Disparities in birth outcomes within the U.S. White population: Prevalence of low birth weight among immigrant mothers from the Middle East and North Africa.

Immigration from the Middle East and North Africa (MENA) has diversified the U.S. non-Hispanic White population. Analyzing health disparities within this group is a complex task due to data limitations across most federal and state data collection systems. This study investigates disparities in the risk of giving birth to a low-birth-weight infant among foreign-born non-Hispanic White MENA and non-MENA mothers and by MENA mothers' nationality. This population-based study uses Restricted-Use Detail Natality Data from 2016 to 2019 accessed through the National Center for Health Statistics and provided by the Centers for Disease Control and Prevention. The study examines the risk of giving birth to a low-birth-weight infant (<2500g) among foreign-born non-Hispanic White mothers by MENA/non-MENA status as the primary independent variable of interest. Logistic regression models are used to control for social and demographic characteristics, medical risk factors, and measures of prenatal care adequacy. Results are presented as odds ratios. Among foreign-born non-Hispanic White mothers, 139,708 (32%) are classified as MENA and 296,093 (68%) as non-MENA. Results show that after controlling for social and demographic characteristics, medical factors, and measures of prenatal care adequacy, foreign-born non-Hispanic White MENA mothers have greater odds of giving birth to a low-birth-weight infant than their non-MENA counterparts (OR: 1.443, p-value <0.001). Increased immigration from the MENA region has contributed to changes in health profiles among foreign-born non-Hispanic White mothers. As this group grows, understanding the impact of immigration on the composition of the non-Hispanic White population, and consequently, racial disparities in the U.S., is crucial for researchers and policymakers.

Beyond Acculturation: Health and Immigrants' Social Integration in the United States.

Immigrants typically have more favorable health outcomes than their U.S.-born counterparts of the same race-ethnicity. However, little is known about how race-ethnicity and region of birth moderate the health outcomes of different immigrant groups as their tenure of U.S. residence increases. We study the association between time spent in the United States and health outcomes among non-Hispanic Black, non-Hispanic White, Asian, and Hispanic immigrants using National Health Interview Survey data. Although all immigrant groups initially report better health outcomes than their U.S.-born counterparts, the association between U.S. tenure and reported health outcomes varies among immigrants by race-ethnicity and region of birth. Black immigrants have the worst hypertension profiles, and Black and Hispanic immigrants have the worst obesity profiles. The results suggest that acculturation cannot fully explain racial-ethnic differences in the association between U.S. tenure and health outcomes. We advance a more complete sociological theory of immigrant integration to better explain disparate immigrant health profiles.

Does college major matter for women's and men's health in midlife? Examining the horizontal dimensions of educational attainment.

Studies on how education shapes adult health have largely conceptualized education as the quantity of schooling attained, coined the "vertical dimension" of education. While this dimension is important, heterogeneity within levels of education (the "horizontal dimension") may also shape health. Using data from the 2010-2014 American Community Survey on adults aged 45-64 with a Bachelor's degree (N = 667,362), we investigate the association between a key indicator of adult health (physical functioning) and an understudied horizontal dimension of education (college major). We find that physical functioning in midlife varies significantly by college major. For instance, the odds of poor functioning for men who majored in Psychology/Social Work were 1.9 (95% CI: 1.7, 2.1) times greater than for men who majored in Business. However, all college graduates, regardless of major, report better functioning than non-graduates. We also find that inequalities in midlife functioning across majors largely reflect differences in human capital skills and financial returns in the labor market. Taken together our findings suggest that college major is an important component of health stratification and should be integrated into the literature on health inequalities.

Health Assimilation among Hispanic Immigrants in the United States: The Impact of Ignoring Arrival-cohort Effects.

