The impact of nativity on uterine cancer survival in the public hospital system of Queens, New York.

OBJECTIVE: We studied cis-women with uterine cancer presenting to the two Public Hospitals in Queens, New York from 2006 to 2015 to examine the relationship between nativity (birthplace) and survival. METHODS: A retrospective review of tumor registries identified women diagnosed with uterine cancer between January 1, 2006, and December 31, 2015. Data from 259 women were available for this analysis. RESULTS: Most women were born outside the United States (US) (76% versus 24%). The majority of US-born women were black (68%). Seventy-seven women (30%) were born in Latin America, 76 in the Caribbean Islands (29%) and 44 in Asia/South Asia (17%). Most women presented with stage I/II disease (70%) and endometrioid/mucinous histology (68%) with no significant differences observed among nativity groups. Kaplan-Meier estimated survival curves stratified by birthplace demonstrated significant differences in survival distributions among the groups using the log-rank test (P < 0.0001). The most favorable survival curves were observed among all foreign-born women, whereas the least favorable survival was demonstrated in US-born women. Time to death was analyzed using the Cox proportional hazards model. Adjusting for age of diagnosis, insurance status, stage, and treatment modality, Latin American and Asia/South Asia birthplace was significantly associated with increased survival time. CONCLUSION: An immigrant health paradox was defined for foreign-born Latin American and Asian/South Asian women presenting to the two Public Hospitals of Queens, New York, as women born in these geographic regions were less likely to die at any given time compared to those born in the United States.

Explaining the attainment of the second-generation: When does parental relative education matter?

How can we understand unexplained variation in the educational outcomes of the children of immigrants? A growing literature posits that standard educational transmission models fail to explain national origin differences in attainment because they ignore immigrant selectivity - the degree to which immigrants differ from non-migrants in their sending countries. The immigrant selectivity hypothesis is usually tested using indicators of parents' relative or "contextual" educational attainment, measuring their rank in the educational attainment distribution of their country of origin. However, using this proxy, current support for the hypothesis is mixed. We outline three conditions for the use of educational selectivity as a proxy for relative social positioning among the children of immigrants. We test our conditions using an adult and a youth sample from a large household panel survey in the UK. We supplement our analyses by exploring relative education data from prior research on Italy, France and the United States. Triangulating these varied sources, we illustrate cases when our three conditions do and do not hold, providing evidence from the UK and other contexts. We provide guidelines on the use of relative education as a measure of relative social standing in cross-national research as well as an assessment of the immigrant selectivity hypothesis in explaining second-generation educational outcomes.

The Immigrant Experience and Alcohol Use: Heart Rate as a Source of Risk and Resilience.

The immigration experience in the USA has been linked to a wide range of behavioral and physical outcomes. Studies report that immigrants, relative to native-born citizens, are less likely to develop alcohol use habits despite facing hardship during the acculturation process. Limited research, however, has examined whether and to what extent resting heart rate (RHR) plays a role in accounting for individual differences in the acculturation process in the USA. To begin to address this gap in research, cross-sectional self-report data (N = 4775) from a nationally representative sample of US adults are analyzed to examine the association between the immigrant experience, alcohol use, and drunkenness. The role of low, mean, and high RHR on this association is investigated. The results reveal that respondents with higher levels of the immigrant experience report lower levels of alcohol use and drunkenness. RHR partially conditions the relationship between the immigrant experience and alcohol use, whereby respondents with higher levels of the immigrant experience and high RHR report less alcohol use and drunkenness, compared to more native respondents with low RHR. Immigrant experience and alcohol use were associated, but not with drunkenness among respondents with average RHR levels, relative to those with low RHR levels. The results suggest that RHR may be a potential source of both risk for and resilience to the development of alcohol use behaviors among immigrants going through the acculturation process in the USA.

Examining the relationship between self-reported lifetime cancer diagnosis and nativity: findings from the National Health and Nutrition Examination Survey (NHANES) 2011-2018.

PURPOSE: Cancer incidence in the USA remains higher among certain groups, regions, and communities, and there are variations based on nativity. Research has primarily focused on specific groups and types of cancer. This study expands on previous studies to explore the relationship between country of birth (nativity) and all cancer site incidences among USA and foreign-born residents using a nationally representative sample. METHODS: This is a cross-sectional study of (unweighted n = 22,554; weighted n = 231,175,933) participants between the ages of 20 and 80 from the National Health and Nutrition Examination Survey (NHANES) 2011-2018. Using weighted logistic regressions, we analyzed the impact of nativity on self-reported cancer diagnosis controlling for routine care, smoking status, overweight, race/ethnicity, age, and gender. We ran a partial model, adjusting only for age as a covariate, a full model with all other covariates, and stratified by race/ethnicity. RESULTS: In the partial and full models, our findings indicate that US-born individuals were more likely to report a cancer diagnosis compared to their foreign-born counterparts (OR 2.34, 95% CI [1.93; 2.84], p < 0.01) and (OR 1. 39, 95% CI [1.05; 1.84], p < 0.05), respectively. This significance persisted only among non-Hispanic Blacks when stratified by race. Non-Hispanic Blacks who were US-born were more likely to report a cancer diagnosis compared to their foreign-born counterparts (OR 2.30, 95% [CI 1.31; 4.02], p < 0.05). CONCLUSION: A variety of factors may reflect lower self-reported cancer diagnosis in foreign-born individuals in the USA other than a healthy immigrant advantage. Future studies should consider the factors behind the differences in cancer diagnoses based on nativity status, particularly among non-Hispanic Blacks.

