be important among immigrant groups in their new homeland, especially during significant life events, such as marriage, pregnancy and funerals, as well as for religious ceremonies and festivities. Aim This study aims to explore pregnancy related food practices among first generation Pakistani women living in the UK. Methods A total of 10 first-generation immigrant women were recruited through a voluntary organisation following a convenience sampling technique and were interviewed. Findings The data revealed that the women attached different symbolic meanings to their food practices, particularly relating to pregnancy. These findings were based on 1) their understanding of the changes their body experienced during pregnancy and 2) responding to these changes through the consumption and/or avoidance of certain foods. Conclusion Understanding the cultural contexts of Pakistani women in the UK is important in order to promote healthy food patterns for that cohort during pregnancy.

Facilitators and Barriers to Healthy Midlife Transition among South Asian Immigrant Women in Canada: A Qualitative Exploration.

Background: South Asian immigrant women make up the largest visible minority in Canada, where visible minorities include persons, other than Aboriginal peoples, who are non-Caucasian in race or non-white in colour, and approximately half of these women are above the age of 35. Few studies have investigated the factors that impact the midlife transition for these women. This study aims to identify the facilitators and barriers experienced by South Asian immigrant women during the midlife transition. Methods: Two focus groups and ten one-on-one interviews about the midlife transition were held with South Asian first-generation immigrant women in the Greater Toronto Area, Ontario, Canada; discussions were analyzed thematically. Findings: Personal facilitators to the midlife transition included being employed and possessing adequate life skills. Personal barriers consisted of financial strain, overwhelming demands, and limited life skills. Familial facilitators were stable financial status and support. Familial barriers included limited understanding and support and high expectations. Community facilitators included a close social circle and adequate healthcare. Community barriers were limited social support and cultural expectations. Fair and respectful societies were a facilitator, whereas inadequate policy support and acculturative stress were societal barriers. An environmental barrier was the colder Canadian climate. Discussion: Employment and education programs for South Asian immigrant women need to be prioritized to help them integrate into society. Family-centred assessment and education can improve familial support. Communities need to foster peer support groups and culturally sensitive healthcare. Social and employment policies should accommodate the midlife transition. Conclusions: South Asian immigrant women experience unique facilitators and barriers to their midlife transition that should be considered by healthcare providers, policymakers and society to support them.

Abstract C080: A successful culturally tailored intervention to empower low-income Asian American women to conduct human papillomavirus self-sampling test

Abstract Background: Asian American women face disproportionate burden of cervical cancer (CC) than do non-Hispanic white women in the United States. Human papillomavirus (HPV) screening rates are still relative low among first-generation immigrant women and those with low socioeconomic status. Self-sampling for HPV is a convenient and cost-effective way to increase screening, especially among the low-income and underserved populations. This study aims to assess the impact of a culturally-tailored intervention to promote HPV self-sampling among low-income Asian American women. Methods: We adopted the community-based participatory research (CBPR) approach to conduct this efficacy study. A total of 156 female participants from three ethnic groups, Chinese (56), Korean (50), and Vietnamese (50) were recruited from community-based organizations (CBOs) such as churches and community centers in the greater Philadelphia metropolitan area. All participants received educations on HPV symptoms, transmissions, and screening, through workshops and group discussions at the CBOs. The workshops included handouts, lectures, and a demonstration on conducting a self-sampling HPV test in Chinese, Korean, and Vietnamese languages. Participants were also given self-sampling kits and were contacted 30 days post intervention (booster contact). Results: The majority of the sample was Asian American women with low annual household income (62.3% earned less than $20,000) and low educational attainment (61.3% without a college degree). We used paired sample t-tests to assess the differences between baseline and post-intervention for knowledge, social support, self-efficacy, and comfortability conducting a HPV self-sample test. We found significant increase in participants’ knowledge on HPV (baseline: 2.83, post: 4.89, p <0.001), social support (baseline: 3.91, post: 4.09, p <0.001), self-efficacy (baseline: 3.05, post: 3.59, p <0.001), and comfortability conducting a HPV self-sample test (baseline: 3.62, post: 4.06, p <0.001). Within 6 months post intervention, all (100%) participants completed the HPV self-sampling test and returned the kits, which were then sent to the lab for analysis. Conclusion: To the best of our knowledge, this is the first intervention to promoted HPV self-sampling among Asian American women. Our findings showed that culturally tailored messages and hands-on demonstrations of the self-sampling kits were highly effective in empowering low-income Asian immigrant women to conduct HPV self-sampling tests. Acknowledgement This study is partially supported by the faculty research funds under the Center for Asian Health, Temple University (PI: Grace X. Ma, PhD). It is also partially supported by the grant of U54 CA221704(5) funded by the National Cancer Institute (NCI) of NIH (Contact PIs: Grace X. Ma, PhD and Olorunseun O. Ogunwobi, MD, PhD). The contents of this abstract are solely the responsibility of the authors and do not necessarily represent the official views of NIMHD or the NCI, NIH. Citation Format: Grace X Ma, Shumenghui Zhai, Lin Zhu, TImmy Lin, Yin Tan, Carolyn Fang, Jerome L Belinson, Minqi Wang. A successful culturally tailored intervention to empower low-income Asian American women to conduct human papillomavirus self-sampling test [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C080.

