The Effects of Adaption on the Health of Immigrants

描述（由申请人提供）：在过去的几十年里，移民到美国的人数增加了两倍。这种移民流动对美国大部分人口的健康有什么影响？移民可能通过增加服务需求或改变移民高度集中地区提供的具体服务类型来影响卫生保健系统。此外，移民有助于美国的社会经济和种族/民族多样性，这对各人口亚群最佳获得和提供医疗保健和卫生服务具有影响。了解移民的特征和健康结果是解决移民对美国人口潜在影响问题的先决条件。我们有兴趣回答以下问题。移民的健康与当地人有何不同，以及健康的沿着哪些方面？移民在适应美国社会的过程中，他们的健康状况如何随着时间的推移而变化？移民与本地人在健康方面的差距如何随着时间的推移和健康结果的变化而变化？许多先前的研究一直受到样本量有限或没有使用全国代表性数据的困扰。此外，关于适应对移民健康是积极影响还是消极影响，文献中没有明确的共识。这部分是因为许多研究比较了移民在抵达美国后的横截面，并推断如果群体在持续时间上有显着差异，则会出现积极或消极的文化适应。然而，如果移民群体在健康或社会经济特征方面存在显著差异，则在横截面中进行的回归可能导致关于同化的错误结论;换句话说，时间和群体效应是混淆的（Borjas，1985年）。 我们通过使用多波具有全国代表性的HRS/AHEAD数据来解决这些缺点，以探索移民随着时间的推移在广泛的健康结果中的健康状况。我们将使用逻辑回归来检查移民与本地人在报告的一般健康状况和慢性健康状况和基线残疾患病率方面的差异。然后，我们将使用风险建模方法来1）探索在基线时没有这些健康状况的受访者中慢性疾病和残疾发作的移民-本地差异，2）确定移民的健康是否改善或随着时间的推移在美国。

DESCRIPTION (provided by applicant): Immigration to the U.S. has tripled over the last few decades. What is the impact of this flow of immigrants on the health of the larger U.S. population? Immigrants may impact the health care system by increasing demand for services or changing the specific type of services offered in areas of high immigrant concentration. Furthermore, immigrants contribute to the socioeconomic and racial/ethnic diversity of the U.S., which has implications for optimal access to and delivery of medical care and health services across various population subgroups. Understanding the characteristics and health outcomes of immigrants is prerequisite to addressing the issue of immigrants' potential impact on the U.S. population. We are interested in answering the following questions. How does the health of immigrants differ from that of natives, and along which dimensions of health? How does the health of immigrants change over time as they adapt to U.S. society? How does the immigrant-native gap in health change over time and across health outcome? Many previous studies have been plagued by limited sample size or have not used nationally representative data. Furthermore, there is no clear consensus in the literature on whether adaptation has positive or negative consequences for immigrants' health. This is partly due to the fact that many studies compare immigrants in the cross-section by years since arrival in the U.S. and infer positive or negative acculturation if groups vary significantly by duration. However, regressions done in the cross-section may lead to incorrect conclusions about assimilation if immigrant cohorts differ significantly in health or socioeconomic characteristics; in other words duration and cohort effects are confounded (Borjas, 1985). We address these shortcomings by using multiple waves of the nationally representative HRS/AHEAD data to explore the health of immigrants over time across a wide range of health outcomes. We will use logistic regression to examine immigrant-native differences in reported general health and prevalence of chronic health conditions and disability at baseline. We will then use a hazard modeling approach to 1) explore immigrant-native differences in the onset of chronic disease conditions and disability among respondents who did not have those health conditions at baseline and 2) determine whether the health of immigrants improves or worsens with time in the U.S.