Health, Wealth, and Nativity: Re-Examining the Immigrant Health Paradox Among Low-Income Mothers

Abstract

The Healthy Immigrant Effect, or the tendency of recent migrants to have better health outcomes than the native-born, despite being of lower socio-economic status, is a welldocumented phenomenon. Given the current administration’s adverse stance towards immigration, and the deep-seated socio-economic and racial disparities which permeate national health outcomes, re-examining immigrant health effects among particularly vulnerable populations paints a more dynamic picture of the many ways immigrants affect American society, as well as how to mitigate detrimental social determinants of health. This thesis builds upon the existing body of literature surrounding immigrant health effects, evaluating whether a foreign-born advantage persists within particular contexts of disadvantage. I chose a study population of low-income mothers, which captured a wide variety of health-influencing factors such as minority status, poverty, low levels of education, as well as the unique stress of independent child rearing. Using data from the Fragile Family and Child Health Wellbeing Study (FFCHWS), I conducted a statistical analysis to estimate how American nativity affected various health behaviors and outcomes, including fast food consumption, smoking habits, low-birthweight, obesity, and asthma, hypothesizing that foreign-born mothers would practice healthier habits and have a lower risk of adverse health outcomes. The results of my analysis supported my hypothesis, estimating that native born mothers were three times as likely to consume fast food frequently, five times as likely to smoke, twice as likely to be obese, and twice as likely to be asthmatic. The effects of nativity on low-birthweight varied by race, highlighting troubling racial disparities in maternal health in the United States. These findings indicate that foreign-born women were able to mitigate the negative health consequences of disadvantage, and emphasize the dangers of tobacco use and poor diet. This thesis serves to inform both immigration and health policy. Firstly, the persistence of an immigrant health paradox within this particularly vulnerable population stands as a powerful counter-narrative to the Trump administration’s portrayal of immigrants as burdens to the American health and welfare systems. Secondly, foreign-born advantages driven by low smoking rates and healthier diets demonstrate the need for remedial action to counteract low-income population’s disproportionately high exposure to tobacco products and fast food.