A large literature has documented that Hispanic immigrants have a health advantage over their U.S.-born counterparts upon arrival in the United States. Few studies, however, have disentangled the effects of immigrants' arrival cohort from their tenure of U.S. residence, an omission that could produce imprecise estimates of the degree of health decline experienced by Hispanic immigrants as their U.S. tenure increases. Using data from the 1996-to-2014 waves of the March Current Population Survey, we show that the health (i.e., self-rated health) of Hispanic immigrants varies by both arrival cohort and U.S. tenure for immigrants hailing from most of the primary sending countries/regions of Hispanic immigrants. We also find evidence that acculturation plays an important role in determining the health trajectories of Hispanic immigrants. With respect to self-rated health, however, our findings demonstrate that omitting arrival-cohort measures from health assimilation models may result in overestimates of the degree of downward health assimilation experienced by Hispanic immigrants.

The healthy immigrant (migrant) effect: In search of a better native-born comparison group.

This paper evaluates whether immigrants' initial health advantage over their U.S.-born counterparts results primarily from characteristics correlated with their birth countries (e.g., immigrant culture) or from selective migration (e.g., unobserved characteristics such as motivation and ambition) by comparing recent immigrants' health to that of recent U.S.-born interstate migrants ("U.S.-born movers"). Using data from the 1999-2013 waves of the March Current Population Survey, I find that, relative to U.S.-born adults (collectively), recent immigrants have a 6.1 percentage point lower probability of reporting their health as fair or poor. Changing the reference group to U.S.-born movers, however, reduces the recent immigrant health advantage by 28%. Similar reductions in the immigrant health advantage occurs in models estimated separately by either race/ethnicity or education level. Models that examine health differences between recent immigrants and U.S.-born movers who both moved for a new job-a primary motivation behind moving for both immigrants and the U.S.-born-show that such immigrants have only a 1.9 percentage point lower probability of reporting their health as fair or poor. Together, the findings suggest that changing the reference group from U.S.-born adults collectively to U.S.-born movers reduces the identified immigrant health advantage, indicating that selective migration plays a significant role in explaining the initial health advantage of immigrants in the United States.

Selection, language heritage, and the earnings trajectories of black immigrants in the United States.

Research suggests that immigrants from the English-speaking Caribbean surpass the earnings of U.S.-born blacks approximately one decade after arriving in the United States. Using data from the 1980-2000 U.S. censuses and the 2005-2007 American Community Surveys on U.S.-born black and non-Hispanic white men as well as black immigrant men from all the major sending regions of the world, I evaluate whether selective migration and language heritage of immigrants' birth countries account for the documented earnings crossover. I validate the earnings pattern of black immigrants documented in previous studies, but I also find that the earnings of most arrival cohorts of immigrants from the English-speaking Caribbean, after residing in the United States for more than 20 years, are projected to converge with or slightly overtake those of U.S.-born black internal migrants. The findings also show three arrival cohorts of black immigrants from English-speaking African countries are projected to surpass the earnings of U.S.-born black internal migrants. No arrival cohort of black immigrants is projected to surpass the earnings of U.S.-born non-Hispanic whites. Birth-region analysis shows that black immigrants from English-speaking countries experience more rapid earnings growth than immigrants from non-English-speaking countries. The arrival-cohort and birth-region variation in earnings documented in this study suggest that selective migration and language heritage of black immigrants' birth countries are important determinants of their initial earnings and earnings trajectories in the United States.

Changes in income inequality and the health of immigrants.

Research suggests that income inequality is inversely associated with health. This association has been documented in studies that utilize variation in income inequality across countries or across time from a single country. The primary criticism of these approaches is their inability to account for potential confounders that are associated with income inequality. This paper uses variation in individual experiences of income inequality among immigrants within the United States (U.S.) to evaluate whether individuals who moved from countries with greater income inequality than the U.S. have better health than those who migrated from countries with less income in equality than the U.S. Utilizing individual-level (March Current Population Survey) and country-level data (the United Nations Human Development Reports), we show that among immigrants who have resided in the U.S. between 6 and 20 years, self-reported health is more favorable for the immigrants in the former category (i.e., greater income inequality) than those in the latter (i.e., lower income inequality). Results also show that self-reported health is better among immigrants from more developed countries and those who have more years of education, are male, and are married.