Perceived Challenges and Unmet Primary Care Access Needs among Bangladeshi Immigrant Women in Canada.

Introduction:Understanding barriers in primary health care access faced by Canadian immigrants, especially among women, is important for developing mitigation strategies. The aim of this study was to gain an in-depth understanding of perceived challenges and unmet primary health care access needs of Bangladeshi immigrant women in Canada.Methods:In this qualitative study, we conducted 7 focus groups among a sample of 42 first-generation immigrant women on their experiences in primary health care access in their preferred language, Bangla. Descriptive analysis was used for their socio-demographic characteristics and inductive thematic analysis was applied to the qualitative data.Results:The hurdles reported included long wait time at emergency service points, frustration from slow treatment process, economic losses resulting from absence at work, communication gap between physicians and immigrant patients, and transportation problem to go to the health care centers. No access to medical records for walk-in doctors, lack of urgent care, and lack of knowledge about Canadian health care systems are a few of other barriers emerged from the focus group discussions.Conclusions:The community perception about lack of primary health care resources is quite prevalent and is considered as one of the most important barriers by the grassroots community members.

1581-P: Increase of Diabetes and Obesity among Descendants of First-Generation Filipino Immigrants to Italy

Aims: Filipino people are one of the largest immigrant populations in Italy. Aim of this study was to assess differences in T2D, prediabetes and obesity between native Italians and Filipino immigrants living in Rome. Changes in metabolic characteristics and dietary habits between first-generation immigrants and their descendants were examined. Methods: A cross-sectional survey was carried out adopting principles of community-based participatory research. A total of 132 first-generation Filipinos aged 35-60 years resident in Rome for ≥ 5 years, 164 age and sex-matched native Italians and 27 descendants of the first-generation immigrants aged 10-18 years were studied. Diabetes history and dietary habits were investigated by standardized questionnaires; anthropometrics, blood pressure and fasting capillary blood glucose were measured. Results: T2D, impaired fasting glucose and obesity were all more prevalent among first-generation immigrants (13.5%, 35.4% and 41.7% respectively) than Italians (7.2%, 22.6% and 36.8%). Descendants showed higher prevalence of overweight and obesity (48.1%) than first-generation immigrants (p<0.05). First-generation immigrants consumed traditional food more days per week compared to their descendants, who preferred western food, with a large consumption (>4 times/week) of eggs (96%), processed meat (74%) and sweet foods or beverages (96%). Body Mass Index was directly related to years spent in Italy (r=0.19, p=0.03) and educational level (r=0.19, p=0.04). Size of household was directly related to weight gain in first-generation immigrant women (r=0.40, p<0.001). Conclusion: This survey reveals a higher prevalence of diabetes and its risk factors among the Filipino community resident in Rome. Obesity prevalence is higher in the second-generation, probably due to unhealthy changes in dietary pattern. These alarming data stress the need of appropriate health programs addressed to the minority groups immigrating in western countries. Disclosure S. Pieralice: None. R. Del Toro: None. Y. Khazrai: None. E. Maddaloni: Speaker's Bureau; Self; Merck & Co., Inc., Pikdare. A. Maurizi: Consultant; Self; AstraZeneca. S. Manfrini: None. P. Pozzilli: None.

First-generation immigrant women faculty’s workplace experiences in the US universities—examples from China and Taiwan

Abstract Higher education institutions around the world have striven to recruit ‘the world’s best and brightest’ faculty to enhance their scientific leadership and innovation, and American colleges and universities recognize their responsibilities to promote international intellectual exchange and encourage the free flow of ideas, knowledge, and people of all nations.While there is a growing body of literature on foreign-born academics, very little is known about foreign-born women in the US higher educational institutes, despite the fact that an increasing number of women exist in all academic disciplines, especially in STEM fields. By exploring Chinese and Taiwanese immigrant women faculty’s stories, this study aims to partially address the gap in the literature concerning foreign-born women faculty’s workplace experiences in US universities and colleges.

