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解读移民健康优势:美国五大主要原籍国移民群体健康相关因素中的自我选择与保护

Explaining the Immigrant Health Advantage: Self-selection and Protection in Health-Related Factors Among Five Major National-Origin Immigrant Groups in the United States.

作者信息

Riosmena Fernando, Kuhn Randall, Jochem Warren C

机构信息

Population Program and Geography Department, University of Colorado at Boulder, 1440 15th Street, 483 UCB, Boulder, CO, 80309, USA.

UCLA Fielding School of Public Health, Department of Community Health Sciences and the California Center for Population Research, University of California, Los Angeles, USA.

出版信息

Demography. 2017 Feb;54(1):175-200. doi: 10.1007/s13524-016-0542-2.

Abstract

Despite being newcomers, immigrants often exhibit better health relative to native-born populations in industrialized societies. We extend prior efforts to identify whether self-selection and/or protection explain this advantage. We examine migrant height and smoking levels just prior to immigration to test for self-selection; and we analyze smoking behavior since immigration, controlling for self-selection, to assess protection. We study individuals aged 20-49 from five major national origins: India, China, the Philippines, Mexico, and the Dominican Republic. To assess self-selection, we compare migrants, interviewed in the National Health and Interview Surveys (NHIS), with nonmigrant peers in sending nations, interviewed in the World Health Surveys. To test for protection, we contrast migrants' changes in smoking since immigration with two counterfactuals: (1) rates that immigrants would have exhibited had they adopted the behavior of U.S.-born non-Hispanic whites in the NHIS (full "assimilation"); and (2) rates that migrants would have had if they had adopted the rates of nonmigrants in sending countries (no-migration scenario). We find statistically significant and substantial self-selection, particularly among men from both higher-skilled (Indians and Filipinos in height, Chinese in smoking) and lower-skilled (Mexican) undocumented pools. We also find significant and substantial protection in smoking among immigrant groups with stronger relative social capital (Mexicans and Dominicans).

摘要

尽管是新来者,但在工业化社会中,移民相对于本土出生人口往往表现出更好的健康状况。我们扩展了先前的研究,以确定自我选择和/或保护是否能解释这一优势。我们在移民前夕检查移民的身高和吸烟水平,以测试自我选择情况;我们分析移民后的吸烟行为,并控制自我选择因素,以评估保护作用。我们研究了来自五个主要国家的20至49岁的人群:印度、中国、菲律宾、墨西哥和多米尼加共和国。为了评估自我选择,我们将在国家健康和访谈调查(NHIS)中接受访谈的移民与在世界卫生调查中接受访谈的移民输出国的非移民同龄人进行比较。为了测试保护作用,我们将移民自移民以来吸烟行为的变化与两个反事实情况进行对比:(1)如果移民采用了美国本土非西班牙裔白人在NHIS中的行为(完全“同化”),他们本应表现出的吸烟率;(2)如果移民采用了移民输出国非移民的吸烟率(无移民情况),他们本应有的吸烟率。我们发现了具有统计学意义的显著自我选择,特别是在来自高技能群体(印度人和菲律宾人的身高、中国人的吸烟情况)和低技能群体(墨西哥人)的无证移民男性中。我们还发现,在具有较强相对社会资本的移民群体(墨西哥人和多米尼加人)中,吸烟方面存在显著且实质性的保护作用。

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