Bacong Adrian, Sohn Heeju
University of California Los Angeles, Los Angeles, California, USA.
Department of Sociology, Emory University, Atlanta, Georgia, USA
J Epidemiol Community Health. 2020 Nov 25. doi: 10.1136/jech-2020-214245.
In the United States, immigration policy is entwined with health policy, and immigrants' legal statuses determine their access to care. Yet, policy debates rarely take into account the health needs of immigrants and potential health consequences of linking legal status to healthcare. Confounding from social and demographic differences and lack of individual-level data with sensitive immigration variables present challenges in this area of research.
This article used the restricted California Health Interview Survey (CHIS) to assess differences in self-rated health, obesity, and severe psychological distress. Between US-born citizens, naturalised citizens, lawful permanent residents (LPR), undocumented immigrants, and temporary visa holders living in California.
Results show that while immigrant groups appear to have poorer health on the surface, these differences were explained predominantly by older age among naturalised citizens and by lower-income and education among LPRs and undocumented immigrants. Favourable family characteristics acted as protective factors for immigrants' health, especially among disadvantaged immigrants.
Immigration policy that limits access to healthcare and family support may further widen the health disadvantage among immigrants with less legal protection.
在美国,移民政策与健康政策相互交织,移民的法律身份决定了他们获得医疗服务的机会。然而,政策辩论很少考虑移民的健康需求以及将法律身份与医疗保健挂钩可能产生的健康后果。社会和人口差异造成的混杂因素以及缺乏包含敏感移民变量的个人层面数据,给该研究领域带来了挑战。
本文使用受限的加利福尼亚健康访谈调查(CHIS)来评估美国出生的公民、入籍公民、合法永久居民(LPR)、无证移民以及居住在加利福尼亚的临时签证持有者之间在自评健康、肥胖和严重心理困扰方面的差异。
结果表明,虽然表面上移民群体的健康状况似乎较差,但这些差异主要是由入籍公民的年龄较大以及LPR和无证移民的低收入和低教育水平所解释的。良好的家庭特征对移民的健康起到了保护作用,尤其是在弱势移民群体中。
限制获得医疗保健和家庭支持的移民政策可能会进一步扩大法律保护较少的移民群体中的健康劣势。