Large Immigrant Population Research Articles

The direct and indirect impacts of liberal immigration policies on the United States’ economy

Abstract Many studies have suggested that stringent labor protections and higher labor costs can limit foreign direct investment (FDI) in host countries. This would imply that the decisions of foreign firms are sensitive to the degree of flexibility in the labor market in the U.S. The U.S. has a steady stream of immigration, which has preserved the stability of the labor supply for the U.S. market. This makes the U.S. a good test case for the relationship between immigration and FDI because it is not only the largest host for FDI but also has the largest immigrant population in the world in absolute terms and is experiencing a significant reduction in labor supply and an increase in the minimum cost of labor. Utilizing a timeseries analysis of data from 1970 to 2016, this study suggests that expansive immigration policies directly increase FDI inflows in the U.S. and indirectly increase FDI inflows by lowering labor costs and securing a stable supply of labor.

“Fucking Koreans!”: Sexual Relations and Immigration in the Philippines

Abstract Drawn by the tropical weather and pristine beaches, significantly lower cost of living, and proximity, South Koreans are now the top tourists in the Philippines. Besides the short-term tourists, more than 100,000 South Koreans have chosen to permanently reside in the Philippines, making them the largest immigrant population in the country. Recently, a tenuous relationship between these two groups has emerged marked by mutual antipathy. I have overheard many Koreans describe Filipinos as impoverished, lazy, and socially backwards. They appear to have internalized a racial hierarchy whereby they perceive their darker-skinned Asian counterparts as ranking lower on the pigmentocracy scale. Conversely, Filipinos complain incessantly that Korean immigrants and visitors alike are arrogant, rude, and provincial, refusing to learn Tagalog or appreciate, much less respect, local customs. The exclamation, “Fucking Koreans!” has become a familiar refrain by Filipinos in response to being treated as second-class citizens in their own country. This utterance also has a secondary meaning as the one area where Koreans and Filipinos commonly do interact is in the form of sexual relationships.

Beginning to Optimize Peripartum Care for Somalia-Born Women by Evaluating Labor, Postpartum and Neonatal Outcomes in the Somali Population Delivering at a Tertiary Care Center in Vermont.

Vermont has a large population of Somali immigrants and previous research has shown outcome disparities in this population. Labor curves, pregnancy and delivery outcomes information is required and critical to optimize current labor management in an institution that provides obstetrical care for this population. Data were collected for both Somalia-born and non Somalia-born parturients in pre-pregnancy, pregnancy, delivery, neonatal and cervical change categories and were compared to non Somalia-born parturients to observe differences in demographic factors and outcomes as well as labor progress. Overall labor length trended differently between the two groups, the rate of preterm birth in the vaginal delivery group in the Somali population was much lower than the unmatched control group and overall more lacerations were noted. Findings are consistent with prior studies related to reduced preterm birth rate in Somalia-born women. Observation regarding refusal of care demonstrates need for targeted research related to concerns of Somali immigrants.

Advancing Integration: The Social Work Response to Restrictionist U.S. Immigration Policies

ABSTRACT This paper argues that social workers must combat historical misinformation, ethnic-racial bias, and narratives of immigrants as threats to advance integrationist immigration policies and immigrant well-being. First, we draw on aLatinx critical theoretical perspective (LatCrit) to expose the role of U.S. immigration policy in the social construction of a large and oppressed Mexican immigrant population that is partially integrated but not legally recognized. Then, we analyze how restrictionist immigration policies violate social work values and human rights and contrast this with an integrationist approach. We conclude with implications for advocacy for integrationist policies and responses to restrictionist policies.

Abstract P531: Immigrants Prioritize Language Over Geography When Accessing Health Care

