Immigration-related Variables Research Articles

Sociocultural determinants of children's oral health among immigrants in Canada.

A conceptual model was designed and tested to predict immigrant children's oral health in Canada by examining parental acculturation and perceived social support (PSS) using structural equation modelling. A convenience sample of first-generation immigrant parents and their children aged 2-12 years were recruited by multilingual community workers in Edmonton, Canada. Parents completed a validated questionnaire on demographics, child's oral health (OH) behaviours, parental acculturation and PSS. Dental examinations determined children's dental caries rate using DMFT/dmft index. Structural equation modelling (SEM) was used to analyse the data. A total of 336 families participated in this study. The average parental acculturation level was 10.46 with a maximum of 15, and the average PSS was 63.27 with a maximum of 75. SEM showed that 77% of the variance of DMFT/dmft scores in children was explained by parental PSS, acculturation level, immigration-related variables, socioeconomic variables and children's OH behaviours. The direct effect of parental PSS was associated with a significantly reduced rate of dental caries (β = -.076, p-value = .008) and lower sugar consumption (β = -.17, p-value = .04). While the mediation effect of parental acculturation on PSS was associated with positive OH behaviours of children (e.g., toothbrushing frequency and dental care utilization), the indirect effect was negatively associated with caries rate (β = .77, p-value = .00). The direct effect of Parental Perceived Stress Scale (PSS) was associated with more favourable oral health behaviours and a lower prevalence of dental caries, while the mediation effect of acculturation was linked to a higher prevalence of dental caries.

Interbirth Intervals of Immigrant and Refugee Women in the United States: A Cross-Sectional Study.

Despite guidelines recommending an interval of at least 18-24 months between a live birth and the conception of the next pregnancy, nearly one-third of pregnancies in the United States are conceived within 18 months of a previous live birth. The purpose of this study was to examine the associations between multiple immigration-related variables and interbirth intervals among reproductive-aged immigrant and refugee women living in the United States. This was a cross-sectional, quantitative study on the sexual and reproductive health (SRH) of reproductive-aged immigrant and refugee women in the United States. The data were collected via an online survey administered by Lucid LLC. We included data on women who had complete information on nativity and birth history in the descriptive analysis (n = 653). The exposure variables were immigration pathway, length of time since immigration, and country/region of birth. The outcome variable was interbirth interval (≤18, 19-35, or ≥36 months). We used multivariable ordinal logistic regression, adjusted for confounders, to determine the factors associated with having a longer interbirth interval among women with second- or higher-order births (n = 245). Approximately 37.4% of study participants had a short interbirth interval. Women who immigrated to the United States for educational (aOR = 4.57; 95% CI, 1.57-9.58) or employment opportunities (aOR = 2.27; 95% CI, 1.07-5.31) had higher odds of reporting a longer interbirth interval (19-35 or ≥36 months) than women born in the United States. Women born in an African country had 0.79 times the odds (aOR = 0.79; 95% CI, 0.02-0.98) of being in a higher category of interbirth interval. Although all birthing women should be counseled on optimal birth spacing through the use of postpartum contraception, immigrant and refugee women would benefit from further research and policy and program interventions to help them in achieving optimal birth spacing. SRH research in African immigrant and refugee communities is especially important for identifying ameliorable factors for improving birth spacing.

Anxiety and depressive symptoms among people from the Micronesian region in Hawaiʻi

ABSTRACT People from the Micronesian region represent one of the fastest growing migrant groups in the U.S., but little is known about their mental health. Research using respondent-driven sampling of 486 Micronesians living in Hawaiʻi was conducted to explore demographics, immigration-related variables, and connections to the Micronesian community and their association with anxiety and depression. Results show that connection to the Micronesian community was related to lower likelihood of experiencing probable anxiety, while depression was not as closely associated with demographic, immigration, or community connection variables. These findings suggest that interventions enhancing cultural pride and connection may be an effective tool to support Micronesians at risk for or experiencing anxiety.

