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

摘要 与在美国出生的同龄人相比，移民往往有更好的健康状况，尽管他们的社会经济地位较低 这一现象被称为“移民健康优势”。然而，移民的健康优势 出现在一些健康结果中，但不是所有结果中。有两个主要的论点可以解释为什么 成为所有健康结果的移民健康优势。首先，在方法上存在局限性。 把移民比作在美国出生的人。两人通常都是在不同的社会环境中长大的，这 自动允许研究人员发现差异。此外，许多分析涉及横断面数据， 通常是在移民迁徙数年后收集的。使用横断面数据限制了一个人检查是否 移民和在美国出生的人之间的差异是由于移民本身，或者他们是否在 移民局。为了应对这种方法论批评，一项使用纵向数据并考虑到 将移民与更合适的反事实群体--那些没有移民的人--进行比较可能是 需要的。除了这一方法论批评，移民融合的压力可能是另一种 为什么移民的健康优势并不适用于所有的健康结果。整合的压力 可能有多种形式，包括移民在获得稳定收入(经济收入)方面遇到的困难 菌株)和基于移民身份的歧视。然而，一些因素保护移民不受 健康状况不佳；移民的社会资本可以减轻融入社会的压力或增加获得健康的机会 推广资源。为了解决文献中的这些差距，本项目将审查以下目标。第一, 我将研究移民与他们的非移民同行在三个健康后果方面的不同： 负荷、心理困扰和睡眠质量。平衡负荷的差异将在基线时检查，而 心理困扰和睡眠质量的差异将在基线和三年内进行检查。 随访期。第二，我将探索与整合压力相关的三个因素--财务压力、 人际歧视和社会资本--从基线到3年跟踪。最后，我会 确定每个健康结果与每个整合压力因素之间的关联。来研究这些 AIMS，我将对正在进行的 纵向研究，菲律宾移民健康研究(HOPE)(n=1637)。这些发现将提供 在移民抵达美国之前，洞察影响移民健康的个人和制度因素。 结果可以突出可能的干预要点，以支持移民融入社会。这项研究起到了 在审查移民前因素如何影响抵达前的健康和建立基线数据方面发挥重要作用 了解移民前因素如何影响移民后的健康。

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.