Introduction: Nationally, New York City (NYC) has one of the largest immigrant populations and highest gentrification rates. Satellite ethnic enclaves are increasingly prevalent as residents relocate to more affordable neighborhoods. Ethnic immigrant communities already face unique challenges to accessing health care, including linguistic and cultural discordance regarding health-related beliefs and norms. Residence outside of ethnic enclaves may further hinder health care utilization, as culturally appropriate services may become less accessible. Characterization of immigrants visiting doctors’ offices within and outside of ethnic enclaves may inform efforts to retain these populations in care. Hypothesis: We compared immigrants accessing health care within major ethnic enclaves to immigrants accessing care elsewhere to ascertain differences in 1) demographic characteristics; 2) reasons for choosing health care facilities; and 3) distances traveled for health care. Methods: Data were from the 2018 Examining Norms and Behaviors Linked to Eating (ENABLE) Pilot Study. Chinese American participants were recruited using venue-based and snowball sampling methods, with assistance from NYC community-based organizations. Surveys included detailed questions on demographics and health-related factors. Participants were included in the analysis if doctor’s office and home zip code data were available (n=143). Data were analyzed using RStudio v.1.2.5 and STATA v.15.0. Results: The majority of participants saw a Chinatown-based doctor (64%; 92 of 143); and were not Chinatown residents (81%; 116 of 143). A greater number of individuals who saw Chinatown-based doctor had less than a college education; were living with food insecurity; were on public insurance; and were less acculturated. Individuals accessing care in Chinatown prioritized doctor’s offices where doctors and medical staff spoke their language more so than individuals accessing care elsewhere. Overall, people who saw a Chinatown-based doctor traveled significantly further (β=1.51 miles [approximately 15 minutes via subway]; 95% CI 0.25, 2.77). Of people who saw a Chinatown-based doctor, 75% (69 of 92) were not Chinatown residents. On average, these individuals traveled 5.14 miles (SD=3.38) to the doctor. Conclusion: In conclusion, there is a need to expand in-language services for immigrant communities. Immigrants visiting doctors in ethnic enclaves are demographically different and travel further distances for health care. Accessing in language services is a priority for these individuals. Immigrants may prioritize language access over geographic access when choosing their health care providers. Strategies to strengthen community-clinical linkages, including connecting community members with bilingual community health workers, may increase healthcare access of under-served, ethnic populations.

The new geography of labour migration: EU11 migrants in rural Norway

Abstract Historically, immigration to Western countries has been an urban phenomenon, but in recent decades, larger immigrant populations have also arrived in rural destinations. In this paper, we address the dynamics of inbound flows and geographical distribution of labour migrants within rural regions: While some rural localities have received large numbers of migrants, others have seen just a few. Specifically, we explore the case of Eastern and Central European labour migrants (EU11 countries) travelling to Norway's rural regions following the EU enlargements in 2004, 2007 and 2013. Which factors explain the spatial distribution of EU11 labour migrants in Norway's rural regions? We evaluate three assumptions in the extant literature – that labour migrant inflows are related to labour market characteristics, demographic profiles and localities' degree of peripherality. Norwegian register data at municipality levels are employed to estimate a regression model for how these characteristics impact sizes of EU11 labour migrant populations in rural municipalities. Finding show that EU11 migrants are found where the most labour-intensive rural industries dominate; industry-particularly fish processing industry, agriculture and the hospitality sector. Further, they reside in areas with higher unemployment and few refugees. Lastly, we find that the rural municipalities that struggles the most with depopulation has not received the relatively largest number of labour migrant, as EU11 migrants are more often found in the more demographically viable rural communities.

Bilingualism Delays Expression of Alzheimer’s Clinical Syndrome

Objective: To evaluate the effects of bilingualism on the emergence of Alzheimer’s clinical syndrome. Background: Studies have proposed an increase in cognitive and neural reserve from the management and control of two languages, with a consequent delayed expression of dementia. Methods: In a clinic with a large immigrant population, we identified 253 patients with probable Alzheimer’s disease (AD) with intermediate or high evidence of AD pathophysiological process. These patients were reviewed for demographic variables, native language (L1) other than English, ages of onset and presentation, Mini-Mental State Examination (MMSE), digit spans, word fluencies, naming, and memory. Results: Among these patients, 74 (29.2%) were bilinguals with various L1s (Farsi, Spanish, Chinese, Tagalog, Arabic, others). When compared to the 179 monolingual AD patients, those who were bilingual had significant delays in ages of onset and presentation of approximately 4 years (p = 0.003). These delays persisted despite bilinguals having worse MMSE scores on presentation. There were no significant group differences on other variables except for worse naming in English among bilinguals versus monolinguals. Caregiver/informants reported that 66 (89.2%) of the 74 bilingual AD patients had gradually regressed to the predominant use of their L1. Conclusions: In line with published reports worldwide, we found that bilingualism delays the expression of Alzheimer’s clinical syndrome. We also found frequent reversion to the first learned language. These findings suggest that, among bilinguals, the availability of an L1 “back-up” either facilitates compensation or masks emergence of the early symptoms of dementia.