Population aging, migration, and productivity in Europe

This paper provides a systematic, multidimensional demographic analysis of the degree to which negative economic consequences of population aging can be mitigated by changes in migration and labor-force participation. Using a microsimulation population projection model accounting for 13 individual characteristics including education and immigration-related variables, we built scenarios of future changes in labor-force participation, migration volumes, and their educational composition and speed of integration for the 28 European Union (EU) member states. We study the consequences in terms of the conventional age-dependency ratio, the labor-force dependency ratio, and the productivity-weighted labor-force dependency ratio using education as a proxy of productivity, which accounts for the fact that not all individuals are equality productive in society. The results show that in terms of the more sophisticated ratios, population aging looks less daunting than when only considering age structure. In terms of policy options, lifting labor-force participation among the general population as in Sweden, and education-selective migration if accompanied by high integration, could even improve economic dependency. On the other hand, high immigration volumes combined with both low education and integration leads to increasing economic dependency. This shows the high stakes involved with integration outcomes under high migration volumes.

The Association of Acculturation with Overt and Covert Perceived Discrimination for Older Asian Americans

AbstractAsian older adults are a fast-growing population in the United States. Because Asian older adults are a largely immigrant population, acculturation has an impact on their perceived discrimination, which is negatively associated with health and mental health. Discrimination can be overt, characterized by distrust and direct messages that are hostile and exclusionary, or covert, characterized by unfair treatment and messages that are negative and degrading. This study investigates the association of acculturation with perceived overt and covert discrimination, measured by the Everyday Discrimination Scale, with a sample of 348 foreign-born older Asian Americans from the National Latino and Asian American Study. Acculturation was measured by English-speaking ability, immigration-related variables, and ethnic identity. Results indicated that perceived covert discrimination was more prevalent than overt discrimination among older Asians. Among acculturation variables, only citizenship was associated with higher perceived covert and overt discrimination. Identifying with the same race was associated with higher covert discrimination. Findings suggest that higher acculturation is associated with greater exposure to discrimination for Asian older adults. Efforts to increase access and utilization of social and health-related services should consider the context of older Asians’ experiences as a discriminated immigrant group in the United States.

POSITIVE AND NEGATIVE SOCIAL INTERACTIONS ON MENTAL HEALTH IN OLDER KOREAN AMERICANS: GENDER DIFFERENCES

While there is substantial documentation of a positive relationship between objective social engagement and mental health, relatively little is known about how perceived quality of social interactions affects mental health and how men and women differ. Considering the gap, the purpose of this study was to investigate gender difference in how social interactions associate with self-rated mental health in older Korean Americans. Data came from a survey with older Korean Americans aged 60 or over that included 713 men and 1437 women living in five sites (California, New York, Texas, Hawaii, and Florida), conducted during 2017−2018. In multiple regression models run separately for men and women, self-rated mental health on a five-point scale (excellent/very good/good/fair/poor) was regressed on four blocks of variables: socio-demographic characteristics (age, marital status, education, financial status, self-rated health, and region), immigration-related variables (length of stay in the U.S. and acculturation), social engagement (family network, friend network, and activity participation), and perceived quality of social interactions (positive or negative family interactions and negative community interactions). In the final models with all covariates, younger age, more years in education, better physical health, higher levels of acculturation, and more positive family interactions were commonly associated with more positively rated mental health for both men and women. For women, stronger family network and fewer negative family interactions were additional contributors. Results suggest that negative and positive indicators of family interactions differentially affect self-rated mental health for older Korean American men and women.

Willingness to Use a Nursing Home in Asian Americans.

This study explores factors associated with willingness to use a nursing home in Asian Americans. Focus is given to demographic variables (age, gender, ethnicity, marital status, and education), health-related variables (chronic medical condition and self-rated health), immigration-related variables (time in the U.S. and acculturation), and family-related variables (family network and family solidarity). Cross-sectional study. Data were drawn from2551 participants in the 2015 Asian American Quality of Life Survey (aged 18-98). Participants were asked to indicate whether they would be willing to use a nursing home in the future. An affirmative response indicated a personal willingness to use a nursing home. Approximately 38% of the sample demonstrated willingness to use a nursing home. Higher odds for willingness were observed among those with advanced age, female gender, Korean ethnicity (compared with Chinese), better education, presence of a chronic medical condition, longer years of residence in the U.S., and lower levels of family solidarity. Reflecting the current trend of an increase in racial/ethnic minorities in nursing homes, a substantial proportion of the present sample of Asian Americans demonstrated willingness to use a nursing home. Findings on the factors associated with willingness provide implications for policies and services to respond to the long-term care needs of this emerging population.

