BBH: Immigration and Health

Race associated with disease: Markel & Stern (2002)

-Asians-Hookworm -Mexicans-Lice and Nits -European Jews-Bacterial Eye Infection or Tuberculosis

What is cultural competency?

-Cultural Competence-An understanding of and attention to the client's total situation. -Culturally Appropriate-Providing the best possible health care based on cultural background and needs. -Culturally Sensitive-Knowledge and constructive attitudes towards the diverse health traditions of cultural groups being served.

What are some major barriers to health?

-Fear of "public charge"-If you are relying welfare or any other social services and you are an immigrants or undocumented, you will be deported. -Lack of access to health services. -Lack of health insurance. -Language barriers. -Cultural ignorance.

1918-1919 Pandemic Influenza: Markel & Stern (2002)

-First discovered in military personnel. -500 million people infected. -50 million deaths. -Did NOT originate in Spain. The Spanish just had freer press and reported the most on deaths. The flu just so happened to be associated with Spain. -Believed to originate in the U.S., but not clear.

What are some explanations for the immigrant paradox?

-Healthy immigrant effect-Better health and healthier lifestyles or health behaviors. -Positive immigrant selectivity. -Better social support/social networks.

Foreignness of Germs: Markel & Stern (2002)

-Immigrant reforms in 1891 prevented entry by criminals, prostitutes, and those with infectious diseases. Wanted "whites of good character". -Elise Island ports was not opened until the mid 1800s. Most immigrants came through other ports. -Racism in early 20th century. -2% denied entry in 1898, 69% in 1915. -Possible diseases outweighed actual diseases. -Many immigrants had to have health screenings. -There were hug campaigns to tarnish Irish immigrants and keep them from coming into the country.

Immigration from 1925-1964: Markel & Stern (2002)

-Immigration rates plummeted. -Entry was mainly awarded based on skin color. -With regard to seating (i.e., first class, second class, etc.), immigrants arriving to the country on ships and trains, had an easier health inspection and medical exam if they were traveling at a higher class. -Class was often used as a means of targeting immigrants for easy or more harsh/lengthy inspections at the U.S. border.

What do immigrants have better health outcomes for?

-Infant mortality. -Pregnancy and birth; breastfeeding. -Child behavioral health and disability. -Adult cardiovascular diseases, obesity, cancer (overall), unintentional injuries, suicide and homicide. -Health behaviors, including smoking and smoking during pregnancy.

Immigration in 2010

-Over 38.5 million foreign-born residents in U.S. -12.9% of the total U.S. population. -62% of the foreign-born population entered U.S. in the last 2 decades; 35% since 2000. -5.6% of foreign-born residents are naturalized citizens. -More likely than native populations to be in larger and multigenerational families U.S. Census Bureau. -Latin america/Carribean, Asia, and Europe are the countries that send the most immigrants. -The majority of undocumented immigrants are people who overstayed their student visas, working visas, or came into the country through aircraft on vacation. -Immigrants populations are expencted to grow to 78.2 million by 2060.

What do immigrants have worse health outcomes for?

-Some cancers (stomach cancer in White immigrants and liver cancer for White and Asian immigrants). -Physical activity/inactivity (adults and children). -Childhood overweight and obesity -Child general health status -Child sports participation -Mother and father rated in poor/fair health. -Unsafe neighborhoods. -Suicide among Asian/Pacific Island woemn. -Homicide among White and Asian males.

Immigration from 1965-2000s: Markel & Stern (2002)

-U.S. borders reopened. -HIV fears rose; associated with immigrants from Haiti and Africa. -Low-paid seasonal work for Mexican laborers who had to leave after their season was over. Lived in crowded, unsanitary conditions. Rise in TB infection among the laborers. Treatment difficult in undocumented immigrants -Migrant workers provide most of the food sold and traded in the American market.

What is the term used to describe the length of residence since immigrating?

Acculturation

Which of the following new modes of travel in the early/mid 1900s raised concerns about the medical inspections process, and the likelihood that immigrants would spread diseases and infections to the American public?

Air Travel -There was a fear that an asymptomatic immigrant would board a flight and then spread their illness to Americans. This became a massive public health concern.

Becoming American: Latino immigrants have better physical and mental health because of the strong social networks they have when they come to the U.S. Either through family, friends, or community. Americans commute up to 50 minutes a day and ten millions commute up to 2 hours. Amricans work more hours than any other industrialized country and social isolation is on the rise in the U.S. Social isolation increases our risk of death and other diseases. Being socially isolated is a chronically stressful situation and it increases aging.

Becoming American: Family ties is not enough to curb the health risks of social isolation. Communities like Kenneth Square, Pennsylvania has good schools, social service, and many other resources to support the residents. Things like the garage (youth community center) help bring people together and lift them up.

Becoming American: After only five years in the U.S., Latino immigrants are five times more likely to have high blood pressure than when they first arrived and to be obese. More than 20 percent of Latino households are poor. The longer they are here, the more immigrant families struggle with discrimination, low paying jobs, bad schools, and bad housing.

Becoming American: One in four Latino children drop out of highschool and one in seven Latino girls attempt suicide. The risk of psychiatric disorders for Latino children depends on their age when they arrive here. The longer you stay in your country of origin, the lower the risks of developing mental disorders.

For which racial or ethnic group was the difference in life expectancy between immigrant and US-born populations the greatest in 1999-2001? That is, which population had the greatest difference in life expectancy years between immigrant and US-born?

Blacks

Positive Immigrant Selectivity refers to the idea that:

Immigrants may be healthier than those who did not leave their country.

What is the immigrants health paradox?

Immigrants tend to have better physical and mental health outcomes, despite often being poorer than US-born populations.

What can you generally conclude about life expectancy between 1999-2001?

Life expectancy is higher in immigrant populations compared to US-born populations.

What is true about the monitoring of health, mortality, and disease patterns among US immigrant populations?

National US data systems do not typically report or analyze data by immigrant status

What is the largest immigrant population in State College?

Russia

What is the Acculturation Process?

With longer residence in the US, health protections begin to wear off, resulting in decreasing health with an increasing length of stay. -Diet becomes westernized.