Fear and Loathing in Times of Distress – Causal Impact of Social and Economic Insecurity on Anti-Immigration Sentiment

The causal nexus between socio-economic insecurity and anti-immigration sentiments remains unclear despite correlational evidence. We exploit the disruption brought about by the Covid-19 outbreak to randomly provide survey respondents with information about the consequences of the epidemic. We find that pessimistic information about both the economic and health consequences causally reinforces the desire to restrict access to health care to native residents. Further, the prospect of dire economic consequences brings about a general adversity to immigration as well as political radicalisation. Both effects are less pronounced in areas with larger immigrant populations. Our theoretical model pins down two possible mechanisms explaining these results: a zero-sum game to split scarce public resources between residents and immigrants on the one hand and, on the other, fear of contagion. These also shape the tradeoff between prioritizing residents and extending vaccination programmes to immigrants to lower contagion risk.

Immigration Policy and the Rise of Self-Employment Among Mexican Immigrants

Over the past two decades, the U.S. has seen a drastic growth in self-employment among Mexican immigrants, the largest immigrant population in the country. This is an interesting yet puzzling trend, in stark contrast to the stagnated growth of self-employment among other disadvantaged minority groups such as blacks and even a significant decline among whites. Little is known of what drives that growth. We propose that the expansion of interior immigration enforcement, a characteristic of the U.S. immigration policy during that time span, might have contributed to this unique trend by pushing Mexican immigrants into self-employment as an alternative livelihood. Exploiting temporal and geographic variation in immigration enforcement measures from 2005 to 2017, we show that tougher enforcement has been responsible for 10 to 20 percent of the rise in Mexican self-employment. The impact mainly concentrates among likely undocumented immigrants. It is mainly driven by police-based enforcement measures responsible for most deportations, as opposed to employment-based enforcement. Our results suggest that apprehension fear, instead of lack of employment opportunities, is the main push factor.

The Space Between: Transformative Learning and Type 2 Diabetes Self-Management.

Immigrant populations experience higher type 2 diabetes mellitus (T2DM) prevalence rates and worse health outcomes secondary to T2DM than native-born populations. But as the largest immigrant population in the United States, the experience of T2DM diagnosis and self-management among Spanish-speaking, limited English-language proficient Latinx immigrants remains largely unexamined. This study used semistructured interviews to explore these phenomena among a cohort of 30 recent Latinx immigrants. All aspects of data collection were conducted in Spanish. Quantitative and qualitative data were collected. Data analysis included descriptive statistical procedures. Qualitative data analysis was conducted using a grounded theory approach. Patterns in the data analysis of 30 interviews identified accepting T2DM as a common transitional process that required significant changes in individuals' self-perspective and ways of being. Accepting T2DM was identified by the participants as a precursor to treatment initiation. And while for most participants this transition period was brief, for some it took months to years. Distinct transitional stages were identified, categorized, and considered within the context of several theoretical orientations and were observed to align with those in transformative learning. Understanding differing responses and processing of a T2DM diagnosis could be leveraged to better support patients' acceptance and transition into treatment.

INTEREST GROUP SESSION—AGING AMONG ASIANS: RESEARCH METHODS IN AGING AMONG ASIANS

Asians are the largest and the fastest growing segment of the world population. Asian immigrants are the second largest immigrant population in the U.S. However, age-related social and health issues are understudied among late-life immigrant and the oldest old Asians. Little data exist to support public health promotion, policy studies and clinical practice in this population. To advance research into aging among Asians living in the U.S. and elsewhere in the world, sound methodologies can be adopted from those well-developed in other settings while novel methodologies are to be developed to meet the unique needs of Asian studies. This symposium brings together four abstracts that address a variety of common methodological issues in social and health studies among Asian older adults. The topics range from culturally and linguistically appropriate strategies for recruiting non-English speaking research participants, assessment of social isolation and transportation barriers using an ethnographical approach, development of a new culturally appropriate measure for successful aging among the oldest old Chinese in China, and evaluation of preventive healthcare use among faith-based first-generation Chinese immigrants using self-administered surveys in the U.S. These studies involve qualitative ethnographical analysis, mixed methods for instrument development, quantitative data analysis, use of geographic information systems and demography to plan participant recruitment, and use of staged community engagement to increase efficiency and representativeness of participant recruitment. Lessons learned from these studies are valuable to future studies on aging among Asians. This symposium is a collaborative effort of the GSA Aging Among Asians Interest Group.