ORAL HEALTH AND DENTAL CARE IN OLDER ASIAN AMERICANS

Responding to the paucity of information on oral health and dental care in older Asian Americans, the present study examined the status and factors associated with dental health insurance, self-rated oral health, and use of preventive dental service. Data were driven from 533 older adult participants (aged 60 and older) in the 2015 Asian American Quality of Life Survey conducted in Central Texas. The criterion variables of interest were selected based on the Andersen’s behavioral model of health services: enabling (dental health insurance), needs (self-rated oral health), and utilization (use of preventive dental service) variables. Using a sequential design, the predictive model of each outcome was built, and sociodemographic and immigration-related variables were used as common covariates. More than 60% of the sample had no dental insurance, 45% reported that their oral health was either fair or poor, and 44% had not had dental check-up in the past 12 months. A series of logistic regression analyses identified the factors posing a significant risk to oral health and dental care. For example, those who had limited English proficiency were three times more likely to lack dental health insurance (enabling) and to have a fair/poor rating of oral health (needs). The odds of not using preventive dental service (utilization) were six times higher among those with no dental insurance coverage (enabling). The overall findings demonstrate substantial inequality in oral health and dental care outcomes in older Asian Americans and suggest strategies to promote their access to dental services.

Hospital stays for hepatitis B or C virus infection or primary liver cancer among immigrants: a census-linked population-based cohort study.

The recent increase in the incidence of primary liver cancer in Canada has been attributed to a higher proportion of immigrants from countries endemic for hepatitis B virus (HBV) and hepatitis C virus (HCV). We examined hospital discharges for liver disease in Canada, focusing on those for all liver-related diseases, HBV infection, HCV infection and primary liver cancer, by 3 immigration-related variables: immigration status, duration of residence in Canada and risk level of the source country. We calculated annualized crude and age-standardized rates of a hospital stay in Canada for HBV infection, HCV infection, primary liver cancer and all liver-related diseases using data from the 2006 Canadian census (long form) linked to the Canadian Institute for Health Information Discharge Abstract Database for fiscal years 2006/07 to 2008/09. We estimated the odds of a hospital stay using logistic regression for the 3 immigration-related variables, adjusting for sociodemographic indicators. Immigrants were less likely than Canadian-born residents to be discharged with a diagnosis of any liver-related condition (odds ratio [OR] 0.83, 95% confidence interval [CI] 0.78-0.89); however, they were more likely to be discharged with a diagnosis of HBV infection (OR 2.02, 95% CI 1.57-2.60) and primary liver cancer (OR 1.43, 95% CI 1.22-1.68). There was a clear association between a hospital stay for HBV infection and immigration from HBV-endemic countries (OR 5.15, 95% CI 3.87-6.84) and between a stay for HCV infection and immigration from HCV-endemic countries (OR 2.98, 95% CI 1.74-5.11). Adjustment for low income status and urban residence did not change the results. Although the odds of a liver-related hospital stay were lower among immigrants than among those born in Canada, immigrants from countries at high risk for HBV infection, HCV infection and primary liver cancer were more likely than Canadian-born residents to have a corresponding liver-related hospital stay. These findings emphasize the importance of identifying immigrants with hepatitis and engaging them in care to prevent complications.

Falling Through the Cracks: Lack of Health Insurance Among Elderly Foreign- and Native-Born Blacks.

Little research examines lack of health insurance among elderly Black immigrants in the US. We use data from the 2008 American Community Survey to describe variation in insurance coverage and conduct multivariate logistic regression analyses of uninsurance. Among elderly Blacks, 1.7% of the US-born were uninsured, compared to 8.4% of the Latin American and Caribbean-born, 23.2% of the African-born, and 9.3% of those born in other regions. In multivariate models, relative to the US-born, the odds of being uninsured were significantly higher among each immigrant group. Among immigrants, the odds of being uninsured were 3.80 times higher among African-born than Latin American and Caribbean-born immigrants net of demographic and socioeconomic controls. This difference was explained by the inclusion of either year of immigration or length of residence. Relative to Latin America and Caribbean-born immigrants, the odds of being uninsured were significantly higher among immigrants from "other" regions only in the model that included the immigration-related variables. This suppression effect was evident when either length of residence or citizenship was controlled. Recently-arrived, elderly Black immigrants fall through the cracks of insurance coverage. Results are discussed in relation to public and private safety net options.