Book Review: Consuming Bollywood: Gender, Globalization, & Media in the Indian Diaspora, by Anjali Ram

Consuming Bollywood: Gender, Globalization, & Media in the Diaspora. Anjali Ram. New York, New York: Peter Lang, 2014. 217 pp. $146.53 hbk. $39.95 pbk.As suggested by the title, Anjali Ram explores the intimate connection between the consumption of Bollywood films and the practice of identity formation among women living in diaspora in Consuming Bollywood. Specifically, Ram examines how notions of gender, nation, culture, and tradition are presented in popular Bollywood films as well as how they are known, negotiated, and challenged by the women who watch these films in their own construction of belonging. This is accomplished through textual analysis, participant observation, and in-depth interviews with both first-generation immigrant women and second-generation American women. As a professor of global communication at Roger Williams University, Ram brings much experience and insights to this project.Ram begins her book by devoting the first two chapters to laying a foundation of knowledge. She synthesizes major theoretical contributions from the fields of media studies, cultural studies, and anthropology that are relevant to the study of diaspora media audiences. Although this task is indeed a great and vast one, Ram manages to succinctly explicate concepts while also offering explanation for application. She draws heavily from Stuart Hall's works and studies from other Bollywood scholars, but readers will also find the research of renowned feminist and anthropology scholars.The subsequent chapters follow a pattern of combined literature review and analysis. At times, Ram will more thoroughly explore historical/cultural events or possibly introduce new concepts before delving into her analysis (making for a lengthy review) whereas at other times she simply reminds readers of key concepts or previous findings. Regardless, her transitions are seamless and logical, providing readers with just the right amount of knowledge to understand her arguments. The author also frequently combines her methods in chapters, which brings nuance and complexity to her thesis. Indeed, the book shines brightest as an example of well-executed qualitative research.The results of Ram's study are clear and multiple, contributing greatly to our understanding of how the media affects the construction of a gendered, transnational identity, specially located within the diaspora. Through interviews with immigrant women, Ram discovers how their consumption on Bollywood films is used to reinforce ideas about Indian (read: Northern Indian, Hindu) cultural values and thus establish a dichotomy between home culture and host culture, to re-affirm their Indian-ness by keeping up with the latest trends (e.g., fashion, music, or pop culture), and to serve as a place to combat feelings of alienation or isolation by offering a generalized and romanced India as something familiar. The author supports these findings through her participant observations of community events and textual analysis of Bollywood film. …

Acculturation and Sleep among a Multiethnic Sample of Women: The Study of Women's Health Across the Nation (SWAN)

Mexican immigrants to the United States report longer sleep duration and fewer sleep complaints than their US-born counterparts. To investigate whether this effect extends to other immigrant groups, we examined whether the prevalence of self-reported sleep complaints is higher among US-born Hispanic/Latina, Chinese, and Japanese immigrant women compared to their first-generation immigrant ethnic counterparts as well as to US-born whites. We examined whether these associations persisted after adjusting for sociodemographic and health characteristics and whether acculturation mediated the effects. Cross-sectional observational study. Multisite study in Oakland, CA; Los Angeles, CA; and Newark, NJ. Hispanic/Latina (n = 196), Chinese (n = 228), Japanese (n = 271) and non-Hispanic white (n = 485) women (mean age = 46 y, range 42-52 y) participating in the Study of Women's Health Across the Nation (SWAN); 410 or 59.0% of the nonwhites were first-generation immigrants. None. Questionnaires were used to assess sleep complaints, race/ethnicity, immigrant status, language acculturation (use of English language), and sociodemographic and health variables. Approximately 25% of first-generation immigrant women reported sleep complaints compared to 37% of those who were US-born nonwhites and 42% of US-born whites. Multivariable adjusted logistic regression analyses showed that US-born nonwhites had higher odds of reporting any sleep complaints (odds ratio = 2.1, 95% confidence interval [CI] 1.5-3.0), compared to first-generation immigrants. Women with higher levels of language acculturation had greater odds of reporting any sleep complaint compared to those with less language acculturation. Adjustment for language acculturation mediated 40.4% (95% CI 28.5-69.8) of the association between immigrant status and any sleep complaint. When results were stratified by race/ethnicity, significant mediation effects of acculturation were only found for Hispanic/Latina and Japanese women, but not for Chinese women. US-born Hispanic/Latina, Chinese, and Japanese immigrants were more likely to report sleep complaints than their first-generation ethnic counterparts, a finding largely explained by language acculturation and unmeasured factors associated with language acculturation.

