As of March 2000, it was estimated that approximately 10.4% of the U.S. population, or 28.4 million individuals, were immigrants. Prior to 1965, the majority of immigrants came from European countries, such as the United Kingdom, Greece, Poland, Portugal, Germany, and Ireland. However, during the past 30 years, an increasing number of immigrants have come from Latin America, Asia, and Caribbean countries, such as El Salvador and Colombia, Vietnam and China, and Haiti and the Dominican Republic. Individuals may seek to enter the United States for any number of reasons, including a desire to reunite with family members, the acceptance of a new employment opportunity, or a need to leave one’s country of origin due to persecution. The majority of individuals entering the United States from other countries do so legally, through established immigration procedures. others enter illegally, oftentimes in search of a safe haven from persecutors.
Findings relating to the health of immigrants have been inconsistent, in part due to reliance on different definitions of “immigrant.” For instance, some studies consider the health or illness of all foreign-born individuals, while others examine the health of those who are here legally or those who are here illegally.
The risk of morbidity and mortality varies by immigrant group and by disease. However, a number of studies have found that black and Hispanic immigrants experience lower rates of mortality than do blacks and Hispanics who were born in the United States. In addition, immigrants’ risks of smoking, substance use, obesity, hypertension, and some forms of cancer are lower than the risks experienced by U.S.-born individuals of equivalent demographic and socioeconomic backgrounds. However, the risk of these illnesses appears to increase with increasing length of residence in the United States. In general, the risk of various infectious diseases, such as tuberculosis and parasitic infections, appears to be higher among various immigrant groups as compared to individuals born in the United States.
Immigrants seeking medical attention may face barriers as a result of language differences and the relative unavailability of competent interpreters, transportation difficulties, and providers’ lack of familiarity with the healing beliefs and practices of their immigrant patients. In addition, the Personal Responsibility and Work Opportunity Reconciliation Act and the Illegal Immigration Reform and Immigrant Responsibility Act, which were both enacted in 1996, severely restrict the ability of even legal immigrants to rely on publicly funded medical services, apart from emergency medical needs and the diagnosis and treatment of specified infectious diseases. Many states have not adopted state legislation that would permit immigrants to rely on publicly funded care when they do not have privately funded health insurance. This is particularly problematic for women of childbearing age, who may not have the funds or the private insurance to cover the costs of prenatal care, labor, and delivery services, or care for their newborns. The legislation has engendered significant controversy because many of the immigrants who are denied publicly funded care, such as Medicaid, actually pay in to the system through their taxes.
Women who immigrate to the United States may experience a number of health-related difficulties that are gender-related. Women may suffer significant trauma during their transit to the United States; this may include sexual assaults and forced labor, sometimes in the form of sexual slavery. once they arrive in the
United States, they may confront additional problems that are gender-related. For instance, many immigrant women are more willing than their male partners to accept low-paying jobs in order to support themselves and their families. Once they become wage earners, they may be introduced to North American conceptualizations of gender roles. Their male partners may, as a result of their own unemployment, feel threatened by what appears to be a shift in the power structure within the family due to their inability to earn a living and their partners’ newfound independence. For some women, these changes in their family structure have been associated with increases in domestic violence. Still other immigrant women may become subject to abuse by their U.S. citizen or legally permanent resident spouses or boyfriends, who have promised to file immigration papers on their behalf but have failed to do so. Specific provisions in our immigration law now permit abused immigrant women in such situations to file petitions on their own behalf so that they will not have to remain captive in abusive relationships.
SEE ALSO: Access to health care, African American, Asian and Pacific Islander, Discrimination, Domestic violence, Latinos
- Fix, M., & Passel, J. S. (1999). Trends in noncitizens’ and citizens’ use of public benefits following welfare reform 1994-97. Washington, DC: Urban Institute.
- Loue, S. (Ed.). (1998). Handbook of immigrant health. New York: Plenum Press.
- Loue, S., & Bunce, A. (1999). The assessment of immigration status in health research (DHHS Publication No. PHS 99-1327). Hyattsville, MD: U.S. Department of Health and Human Services.