A Cross-National Perspective in Migrant Health

描述（由申请人提供）：本研究旨在揭示美国移民群体与其原籍国健康状况之间的健康差异，并有助于我们理解移民合并过程对公共卫生的影响。我们通过比较来自五个原籍国的移民男性和女性的健康状况和（横断面）年龄特定健康轨迹，与那些具有相似特征但仍留在原籍社会的非移民的健康状况和健康轨迹，专门解决移民健康选择和文化适应的解释。与大多数现有研究相比，起源社会比较将提供更合适的分析反事实，这些研究只将移民与本地人或其他移民群体进行比较。跨国比较将使我们能够进一步研究以下方面的相关性：A)移民条件在确定性别特异性移民选择中的作用；b)接收移民在目的地面临的影响移民健康轨迹的背景。我们研究了五个主要的移民群体，他们的健康状况、移民条件和接受环境差异显著：中国人、多米尼加人、印度人、墨西哥人和菲律宾人。我们使用来自美国和这五个派遣国的具有全国代表性的数据，即前者的全国健康访谈调查和新移民调查，后者的世界健康调查和全球老龄化和成人健康调查。我们研究了文化适应在理论上以不同方式影响的几种健康结果，以及主要慢性疾病的关键风险因素，包括自我报告的身高、身体质量指数（BMI）水平、当前吸烟状况，以及自我报告的糖尿病状况。我们还采用了自评健康（SRH）指标，这些指标包括客观健康、总体幸福感，甚至是对美国社会的文化适应程度。多变量回归和匹配技术的结合将使我们能够专注于健康选择性问题，同时最大限度地减少因移民不代表其原籍人口的随机子集这一事实而产生的健康差异。最后，我们将基于多状态生命表技术估计假想人群在整个生命历程（根据他们迁移的时间）的总结措施，以便根据他们的文化适应水平比较个人的潜在健康轨迹，同时保留非移民轨迹作为反事实的兴趣。

DESCRIPTION (provided by applicant): This study aims to shed light on health disparities among immigrant groups in the U.S. relative to health conditions in their sending countries and to contribute to our understanding of the public health implications of immigrant incorporation processes. We specifically address explanations for immigrant health selection and acculturation by comparing the health status and (cross-sectional) age-specific health trajectories of immigrant men and women from five origin nations against those of non-migrants with similar characteristics who remain in the origin society. The origin-society comparison will offer a more appropriate analytic counterfactual than that used in most existing studies, which only compare immigrants to natives or to other immigrant cohorts. A cross-national comparison will allow us to further examine the relevance of a) conditions of emigration in determining sex-specific migrant selectivity and b) the context of reception immigrants' face in destinations in influencing immigrant health trajectories. We look at five major immigrant groups where health outcomes, conditions of emigration, and contexts of reception vary conspicuously: Chinese, Dominicans, Indians, Mexicans, and Filipinos. We use nationally-representative data from both the United States and each of these five sending countries, namely National Health Interview Survey and New Immigrant Survey in the former and World Health Survey and the Survey of Global Ageing and Adult Health in the latter. We look at several health outcomes theoretically affected in different ways by acculturation and which are key risk factors of major chronic conditions, including self-reported height, body mass index (BMI) levels, and current smoking status, in addition to self-reported diabetes status. We also employ self-rated health (SRH) measures, which capture objective health, general well-being, and even acculturation to U.S. society. A combination of multivariate regression and matching techniques will allow us to focus on the health selectivity issue while minimizing health differences arising from the fact that migrants do not represent a random subset of their populations of origin. Finally, we will estimate summary measures for hypothetical groups of people across the life course (according to the timing of their migration) based on multistate life table techniques in order to compare the potential health trajectories of individuals according to their level of acculturation while keeping non-migrant trajectories as the counterfactual of interest. PUBLIC HEALTH RELEVANCE: This project compares several major health outcomes (height, BMI, smoking, diabetes, self-rated health) and their age-specific trajectories among immigrant adult men and women coming from five major immigrant origins (China, the Dominican Republic, India, Mexico, and the Philippines) with those prevalent among non-migrants in their respective sending countries. By comparing both the levels and trajectories of immigrants with those of non-migrants in origin, this study aims to shed light on health disparities among immigrant groups in the U.S. relative to health conditions in their sending countries and to contribute to our understanding of the public health implications of immigrant incorporation processes.