Association of acculturation with cardiac structure and function among Hispanics/Latinos: a cross-sectional analysis of the echocardiographic study of Latinos

ObjectiveHispanics/Latinos, the largest immigrant population in the USA, undergo the process of acculturation and have a large burden of heart failure risk. Few studies have examined the association of acculturation...

2840 The Association of Polish Ethnicity and Polyp Risk on Screening Colonoscopy in a Local Brooklyn Population

INTRODUCTION: The Brooklyn Hospital Center (TBHC) serves an ethnically diverse community with a large Polish immigrant population. There was a perceived increased quantity of polyps in our Polish patients. Multiple adenomas, larger sized adenomas, and adenomas with advanced histology on index colonoscopy are associated with increased risk for colorectal cancer (CRC). Studies in African Americans demonstrated higher incidence of CRC and mortality compared to whites suggesting different ethnic groups may be at increased risk for CRC. The goal of our study is to see if the Polish population is at increased risk for adenomatous polyps, large polyps(≥1 cm), multiple adenomas(≥3), or advanced adenomas(tubulovillous, villous, or high grade dysplasia) when compared to the non-Polish white population. METHODS: A retrospective chart review was performed from 1/2012 to 10/2018. Inclusion criteria were patients ≥50 years of age undergoing screening colonoscopy. Exclusion criteria consisted of an incomplete exam, personal or family history of CRC, or indication other than screening. Polish and non-Polish whites were identified by demographic data. 121 Polish patients were matched to 121 non-Polish white patients by gender and age. High-risk patients were those having large, multiple or advanced adenomas. Statistical analysis utilized student’s 2 sample t-test for P-values, with an alpha level of 0.05, and odds ratios (OR) with 95% confidence intervals (CI). RESULTS: Each arm consisted of 56 men (46%) and 65 women (54%) with an average age of 64.3 years in both. There was a statistically significant difference between the number of high-risk Polish vs. non-Polish white patients (OR 1.95, 95% CI: 1.07-3.53; P = 0.026). Although not statistically significant, Polish patients had an increased prevalence of total polyps (OR 1.22, 95% CI: 0.73-2.0; P = 0.23), large polyps (OR 1.69, 95% CI:0.88-3.22; P = 0.10), adenomas (OR 1.38, 95% CI: 0.81-2.32; P = 0.23), multiple adenomas (OR 1.63, 95% CI: 0.60-4.35; P = 0.33), and advanced adenomas (OR 1.85, 95% CI: 0.74-4.58; P = 0.18). We also found 2 cases of CRC in the Polish group and no cases in the non-Polish group (P = 0.15). CONCLUSION: These results show a statistically significant difference in the number of high-risk Polish vs. non-Polish white patients with an increase rate of CRC in the Polish group although not statistically significant. These findings warrant larger population based studies to further investigate the benefit of earlier screening for these patients similar to African Americans.

Preschool for all? Enrollment and maternal labour supply implications of a bilingual preschool policy

ABSTRACTPrevious research supports the effectiveness of preschool in various contexts, yet there is limited evidence whether universal-type preschool policies induce changes in enrollment. While certain states have enacted universal preschool policies, some have also considered bilingual preschool mandates, either as a supplementary or stand-alone policy, requiring schools to open up bilingual classrooms for children from non-English speaking families. The question of whether bilingual preschool policies can induce enrollment and close achievement gaps between English learners and English speakers is particularly important today for urban cities and states with large immigrant populations. In this study, I exploit exogenous variation from the first bilingual prekindergarten mandate in Illinois to estimate the causal effects on preschool enrollment and maternal labour supply of recently immigrated and Hispanic families. Utilizing a difference-in-differences strategy, estimates suggest significant effects on preschool enrollment between 18% and 20% and no effects of increasing maternal labour supply in Illinois. Estimates are robust to various specifications, control groups, and timeframes. I use the analysis to further discuss whether universal preschool policies are designed sufficiently for access and inclusion of various student types, and contribute to our understanding on the effectiveness of using childcare subsidies to increase the welfare of low-income families.

