Does Selective Migration Explain the Hispanic Paradox?: A Comparative Analysis of Mexicans in the U.S. and Mexico

Latino immigrants, particularly Mexican, have some health advantages over U.S.-born Mexicans and Whites. Because of their lower socioeconomic status, this phenomenon has been called the epidemiologic “Hispanic Paradox.” While cultural theories have dominated explanations for the Paradox, the role of selective migration has been inadequately addressed. This study is among the few to combine Mexican and U.S. data to examine health selectivity in activity limitation, self-rated health, and chronic conditions among Mexican immigrants, ages 18 and over. Drawing on theories of selective migration, this study tested the “healthy migrant” and “salmon-bias” hypotheses by comparing the health of Mexican immigrants in the U.S. to non-migrants in Mexico, and to return migrants in Mexico. Results suggest that there are both healthy migrant and salmon-bias effects in activity limitation, but not other health aspects. In fact, consistent with prior research, immigrants are negatively selected on self-rated health. Future research should consider the complexities of migrants’ health profiles and examine selection mechanisms alongside other factors such as acculturation

Perceived Discrimination and Self-Reported Quality of Care Among Latinos in the United States

Given the persistence of health and health-care disparities among Latinos in the United States and evidence that discrimination affects health and health care, an investigation of the relationship between perceived discrimination and quality of health care among Latinos is warranted. To examine the relationship of perceived discrimination (in general and in regard to doctors and medical personnel) with self-reported quality of health care and doctor-patient communication in a nationally representative Latino population sample. Participants were 1,067 Latino adults aged ≥18 years living in the US selected via random-digit dialing. Telephone interviews were conducted in 2008 during Wave 2 of the Pew Hispanic Center/Robert Wood Johnson Foundation Hispanic Healthcare Survey. US-born Latinos were twice as likely to report general discrimination as foreign born: 0.32 SD versus −0.23 SD (P < 0.001) on the Detroit Area Survey (DAS) discrimination scale. Higher DAS discrimination was associated with lower self-reported quality of care in US-born Latinos [OR = 0.5; 95% CI (0.3, 0.9); P = 0.009]. For foreign-born Latinos, report of any doctor or medical staff discrimination was associated with lower quality of care [OR = 0.5; 95% CI (0.3, 0.9); P = 0.03], but the DAS was not. For US-born Latinos, doctor discrimination and higher DAS were jointly associated with worse doctor-patient communication. For foreign-born Latinos, the effect of discrimination on doctor-patient communication was significantly smaller than that observed in US-born Latinos. Given the association between perceived discrimination and quality of care, strategies to address discrimination in health-care settings may lead to improved patient satisfaction with care and possibly to improved treatment outcomes

Perceived Discrimination and Health Outcomes Among Asian Indians in the United States

Background: Perceived interpersonal discrimination while seeking healthcare services is associated with poor physical and mental health. Yet, there is a paucity of research among Asian Americans or its subgroups. This study examined the correlates of reported interpersonal discrimination when seeking health care among a large sample of Asian Indians, the 3rd largest Asian American subgroup in the US, and identify predictors of adverse self-rated physical health, a well-accepted measure of overall health status. Methods: Cross-sectional survey. Participants comprised of 1824 Asian Indian adults in six states with higher concentration of Asian Indians. Results: Mean age and years lived in the US was 45.7 ± 12.8 and 16.6 ± 11.1 years respectively. The majority of the respondents was male, immigrants, college graduates, and had access to care. Perceived interpersonal discrimination when seeking health care was reported by a relatively small proportion of the population (7.2 %). However, Asian Indians who reported poor self-rated health were approximately twice as likely to perceived discrimination when seeking care as compared to those in good or excellent health status (OR 1.88; 95 % CI 1.12–3. 14). Poor self-rated health was associated with perceived health care discrimination after controlling for all of the respondent characteristics (OR 1.93; 95 % CI: 1.17–3.19). In addition, Asian Indians who lived for more than 10 years in the U.S. (OR 3.28; 95 % CI: 1.73–6.22) and had chronic illnesses (OR 1.39; 95 % CI: 1.17–1.64) (p \u3c 0.05) were more likely to perceive discrimination when seeking health care. However, older Asian Indians, over the age of 55 years, were less likely to perceive discrimination than those aged 18–34 years Indian American. Conclusion: Results offers initial support for the hypothesis that Asian Indians experience interpersonal discrimination when seeking health care services and that these experiences may be related to poor self-rated health status

Immigration, Acculturation and Chronic Back and Neck Problems Among Latino-Americans

Higher acculturation is associated with increased obesity and depression among Latino-Americans, but not much is known about how acculturation is related to their prevalence of back and neck problems. This study examines whether acculturation is associated with the 12-month prevalence of self-reported chronic back or neck problems among US-born and immigrant Latinos. We performed multivariable logistic regression analysis of data from 2,553 noninstitutionalized Latino adults from the 2002–2003 National Latino and Asian American Survey (NLAAS). After adjusting for demographic, physical and mental health indicators, English proficiency, nativity and higher generational status were all significantly positively associated with the report of chronic back or neck problems. Among immigrants, the proportion of lifetime in the US was not significantly associated. Our findings suggest that the report of chronic back or neck problems is higher among more acculturated Latino-Americans independent of health status, obesity, and the presence of depression

Transnational social networks, health, and care : a systematic narrative literature review

While transnational social ties and exchanges are a core concern within migration studies, health researchers have often overlooked their importance. Continuous and circular exchanges of information within transnational networks, also defined as social remittances, facilitate the diffusion of innovations, potentially driving contemporary social and cultural change. Influences on health, wellbeing, and care-seeking are important, but under-researched, dimensions for consideration. We undertook a systematic narrative evidence synthesis to describe the current state of knowledge in this area and to identify gaps and future directions for health researchers to take. Between April 2017 and May 2019, an iterative series of searches in Medline, Embase, PsycINFO and PubMed, plus backward and forward citation searches identified 1,173 potential papers. Screening resulted in 36 included papers, eighteen focused on migrant populations and eighteen on those who remain behind. The top three health topics were health-seeking strategies, sexual and reproductive health issues, and healthcare support. And, while not always explicitly identified, mental health and wellbeing was a further prominent, cross-cutting theme. Articles on migrant populations were all conducted in the global North and 13 out of 18 used qualitative methods. Five main themes were identified: therapeutic effect of the continuing social relationships, disrupted social relationships, hybridisation of healthcare, facilitation of connections to healthcare providers, and factors encouraging or undermining transnational social exchanges. Papers concerned with those who remain behind were mainly focused on the global South and used a mix of qualitative and quantitative approaches. Four main themes were identified: transnational transfer of health-related advice, norms, and support; associations between migrant linkages and health behaviours/outcomes; transnational collective transfer of health knowledge; and power and resistance in exchanges. Findings suggest that transnational social exchanges can both support and undermine the health of migrants and those who remain behind. This review confirms that the volume and quality of research in this area must be increased so that health policy and practice can be informed by a better understanding of these important influences on the health of both migrants and those who remain behind