TURNING POINTS AND TRANSITIONS: THE ROLE OF FAMILY IN WOMEN’S IMMIGRATION EXPERIENCES

Given the significant number of immigrants in the United States, especially immigrant families with young children, there is a need to better understand the experiences of immigrant women, and especially immigrant mothers. In particular, the factors impacting women’s decisions to migrate, migration journeys, and post-migration adjustment should be examined. Framed in family life course theory and using ethnographic, in-depth interviews, we explored these three immigration phases for 40 first-generation Latina and African immigrant women who experienced motherhood in the U.S. Results of the study expand the literature focused on immigration experiences by considering turning points and transitions in women’s migration processes, as they are shaped by both micro- (family) and macro- (socio-historical) level factors. The findings illustrate the spontaneous nature of some decisions to migrate, as well as how immigration journeys are influenced by the financial and physical supports of families and the status of their documentation. In addition, study findings point to motherhood as an important turning point for first-generation immigrant women in their adjustment to life in the U.S., and particularly in their planning with respect to staying long term. Implications for programs, policy, and future research are discussed.

Ethnic identity, majority norms, and the native–immigrant employment gap

Earlier studies do not agree on whether ethnic identity, i.e., immigrants’ attachment to the home country and the host country, can explain lower employment outcomes among immigrants. This study investigates the relationship between employment and ethnic identity and complements the literature by capturing a novel dimension of ethnic identity: openness to majority norms. Reproducing measures from earlier studies, I find that immigrants’ employment outcomes do not systematically associate with their ethnic identity. However, immigrants who share social norms with the majority experience significantly better employment outcomes, particularly first-generation immigrant women. Furthermore, I show that interethnic differentials in majority norms could account for up to 20 % of the explained part of the employment gap between natives and first-generation immigrants. Those results shed more light on the interethnic employment gap and aspects of immigrants’ identity relevant to economic integration.

Is There Migration-Related Inequity in Access to or in the Utilisation of Health Care in Germany?

This paper analyses immigrants' access to health care and utilisation of health care services in Germany. Thereby, it is investigated if there is inequity in access to or in the utilisation of health care services due to a lack of language skills or due to a lack of information about the health care system (approximated by years since migration) among first- and secondgeneration immigrants. The data used are drawn from eleven waves of the SOEP (1995-2006). With regard to the probability to contact a physician (as a proxy for access), German language skills are found to have no significant influence for all groups of immigrants. The hypothesis of inequity in access to health care due to access barriers caused by a lack of German language skills is therefore not supported by the data. However, mother tongue language skills seem to be important for the contact probability of the first- and secondgeneration: Having only good or poor mother tongue language skills reduces the probability of a doctor contact. The effect is found to be significant for first- and second-generation men. For the frequency of doctor visits (utilisation), poor German language skills are found to exert a significant influence: Those reporting poor language skills have a lower expected number of doctor visits. The effect is found to be significant for first-generation men and for secondgeneration men and women. Hence, there seems to be inequity in health care utilisation due to a lack of German language skills. With the exception of first-generation men - where it is found that poor mother tongue language skills reduce the expected number of doctor visits significantly, no significant effect is found for mother tongue language skills. With regard to the duration of residence, the results indicate that years since migration have an impact on the contact decision of first-generation immigrant women, whereby a significant positive influence is found. Hence, missing knowledge about the health care system could create additional access barriers and yield inequity in access to health care in the group of firstgeneration women. The duration of residence seems to have no influence on the frequency decision.