Immigration and loneliness in later life

ABSTRACTAlthough the loneliness of both older adults and immigrants is frequently asserted, knowledge regarding the implications of immigration for loneliness in later life is limited. In particular, little attention has been directed to the impact of factors that might differentiate individuals within the immigrant population. Using data from the 2007 General Social Survey (GSS-21) conducted by Statistics Canada, this study examined the effects of immigrant status as well as immigrant generation, length of residence in Canada and race/ethnicity on loneliness among adults aged 60 and over (N=10,553). Regression analyses (ordinary least squares) estimating both the general and age-specific effects of immigrant experience on loneliness, indicated that immigrants report higher levels of loneliness than native-born Canadians, that race/ethnicity influenced loneliness particularly among immigrants and that generational status as well as length of residence also had an impact, but one that differed across age groups. Immigration-related variables appeared less consequential for loneliness in the oldest-old (aged 80+) than in younger elderly age groups. These findings attest to the significance of immigrant status for an understanding of loneliness in later life but suggest a need to acknowledge the diversity of immigrant experiences associated with lifecourse and other factors.

The effect of immigrant generation and duration on self-rated health among US adults 2003–2007

Global self-rated health (SRH) is increasingly a key indicator in the assessment of immigrant health. However, evidence of the impact on SRH of generational status, duration of residence in the US, and socioeconomic status (SES) among immigrants and their offspring is limited and inconsistent. We overcome limitations in existing research on this topic by using a uniquely large and diverse data source, the March Annual Social and Economic Supplement of the Current Population Survey (CPS; 2003-2007) (n = 637,209). As a result, we are able to disaggregate results by race/ethnicity, account for country of origin, and consider the role of multiple dimensions of SES. We find that overall first-generation immigrants in the US have lower odds of poor/fair SRH compared to the third-generation. This association is particularly strong for blacks and Hispanics but not significant for Asians. Among first-generation Asians and Hispanics, longer duration of residence is positively associated with poor/fair SRH. Finally, socioeconomic gradients in SRH tend to be less pronounced among the first-generation (versus the third) and, within the first-generation, among recent arrivals (versus those with longer durations). Our results highlight the importance of explicitly accounting for multiple immigration-related variables and their interactions with race/ethnicity and SES. Otherwise, studies may misestimate SRH differences by race/ethnicity and socioeconomic status. The continued growth of the US immigrant population and the second-generation underscore the need to examine patterns in immigrant health systematically.

Toward a Dynamic Conceptualization of Social Ties and Context: Implications for Understanding Immigrant and Latino Health

Researchers have posited that social ties and social support may contribute to better-than-expected health outcomes among Mexican immigrants vis-à-vis their US-born counterparts. However, in our review of studies examining social ties and health by immigration-related variables among this group, we found little support for this hypothesis. To better understand the social factors that contribute to the health of Mexicans in the United States, we conducted a qualitative analysis of social relationships and social context among first- and second-generation Mexican women. Our results highlight the interplay between immigration processes and social ties, draw attention to the importance of identity support and transnational social relationships, and suggest ways to reconceptualize the relationship between social contexts, social ties, and immigrant and Latino health.

Associations of Doctor-Diagnosed Asthma with Immigration Status, Age at Immigration, and Length of Residence in the United States in a Sample of Mexican American School Children in Chicago

Among Mexican Americans in the United States, children who were born in the US had higher rates of asthma than their Mexico-born peers. The purpose of this study was to examine the associations of doctor-diagnosed asthma with immigration-related variables and to investigate whether these associations could be explained by factors that may change with migration. We surveyed parents of 2,023 school children of Mexican descent and examined the associations of asthma with nativity, age at immigration, and length of residence in the US after adjusting for potential confounding variables. In multivariate analyses, US-born children had a 2.42-fold (95% confidence interval [CI]: 1.52-3.83) increased odds of asthma compared with their Mexico-born peers. Mexico-born participants who moved to the US before 2 years of age were almost twice as likely to experience asthma compared with Mexico-born children who moved to the US >or=2 years of age. In addition, Mexico-born participants who lived in the US for 10 years or more were 2.37 times more likely to have asthma than Mexico-born students who lived in the US for less than 10 years. These associations were not explained by a wide variety of factors such as place of residence in infancy; exposure to animals/pets; history of infections, Tylenol use, and antibiotic use in infancy; breastfeeding; exposure to environmental tobacco smoke; daycare attendance and number of siblings; and language use. Our findings point to the effects of nativity, age at immigration, and duration of residence in the US on the risk of asthma in Mexican American children, suggesting that potentially modifiable factors that change with migration may be linked with the disease. The findings of this study should stimulate further research to explain factors that may be responsible for the observed differentials in the risk of asthma among Mexican Americans.

