This blog is intended to go along with Population: An Introduction to Concepts and Issues, by John R. Weeks, published by Cengage Learning. The latest edition is the 12th (it came out in 2015), but this blog is meant to complement any edition of the book by showing the way in which demographic issues are regularly in the news.

If you are a user of my textbook and would like to suggest a blog post idea, please email me at: john.weeks@sdsu.edu

Tuesday, April 17, 2018

More Evidence That Americanization is Bad for Your Health

One of the saddest commentaries about health care in the U.S. is that we pay more per person than any other country, but still wind up with the poorest health outcomes of any rich country. In that general sense, Americanization is bad for your health. The easiest way to see that is to compare the health of immigrants with people who were born in the U.S. A lot of people have done this, including me and my long-time friend and colleague, Dr. Rubèn Rumbaut at UC Irvine. As I noted a few years ago, we published a chapter in an edited volume which we titled "Children of Immigrants: Is Americanization Hazardous to Infant Health?" We also published a paper in the Journal of Immigrant Health that same year based on collaborative work with Dr. Norma Ojeda, who was then at El Colegio de la Frontera Norte in Tijuana, Mexico, but is now a Professor of Sociology here at SDSU. We found that the superior birth outcomes among immigrant women was not just a function of migration selectivity (the "healthy migrant" hypothesis). We compared Mexican women delivering in Tijuana with Mexico-born women delivering in San Diego and found that after controlling for characteristics of the women, birth outcomes were actually better among women in Tijuana than in San Diego. One variable that stood out was that women in Mexico were more likely to have multiple prenatal visits (which can identify problems and allow health care providers to deal with them) than in San Diego. Our research was 20 years ago, and even then health care outcomes were better on the southern side of the border than on this side. And keep in mind that the Mexico-born women had better birth outcomes than non-Hispanic white women in San Diego.

I bring all of this up because a paper has just been published in Public Health Reports that references our research and finds once again that foreign-born Hispanic women have better outcomes than U.S.-born Hispanic women. While our research focused on local outcomes, this research compares birth records for the entire U.S. with outcomes measured for the countries from which the immigrant mothers came. As is so often true with the world, the results are complicated by the fact that women born in Mexico, in particular, tend to have better outcomes than those born in other Latin American countries.
Our study found that US-born Hispanic women had a significantly greater risk of preterm birth, low birth weight, and small for gestational age than that of foreign-born Hispanic women. However, we  also found substantial variation in the rates of adverse birth outcomes among foreign-born women by country of birth, which remained after adjusting for maternal characteristics.
And, of course, this health disadvantage in the U.S. is not just one that shows up at birth. It persists into childhood and adulthood and will continue to do so until collectively we decide to change our diets and our health insurance schemes.

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