Coronary heart disease risks in first‐ and second‐generation immigrants in Sweden: a follow‐up study

To analyse whether there is an association between country of birth in first-generation immigrants and first hospitalization for or death from coronary heart disease (CHD) and to analyse whether this association remains in second-generation immigrants. In this follow-up study, the MigMed database at the Karolinska Institute, Stockholm, was used to identify all hospital diagnoses of and deaths from incident CHD in first- and second-generation immigrants in Sweden between 1 January 1987 and 31 December 2001. Incidence ratios standardized by age, geographical region and socio-economic status were estimated by sex in first- and second-generation immigrants; the reference group was Swedish-born people whose parents were both born in Sweden. The total Swedish population aged 25-69 years. First-generation immigrants from Finland, central European countries, other eastern European countries and Turkey had higher rates of CHD than men or women in the reference group. First-generation immigrant women born in southern Europe, other western European countries and Baltic countries had lower CHD risks than the reference group. Sons of both male and female first-generation immigrants showed CHD risks similar to or slightly higher than those of their parents. Amongst second-generation women, only subjects with Finnish fathers or mothers had higher risks of developing CHD than the reference. Increased risks of CHD found in some first-generation immigrant groups often persist in second-generation immigrant men. Healthcare professionals and policy makers should take this into account when designing and undertaking measures to prevent CHD.

Non-Mainstream Education, Limited Mobility, and the Second Generation of Moroccan Immigrant Women: The Case of the Kindergarten Teacher's Assistant

"What do you do?" I asked Miriam, a forty-year-old second-generation Moroccan immigrant woman in Israel. "I am in education." "Are you a teacher?" "No," she answered. "Are you a principal in a school?" "No. I am a kindergarten teacher's assistant," she replied proudly. Miriam's self-definition as an educator reveals an alternate strategy by which second-generation immigrant women can conform to the hegemonic cultural norm of upward educational and occupational mobility, characteristic of Israeli society and of modernity in Western societies. Israeli society recognizes this strategy through the granting of semi-professional status by means of credentials to certain roles—in this case, the role of the kindergarten teacher's assistant. Many studies have noted that the first generation of North African immigrants to Israel, the majority of whom were from Morocco,1 possessed lower levels of education and occupational-professional skills than the European immigrants. They became clustered in the low-income strata, while the Europeans became clustered in the middle and upper-income strata. Thus, an ethnic stratification evolved between these two groups, in which those of European ethnic origin became the superordinate status group, while those of North African origin became the subordinate status group. This was equally true for the women in these two ethnic groups.2 More recent studies on the daughters [End Page 50] of these women, the second generation, show that the socio-economic differences between the women in these two ethnic groups have persisted, if not increased.3 However, studies have also revealed that approximately one third of those belonging to the North Africans groups, Moroccans among them, have accomplished upward mobility into the middle class.4 In spite of this, little research has focused on women within the second generation of Moroccan immigrants who are upwardly mobile, or on how they have achieved their mobility. The purpose of this paper is to serve as a corrective to this neglected topic. It is a case study of a second-generation Moroccan immigrant woman, Miriam, who accomplished limited upward mobility by moving out of the physical labor working class of her immigrant parents and into a semi-professional status. While this semi-profession provided only a low income and little opportunity for advancement, it offered symbolic rewards of status and prestige that compensated somewhat for the low material reward. Miriam achieved this mobility by using a particular non-mainstream type of educational structure consisting of a two-year course and continuing courses. This granted her semi-professional accreditation and increased her educational qualifications, providing an institutionalized path for her mobility. Research on immigrant women in Western capitalist societies and in Israel has shown that first-generation immigrant women, generally those with low human capital, have used entrepreneurship as an alternate strategy to educational attainment in order to accomplish upward mobility.5 The present case study shows how second-generation Moroccan immigrant women, typified by Miriam, can use education acquired through a non-mainstream educational structure as another alternate strategy to accomplish such mobility. I argue that the importance of non-mainstream education in relation to second-generation immigrant women's mobility lies in the options it provides for accomplishing upward mobility. The expansion of various types of educational opportunities for "mature" and "non-traditional" groups of students in Western capitalist societies and in Israel6 has increased the opportunities for second-generation immigrant women to use diverse educational structures as a means of accomplishing occupational mobility. In Israeli society, Moroccan immigrant women of the second generation have by now reached mid-life and, probably, their maximum mobility attainments. This enables us to study the mobility outcomes of their use of the non-mainstream structure of education. [End Page 51] Mainstream and Non...

Immigration, the Family, and Female Caregivers in Australia

Immigration in the United States increased dramati- cally during lhe 1980s but its meaning for the field of aging has not been fully explored. This article explores the impact of immigration on first-generation immigrant women in Australia who are providing care for their parents. The women are from a variety of European and Asian countries. They must not only provide care for their par- ents but must also mediate conflicts between their parents, their spouse, and their children. The intergenerational issues found in this s~tuation have implications for social work services in the United States.