Sunday 19 May 2013

The Health Toll of Immigration

BROWNSVILLE, Tex. — Becoming an American can be bad for your health.

A growing body of mortality research on immigrants has shown that the longer they live in this country, the worse their rates of heart disease, high blood pressure and diabetes. And while their American-born children may have more money, they tend to live shorter lives than the parents.

The pattern goes against any notion that moving to America improves every aspect of life. It also demonstrates that at least in terms of health, worries about assimilation for the country’s 11 million illegal immigrants are mistaken. In fact, it is happening all too quickly.

“There’s something about life in the United States that is not conducive to good health across generations,” said Robert A. Hummer, a social demographer at the University of Texas at Austin.

For Hispanics, now the nation’s largest immigrant group, the foreign-born live about three years longer than their American-born counterparts, several studies have found.

Why does life in the United States — despite its sophisticated health care system and high per capita wages — lead to worse health? New research is showing that the immigrant advantage wears off with the adoption of American behaviors — smoking, drinking, high-calorie diets and sedentary lifestyles.

Here in Brownsville, a worn border city studded with fast-food restaurants, immigrants say that happens slowly, almost imperceptibly. In America, foods like ham and bread that are not supposed to be sweet are. And children lose their taste for traditional Mexican foods like cactus and beans.

For the recently arrived, the quantity and accessibility of food speaks to the boundless promise of the United States. Esther Angeles remembers being amazed at the size of hamburgers — as big as dinner plates — when she first came to the United States from Mexico 15 years ago.

“I thought, this is really a country of opportunity,” she said. “Look at the size of the food!”

Fast-food fare not only tasted good, but was also a sign of success, a family treat that new earnings put in reach.

“The crispiness was delicious,” said Juan Muniz, 62, recalling his first visit to Church’s Chicken with his family in the late 1970s. “I was proud and excited to eat out. I’d tell them: ‘Let’s go eat. We can afford it now.’ ”

For others, supersize deals appealed.

“You work so hard, you want to use your money in a smart way,” said Aris Ramirez, a community health worker in Brownsville, explaining the thinking. “So when they hear ‘twice the fries for an extra 49 cents,’ people think, ‘That’s economical.’ ”

For Ms. Angeles, the excitement of big food eventually wore off, and the frantic pace of the modern American workplace took over. She found herself eating hamburgers more because they were convenient and she was busy in her 78-hour-a-week job as a housekeeper. What is more, she lost control over her daughter’s diet because, as a single mother, she was rarely with her at mealtimes.

Robert O. Valdez, a professor of family and community medicine and economics at the University of New Mexico, said, “All the things we tell people to do from a clinical perspective today — a lot of fiber and less meat — were exactly the lifestyle habits that immigrants were normally keeping.”

As early as the 1970s, researchers found that immigrants lived several years longer than American-born whites even though they tended to have less education and lower income, factors usually associated with worse health. That gap has grown since 1980. Less clear, however, was what happened to immigrants and their American-born offspring after a lifetime in the United States.

Evidence is mounting that the second generation does worse. Elizabeth Arias, a demographer at the National Center for Health Statistics, has made exploratory estimates based on data from 2007 to 2009, which show that Hispanic immigrants live 2.9 years longer than American-born Hispanics. The finding, which has not yet been published, is similar to those in earlier studies.


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