The Health Consequences of Asian Immigrant Integration.

Abstract

This dissertation consists of three papers that explore contextual influences on the health trajectories of Asian immigrants. Current public health research has largely attributed Asian immigrants’ changing health patterns to lifestyle and behavioral changing stemming from acculturation. My first paper developed an alternative framework of Asian immigrant integration that incorporates health influences from economic, social and cultural integration processes. Each form of integration produces health stressors and resources, which in turn interact and accumulate to form broad contexts of disease. I also considered how health trajectories may vary across distinct Asian immigrant groups. I identified three potential sources of group heterogeneity: year of entry cohorts, gender and Asian ethnicity. In my second paper, I examined whether separate year of entry cohorts of Asian immigrants have unique disability, self-rated health and obesity health trajectories with increased duration in the United States. I identified four cohorts of modern Asian immigrants and hypothesized that they would display different baseline health and duration patterns according to the selectivity of concurrent immigration policy, home country circumstances, openness of societal reception and labor market opportunities. Using the 1995-2005 waves of the National Health Interview Survey (NHIS), I found that immigrants who entered during selective policy periods had better baseline disability status and self-reported health. Immigrants who entered during more open periods of societal reception displayed better disability status and self-rated health with duration. My final paper examines the health consequences of concurrent economic and social integration. Using the 2005-2007 waves of the American Community Survey (ACS), I found that immigrants displayed both rising wages and higher odds for disability with increased duration. While higher wages was consistently associated with lower odds of disability, this relationship was weaker among immigrants with longer duration. When I tested this interaction among separate Asian ethnic groups, I found the same pattern among Asian Indian and Filipino groups. I suggested that longer-term immigrants have been exposed longer to health-degrading processes, such as racial discrimination and occupational barriers, which can counteract the health-protective benefits of SES.