Associations of Doctor-Diagnosed Asthma with Immigration Status, Age at Immigration, and Length of Residence in the United States in a Sample of Mexican American School Children in Chicago

Objectives. Among Mexican Americans in the United States, children who were born in the US had higher rates of asthma than their Mexico-born peers. The purpose of this study was to examine the associations of doctor-diagnosed asthma with immigration-related variables and to investigate whether these associations could be explained by factors that may change with migration. Methods. We surveyed parents of 2,023 school children of Mexican descent and examined the associations of asthma with nativity, age at immigration, and length of residence in the US after adjusting for potential confounding variables. Results. In multivariate analyses, US-born children had a 2.42-fold (95% confidence interval [CI]: 1.52–3.83) increased odds of asthma compared with their Mexico-born peers. Mexico-born participants who moved to the US before 2 years of age were almost twice as likely to experience asthma compared with Mexico-born children who moved to the US ≥2 years of age. In addition, Mexico-born participants who lived in the US for 10 years or more were 2.37 times more likely to have asthma than Mexico-born students who lived in the US for less than 10 years. These associations were not explained by a wide variety of factors such as place of residence in infancy; exposure to animals/pets; history of infections, Tylenol use, and antibiotic use in infancy; breastfeeding; exposure to environmental tobacco smoke; daycare attendance and number of siblings; and language use. Conclusions. Our findings point to the effects of nativity, age at immigration, and duration of residence in the US on the risk of asthma in Mexican American children, suggesting that potentially modifiable factors that change with migration may be linked with the disease. The findings of this study should stimulate further research to explain factors that may be responsible for the observed differentials in the risk of asthma among Mexican Americans.

Associations of physician-diagnosed asthma with country of residence in the first year of life and other immigration-related factors: Chicago Asthma School Study

Among Mexican Americans in the United States, US-born children have higher rates of asthma than their Mexico-born peers. To evaluate the associations of immigration-related variables with physician-diagnosed asthma in a sample of Mexican American children. We analyzed data from the ongoing Chicago Asthma School Study, a population-based cross-sectional study, for 10,106 Mexican American schoolchildren in Chicago, Illinois. Mexican American children who lived in the United States in the first year of life were more likely to have physician-diagnosed asthma than their peers who lived in Mexico in the first year of life, independent of age, sex, income, language, and country of birth (odds ratio [OR], 1.79; 95% confidence interval [CI], 1.09-2.94). The risk of asthma in US-born children was higher (but not significantly) than that observed in Mexico-born children after accounting for covariates, including country of residence in the first year of life (OR, 1.37; 95% CI, 0.86-2.18). Long-term immigrants (lived in the United States for 10 years) had an increased risk of asthma compared with short-term immigrants (lived in the United States for <10 years), independent of country of residence in the first year of life (OR, 1.93; 95% CI, 1.00-3.73). These findings confirm the importance of early childhood exposures and environmental factors that are modified with migration and acculturation in asthma development.

The Effects on Union Membership of Race and Immigration Status

This study empirically examined the relationship between individuals' race and their union membership status, with particular emphasis on Asian Americans. Using a data set drawn from 14,178 respondents in the March 1996 Current Population Survey, the authors evaluated the predictions of three competing theoretical perspectives-the segmented labor market model, the assimilation model, and the self-protection model-on the union status of Asian Americans. Probit regression results showed that Asians are more likely to join unions than whites. Contrasted to the cases of blacks and whites, immigration-related variables (e.g., length of stay in the United States, naturalized citizens, and foreign nationals) were found to be more significant determinants of union status for Asians than the conventional explanatory variables of union status (e.g., earnings and age). These results are more compatible with the assimilation and the self-protection models than the segmented labor market model.