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Revisiting the Immigrant Epidemiological Paradox: Findings from the American Panel of Life 2019.

ABSTRACT: Immigrants enjoy a health advantage over their US-born counterparts (termed the immigrant paradox), though the extent of this paradox may not extend to all health outcomes. We analyzed data from the RAND American Life Panel. Using multivariable logistic regression, we examined the associations between immigrant status and a wide range of health outcomes (e.g., cardiovascular diseases, mental health), adjusting for sociodemographic characteristics. Being an immigrant was associated with lower odds of having any health condition, multimorbidity, and number of health conditions. When looking at specific conditions, however, immigrant status was only significantly associated with lower odds of depression, nerve problem causing numbness or pain, and obesity, but not other conditions. The immigrant paradox is evident when examining overall health, and specifically depression, nerve problems, and obesity.

SUBMITTER: Oh H

PROVIDER: S-EPMC8123790 | biostudies-literature | 2021 Apr

REPOSITORIES: biostudies-literature

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Revisiting the Immigrant Epidemiological Paradox: Findings from the American Panel of Life 2019.

Oh Hans H Goehring Jessica J Jacob Louis L Smith Lee L

International journal of environmental research and public health 20210427 9

<h4>Objective</h4>Immigrants enjoy a health advantage over their US-born counterparts (termed the immigrant paradox), though the extent of this paradox may not extend to all health outcomes.<h4>Methods</h4>We analyzed data from the RAND American Life Panel. Using multivariable logistic regression, we examined the associations between immigrant status and a wide range of health outcomes (e.g., cardiovascular diseases, mental health), adjusting for sociodemographic characteristics.<h4>Results</h4> ...[more]

PMID: 33925351

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Project description:BackgroundForeign-born Black and Latina women on average have higher birthweight infants than their US-born counterparts, despite generally worse socioeconomic indicators and prenatal care access, i.e., "immigrant birthweight paradox" (IBP). Residence in immigrant enclaves and associated social-cultural and economic benefits may be drivers of IBP. Yet, enclaves have been found to have higher air pollution, a risk factor for lower birthweight.ObjectiveWe investigated the association of immigrant enclaves and children's birthweight accounting for prenatal ambient air pollution exposure.MethodsIn the Boston-based Children's HealthWatch cohort of mother-child dyads, we obtained birthweight-for-gestational-age z-scores (BWGAZ) for US-born births, 2006-2015. We developed an immigrant enclave score based on census-tract percentages of foreign-born, non-citizen, and linguistically-isolated households statewide. We estimated trimester-specific PM2.5 concentrations and proximity to major roads based residential address at birth. We fit multivariable linear regressions of BWGAZ and examined effect modification by maternal nativity. Analyses were restricted to nonsmoking women and term births.ResultsForeign-born women had children with 0.176 (95% CI: 0.092, 0.261) higher BWGAZ than US-born women, demonstrating the IBP in our cohort. Immigrant enclave score was not associated with BWGAZ, even after adjusting for air pollution exposures. However, this association was significantly modified by maternal nativity (pinteraction = 0.014), in which immigrant enclave score was positively associated with BWGAZ for only foreign-born women (0.090, 95% CI: 0.007, 0.172). Proximity to major roads was negatively associated with BWGAZ (-0.018 per 10 m, 95% CI: -0.032, -0.003) and positively correlated with immigrant enclave scores. Trimester-specific PM2.5 concentrations were not associated with BWGAZ.SignificanceResidence in immigrant enclaves was associated with higher birthweight children for foreign-born women, supporting the role of immigrant enclaves in the IBP. Future research of the IBP should account for immigrant enclaves and assess their spatial correlation with potential environmental risk factors and protective resources.

Dataset Information

Revisiting the Immigrant Epidemiological Paradox: Findings from the American Panel of Life 2019.

Publications

Revisiting the Immigrant Epidemiological Paradox: Findings from the American Panel of Life 2019.

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