How can we bridge the cardiac needs of a large underserved immigrant population

Purpose Immigrant and resettled refugee populations in the US face several barriers to seeking health care, especially access to subspecialty pediatric care. These barriers can lead to delays in diagnosis and treatment, with negative effects on the physical and psychosocial health of these children. We observed that immigrant / resettled refugee families referred for pediatric cardiac evaluation from a community federally qualified healthcare clinic demonstrated a high “no show” rate at tertiary referral centers. We hypothesized that introduction of an outreach pediatric cardiology clinic where by the cardiology team goes to the primary care clinic would help to increase compliance and mitigate the barriers to health care in this population. Currently, there is no study that evaluates the pediatric cardiac care of immigrant families in the US. Methods A monthly outreach pediatric cardiology clinic was established at a federally qualified healthcare clinic serving an immigrant and resettled refugee population. The team was comprised of a pediatric cardiologist, cardiology fellow and a cardiac sonographer. Patients deemed to require further evaluation were then referred to a tertiary specialty hospital with social services and transportation support facilitated by the primary clinic. Following IRB approval, medical records for patients seen between 2/2014 to 12/2017 were retrospectively reviewed at both institutions. Descriptive analysis was performed. Results A total of 366 patients (222 Males, 61%), median age 6.3 (range 0.02 - 18.2) years were evaluated. Indications for referral included murmur (257, 70%), non-exertional symptoms (31, 9%), exertional symptoms (24, 7%), arrhythmia/bradycardia (12, 3%) and others (42, 11%). Echocardiograms were performed on 136 patients (51 were abnormal, 38%) and 70 patients were referred on for further management at the tertiary center. These referrals were for cardiac reasons in 63 patients and for non-cardiac reasons in 7 patients. Eleven patients did not follow up. Cardiac surgery was performed in 9 patients, transcatheter interventions in 4 patients, medical therapy was initiated in 4 patients and 2 patients are being scheduled for surgery/interventions. Patients have been followed for a median of 0.7 years (range 0 - 3.3). Conclusion An outreach pediatric cardiac clinic can help mitigate the healthcare barriers in an underserved immigrant and resettled refugee population in the US. This clinic served as a means to develop referral channels for long term care for these children with heart diseases. This platform can also be utilized for other subspecialty pediatric care in these populations.

A Novel Approach to Improve Health Literacy in Immigrant Communities.

Background:Anchorage, Alaska, has a large immigrant and refugee population. In fact, it is one of the most ethnically diverse cities in the United States with almost 100 languages spoken by children in the public school system. The city's immigrant and refugee population speaks limited English, and most of these residents are unfamiliar with where or how to obtain health care services through the American health care system.Brief Description of Activity:We developed a peer language navigator (PLN) program.Implementation:The Anchorage Health Literacy Collaborative developed a community-wide program to address the health literacy needs of the city's immigrant and refugee population. Select people who attended Anchorage's adult literacy program (the Alaska Literacy Program) were chosen to learn about health and wellness topics as well as how to obtain health information from reliable online sources. These people, initially known as PLNs, were then trained to share health information resources with their respective communities.Results:A recent evaluation of the program using ripple effects mapping showed that the program has demonstrated wide success, providing understandable health information to hundreds of new English learners throughout the area and guiding them to reliable health and wellness information they can use for themselves, their families, and their community. PLNs have become leaders in their communities and have been renamed peer leader navigators.Lessons Learned:For similar programs to be successful, PLNs should be trained using adult learning principles, allowing them to focus on topics and issues of interest to them. The program should link with community organizations to extend the reach of the program. Care must be exercised to avoid overextending or overwhelming PLNs because after they become leaders in their communities, they will receive many requests to provide guidance and education. Finally, when possible, PLNs should be compensated so they can more fully devote their efforts to serving the community. [HLRP: Health Literacy Research and Practice. 2019;3(Suppl.):S15–S24.]Plain Language Summary:The Anchorage Health Literacy Collaborative in Alaska developed a program in which immigrant and refugees attending the city's adult education program to learn beginning English are chosen to serve as peer language navigators (PLNs). The PLNs learn how to obtain credible and easy-to-understand health information and then share it with their respective cultural communities. Lessons learned over time are shared.

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.

A Single-Center Experience with a Pregnant Immigrant Population and Zika Virus Serologic Screening in New York City.

