Reconsidering the Relationship between Age at Migration and Health Behaviors among US Immigrants: The Modifying Role of Continued Cross-border Ties

Abstract

Age-at-migration is commonly utilized as a proxy measure for assimilation. We re-consider this approach by examining the role of continued connection with places of origin on alcohol use. Cross-border connections may diminish the association between earlier age-at-migration and alcohol use by providing an alternative channel of influence for behavioral norms. Alternatively, a stress and coping perspective on cross border ties suggests potentially countervailing impacts of these connections on alcohol use. We use data from the 2002/2003 National Latino and Asian American Study (NLAAS) (n=1641/1630 Asian and Latino origin respondents, respectively). We first estimate the association between age-at-migration (child/adolescent versus adult migrant) and any past-year alcohol use. We subsequently test the interaction between age-at-migration and two measures of cross-border contact. All models are stratified by region of origin and gender. For Latin American-origin women, cross-border ties are associated with increased risk for alcohol use among those who migrated early in life. In contrast, Asian-origin men and women who migrated as adults and have contact with family and friends abroad have the lowest predicted probabilities of past-year alcohol use. The results among Asians support the idea that cross-border ties can be alternative influences on health behavior outcomes, particularly for adult migrants. Overall, we find qualified support for both transnational and assimilationist perspectives on alcohol use behaviors among US immigrants -- as well as the interaction between these two frameworks. The joint influences of cross-border ties and age-at-migration were observed primarily for immigrant women, and not always in expected directions. We nevertheless urge future research to consider both US and country-of-origin influences on a wider range of health and health behavior outcomes for immigrants, as well as the potential intersection between US and cross-border connections.

The Association Between the Perceived Unjust Treatment in Healthcare Settings and the Unmet Need for General Practitioner Services Among People With Foreign Background in Finland

“…Adjusting for other tested factors did not affect this association. The results differ from previous studies in which the used factors have been associated with unmet need for medical care 3,5,6,12,15,16,[18][19][20][21][22]24,26,27 . The strong association could be due to a bi-directional relationship between the discriminatory treatment and unmet need for care.…”

“…By contrast, a higher degree of social integration predicted less use of cross-border medical services. 25 Age at migration has been recognized as a moderator of social integration as it affects different opportunities as well as ability to and e ciency in learning new languages 26,27 .…”

Pre-acculturation as a risk factor for obesity: Findings from the Health of Philippine Emigrants Study (HoPES)

“…Our results are preliminary, but suggest that immigrant acculturation can occur prior to migration (Torres, Ro and Sudhinaraset 2019). Supposing this was true, it suggests that simple dichotomies of “western” versus “eastern” cultures may not sufficiently capture the complexities of a globalizing world.…”

Oral Health, Health Service Utilization, and Age at Arrival to the U.S. among Safety Net Patients

“…Findings reflect other studies' observations of differences in health outcomes by age-at-migration. While age-at-migration has commonly and controversially been used as a proxy variable for acculturation [23], lifestage measures such as duration of time in a specific community context may also indicate, using lifecourse theory, cumulative exposure to risk or protective factors that have lasting impacts on health [3][4][5]. This is the first study, to our knowledge, to apply a lifecourse approach to examine immigrant safety net patients' oral health self-report and service utilization outcomes.…”

“…For example, younger age-at-migration or being born in the U.S. is associated with obesity among heterogeneous Latinx/Hispanic-Americans, as well as with depression among older Mexican-Americans [20][21][22]. While age-at-migration is conventionally (and increasingly controversially) understood as a proxy measure for acculturation, a lifecourse understanding of age with regard to migration dynamics can, through a lifecourse approach, suggest duration of exposures to risks for which cumulative effects are meaningful, for example inadequate water, sanitation resources, or nutrition in communities of origin that experienced disinvestments by the state, or harmful "conveniences" of higher income countries such as excess processed foods and other addictive substances [16,23].…”