Resilience in the Face of Adversity: Family Processes and the Immigrant Paradox in Youth Externalizing Problems.

BACKGROUND: Despite increased exposure to social adversity, immigrant youth have fewer externalizing problems compared to non-immigrants. Explanations for this apparent advantage remain unclear. This study examined the extent to which socio-economic characteristics and family processes account for group differences in externalizing problems between immigrant and non-immigrant youth. METHODS: Data come from a population-based cross-sectional study of 1,449 youth and their primary caregiver in Hamilton, Ontario. Computer-assisted structured interviews were administered separately to primary caregivers and youth, which included assessments of externalizing problems and measures of family obligation, parental monitoring, value of education and socio-economic characteristics. RESULTS: First- and second-generation immigrant youth had lower levels of externalizing problems compared to non-immigrants. The magnitude of group differences was larger for parent (d = 0.37-0.55) versus youth reports of externalizing behaviours (d = 0.15-0.29). Family socio-economic and process characteristics partially accounted for group differences, which remained significant in the parent-reported model but rendered non-significant in the youth-reported model. CONCLUSION: Results suggesting the potential protective effects of positive family processes for immigrant youth could be extended to non-immigrant youth to inform the development of parenting and family skills interventions. Promoting familial sources of resilience is a potential avenue for reversing downward trends in mental health seen across successive generations of immigrant youth, while also reducing risk of behavioural difficulties among non-immigrant youth.

Beyond the healthy immigrant paradox: decomposing differences in birthweight among immigrants in Spain.

BACKGROUND: The healthy immigrant paradox refers to the unexpected health advantages of immigrant groups settled in host countries. In this population-based study we analyze immigrant advantages in birthweight decomposing differences between infants born to immigrant mothers from specific origins. METHOD: Using publicly available data from Spanish Vital Statistics for the period 2007-2017, differential birthweights among several groups of immigrants were estimated with an ordinary least squares regression. The Oaxaca-Blinder regression-based decomposition method was then applied to identify the extent to which differences in birthweight between groups corresponded to compositional disparities or to other factors. RESULTS: Our analysis of singleton live births to migrant mothers in Spain between 2007 and 2017 (N = 542,137) confirmed the healthy immigrant paradox for certain immigrant populations settled in Spain. Compared with infants born to mothers from high-income countries, the adjusted birthweight was higher for infants born to mothers from non-high- income European countries (33.2 g, 95% CI: 28.3-38.1, P < 0.01), mothers from African countries (52.2 g, 95% CI: 46.9-57.5, P < 0.01), and mothers from Latin American countries (57.4 g, 95% CI: 52.9-61.3, P < 0.01), but lower for infants born to mothers from Asian non-high-income countries (- 31.4 g, 95% CI: - 38.4 to - 24.3, P < 0.01). Decomposition analysis showed that when compared with infants born to mothers from high-income countries, compositional heterogeneity accounts for a substantial proportion of the difference in birthweights. For example, it accounts for 53.5% (95% CI: 24.0-29.7, P < 0.01) of the difference in birthweights for infants born to mothers from non-high-income European countries, 70.9% (95% CI: 60-66.7, P < 0.01) for those born to mothers from African countries, and 38.5% (95% CI: 26.1-29.3, P < 0.01) for those born to mothers from Latin American countries. CONCLUSIONS: Our results provide strong population-based evidence for the healthy immigrant paradox in birthweight among certain migrant groups in Spain. However, birth outcomes vary significantly depending on the origins of migrant subpopulations, meaning that not all immigrant groups are unexpectedly healthier. A significant portion of the perinatal health advantage of certain immigrant groups is only a by-product of their group composition (by age, parity, marital status, socioeconomic status, and citizenship of mother, age and migratory status of father and type of delivery) and does not necessarily correspond to other medical, environmental, or behavioral factors.

SALaMA study protocol: a mixed methods study to explore mental health and psychosocial support for conflict-affected youth in Detroit, Michigan.