Our institution is in an area of New York City with a large population of immigrants from Zika virus endemic areas. With the recent Zika virus outbreak, we sought to examine our center's experience with screening for Zika virus and outcomes among patients who tested positive for the disease during pregnancy. We performed a chart review of all pregnant patients who tested positive (positive serum or urine polymerase chain reaction [PCR]) or presumed positive (immunoglobulin M [IgM] enzyme-linked immunosorbent assay [ELISA] positive or IgM ELISA equivocal with positive plaque reduction neutralization test) for Zika virus. All tests were performed by the Department of Health (DOH) and followed Centers for Disease Control and Prevention guidelines in effect at the time of specimen collection. Testing of cord blood, placenta, and/or neonatal blood were/was performed by the DOH for New York County. Prenatal ultrasounds for fetal head size and surveillance for calcifications were performed by maternal-fetal medicine specialists. Infant head ultrasound results were included when available. Between March 2016 and April 2017, 70 pregnant patients were positive or presumed positive for Zika infection during pregnancy. Of those, 16 women had positive urine or serum PCR and the remaining 54 were presumed positive. Among positive cases, five women tested positive via urine PCR only, nine women tested positive via serum PCR only, and two women had both positive urine and serum PCR. Fifteen of 67 infants (22%) born during the study period were born to mothers with positive urine or serum PCR testing. Sixty-five newborns were clinically normal with normal head measurements. Of the intracranial ultrasound performed, one infant had a grade 1 intraventricular hemorrhage, four had incidental choroid plexus cysts, and one had severe ventriculomegaly that was also noted antenatally. There were 2 positive and 15 equivocal infant serum IgM samples and 1 positive placental PCR from these pregnancies. There were four pregnancy terminations and two cases with fetal anomalies in this population that were split evenly between patients who tested positive and those who tested presumed positive for Zika virus during pregnancy. We found no differences in pregnancy or neonatal outcomes between women who tested positive and presumed positive for Zika virus during pregnancy. Testing of infants and placenta tissue after delivery was largely inconclusive. Improvement in testing for Zika virus infection is needed to determine which pregnancies are at risk for congenital anomalies. Further research is still needed to determine which children are at risk for poor neurodevelopmental outcomes related to Zika virus and how to best coordinate care among the immigrant population during a new disease epidemic.

Breast cancer incidence by country of birth among immigrant women in British Columbia, Canada

IntroductionBreast cancer rates vary internationally and between immigrant and non-immigrant populations. We describe breast cancer incidence by birth region and country in British Columbia, Canada. MethodsWe linked population-based health and immigration databases for a population with >1.29 million immigrants to assess breast cancer incidence among immigrant and non-immigrant women. We report age-standardized incidence ratios (SIRs) by birth region and country using non-immigrant women as the standard. ResultsSIRs varied widely by both birth country and region. Low rates were found for South (SIR = 0.52, 95% CI: 0.47,0.59) and East Asian (SIR = 0.75, 95% CI: 0.72,0.79) women and a higher rate for Western Europeans (SIR = 1.15, 95% CI: 1.01,1.30). ConclusionThere is considerable variation in SIRs across some of British Columbia’s largest immigrant populations and several demonstrate significantly different risk profiles compared to non-immigrants. These findings provide unique data to support breast cancer prevention and control.

Evaluating Personal Stroke Narratives from Bilingual Greek-English Immigrants with Aphasia

Objective: For people with aphasia (PWA) and their significant others, narratives are intricately intertwined with quality of life, culture, and social participation. This paper reports stories told by bilingual people with aphasia (bPWA), describing the events or consequences of a stroke on their lives. Patients and Methods: Six participants with chronic mild-moderate anomia (mean age 70 years) spontaneously produced a narrative recounting their personal experience of stroke in their native language (Greek) and in their second language (English). All bPWA had learned English in early adulthood upon migration from Greece to Australia, not through formal teaching but on the job (e.g., in the factory). The bPWA had lived in Australia for 46 years (average) and were less than 4 years post-stroke. Results: Narratives in the two languages underwent quantitative (number of propositions, noun/verb tokens) and qualitative analyses (ratings of coherence, ratings of clarity). Most bPWA produced coherent “tellable” stories despite disruptions in language because of aphasia. Overall, stories were better told (length, complexity of content, temporal-causal sequencing, reference) in Greek – their native language. Conclusion: The results have implications for policy-makers providing health and welfare services to ageing immigrant populations. The findings are also relevant to other countries that have large immigrant populations of stroke survivors.