Sandra Albrecht
A large body of evidence has shown that U.S. immigrants appear healthier across a wide range of outcomes compared to U.S.-born populations, even though immigrants tend to have, on average, lower socioeconomic status (SES). But with longer time in the U.S., their health appears to decline, theoretically because of adoption of behavioral norms more common in American society (e.g. poor diet, higher sedentary behavior, and increased smoking and alcohol consumption).
Much of the research on immigrant health has been dominated by cross-sectional designs, limited attention to the heterogeneity of immigrants, and a focus on individual-level processes of acculturation (process by which individuals adopt the norms, values, and practices of their new host society). There is a need for more longitudinal designs and better methods to improve causal inference. There is also a need to consider differences in patterns by country of origin, legal status, race, SES, life stage at migration, and geography of U.S. residence (among other factors) to better identify high-risk populations, but also to identify healthier subsets of the population that could benefit from intervention strategies to support the maintenance of good health. The COVID-19 pandemic has also laid bare the vulnerability of immigrants to crises, especially the broader social factors that limit the ability of immigrants to adhere to preventive measures, and poor access to care and treatment which have implications for disease severity.
Below, I provide a sample of papers that provide a conceptual overview of topics important for immigrant health, and future directions. I also list empirical papers that have moved beyond the cross-sectional designs that have dominated the literature, that have attempted to parse out heterogeneity, and/or that consider the role of structural factors and policies that influence immigrant health.