The Role of Financial Strain, Discrimination, and Social Capital on the Health of Immigrants Over Time

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Abstract Immigrants tend to have better health compared to their U.S.-born peers despite being of lower socioeconomic attainment, a phenomenon called the “immigrant health advantage”. However, the immigrant health advantage is seen in some health outcomes but not all outcomes. There are two main arguments as to why there may not be an immigrant health advantage for all health outcomes. First, there are methodological limitations in comparing immigrants to U.S.-born people. Both often grow up in distinct social circumstances, which automatically allows researchers to find differences. Moreover, many analyses involve cross-sectional data, typically collected years after immigrants migrate. Using cross-sectional data limit one’s ability to examine if differences between immigrants and U.S.-born people are due to immigration itself or if they existed prior to immigration. To address this methodological critique, a study that uses longitudinal data and allows for comparison of immigrants to a more appropriate counterfactual group – those who do not migrate – may be needed. In addition to this methodological critique, the stresses of immigrant integration may be another reason why the immigrant health advantage does not exist for all health outcomes. The stresses of integration can come in many forms including the difficulties immigrants experience in securing stable income (financial strain) and discrimination based on one’s immigration status. However, some factors protect immigrants from poor health; immigrants’ social capital could reduce the stresses of integration or increase access to health promoting resources. To address these gaps in the literature, this project will examine the following aims. First, I will examine how immigrants differ from their non-migrant counterparts for three health outcomes: allostatic load, psychological distress, and sleep quality. Differences in allostatic load will be examined at baseline while differences in psychological distress and sleep quality will be examined both at baseline and over a 3-year follow-up period. Second, I will explore how three factors related to the stress of integration – financial strain, interpersonal discrimination, and social capital – change from baseline to 3-year follow-up. Finally, I will determine the association of each health outcome to each factor of stress of integration. To examine these aims, I will conduct a secondary data analysis of the baseline, 1-year, 2-year, and 3-year data of an ongoing longitudinal study, the Health of Philippine Emigrants Study (HoPES) (n=1637). These findings will provide insight into both individual and institutional factors that affect migrant health before arrival in the U.S. Moreover, results can highlight possible points of interventions to support immigrant integration. This research plays an important role in examining how pre-migration factors affect health before arrival and sets up the baseline data on understanding how pre-migration factors can affect post-migration health.