BACKGROUND: Families resettling to the U.S. from conflict-affected countries in the Middle East and North Africa (MENA) face countless challenges. These families must cope with experiences of armed conflict and forced migration while also assimilating to a new society. According to the 'immigrant paradox,' time spent in a new country can compound the effects of migration and assimilation challenges and lead to deteriorated mental health. This study aims to assess the psychosocial wellbeing of MENA-born or first-generation adolescents attending school in the Detroit metropolitan area (DMA) to understand how schools, families, and communities play a role in supporting these adolescents' wellbeing. METHODS: The quantitative component of this mixed methods study will involve a self-administered survey with a sample of students whose responses will be linked to academic records and behavioral assessments. The survey will utilize validated instruments to measure depressive and anxiety symptoms (Hopkins Symptom Checklist-37A), hope (Children's Hope Scale), resilience (Child and Youth Resilience Measure-12), externalizing and prosocial behavior (Hopkins Symptom Checklist-37A, Strengths and Difficulties Questionnaire), school belonging (Psychological Sense of School Membership), and peer relationships (Multidimensional Scale of Perceived Social Support). Differences in outcomes will be analyzed across two strata: students born in the MENA region and first-generation students whose parents immigrated to the US from the MENA region. The qualitative component will involve semi-structured key informant interviews with parents, school administrators, educators, and mental health providers, and focus group discussions (FGDs) with a purposive sample of adolescents born - or whose parents were born - in the MENA region. The FGDs will include a participatory ranking activity where participants will be asked to free-list and rank ideas about how schools can better support students like them. Thematic content analysis will be conducted to identify common themes. DISCUSSION: This study will contribute evidence about the wellbeing of adolescents who come from - or whose parents come from - conflict-affected countries currently living in the U.S. Findings can be used to inform program and policy development to enable schools and their community partners to serve this population more effectively.

Explaining the Immigrant Paradox: The Influence of Acculturation, Enculturation, and Acculturative Stress on Problematic Alcohol Consumption.

The present study explored the Immigrant Paradox (IP), generational differences in problematic alcohol use (alcohol consumption and alcohol-related consequences), among immigrants and US born groups from a number of ethnic minority backgrounds. Our approach separates group differences in problematic alcohol consumption in a counterfactual manner for immigrants and the US born to answer the following counterfactual question: "What would problematic alcohol use levels be for the US born had they been exposed to the alcohol use generation (or protective) processes of immigrants and vice versa?" Multidimensional measures of enculturation (involvement with heritage culture), acculturation (involvement with US culture), acculturative stress, and demographic covariates were used to statistically explain these differences. The sample consisted of Asian American (n = 1,153), Black American (n = 833), and Latinx (n = 1,376) college students from 30 universities. Results indicated significant generational differences in mean levels of alcohol consumption but not alcohol-related consequences. Differences in measured characteristics (endowments) marginally explained differences between immigrants and the US born. On the other hand, endowments significantly explained generational differences and represented an increase in alcohol consumption among immigrants if they had the endowments of the U.S. born. Results are discussed in light of cultural and social factors that contribute to the IP.

Alcohol use severity, depressive symptoms, and optimism among Hispanics: Examining the immigrant paradox in a serial mediation model.

OBJECTIVE: Hispanic immigrants exhibit more positive outcomes than U.S.-born Hispanics across educational, psychological, and physical health indices, a phenomenon called the immigrant paradox. We examined the immigrant paradox in relation to alcohol use severity among Hispanic young adults while considering both positive (optimism) and negative (depressive symptoms) processes. METHOD: Among 200 immigrant and U.S.-born Hispanic young adults (Mage = 21.30; 49% male) in Arizona and Florida, we tested whether optimism and depressive symptoms statistically mediated the relationship between nativity and alcohol use severity. Specifically, we examined whether Hispanic immigrants reported greater optimism than their U.S.-born counterparts, and whether such optimism was, in turn, associated with less depressive symptoms and thus lower alcohol use severity. RESULTS: Indirect effects were significant in hypothesized directions (nativity → optimism → depressive symptoms → alcohol use severity). CONCLUSIONS: Both positive and negative psychological processes are important to consider when accounting for the immigrant paradox vis-à-vis alcohol use severity among Hispanic young adults.

Tied Together: Adolescent Friendship Networks, Immigrant Status, and Health Outcomes.

This study examines the social integration of adolescent immigrants by directly analyzing the composition of their friendship networks. Using statistical network analysis, I first consider whether adolescents are more likely to befriend peers who share their immigrant generation status in a large, diverse sample of 7th through 12th graders from the National Longitudinal Study of Adolescent to Adult Health (n = 67,586). Next, I test whether having a higher proportion of same-generation friends can protect immigrant youth from experiencing negative health outcomes and adopting risky behaviors. Results indicate that adolescents are more likely to form friendships with peers who share their immigrant generation status and that this tendency is particularly strong for first-generation immigrants. Furthermore, immigrant youth with greater proportions of same-generation friends are less likely to report several negative health behaviors and outcomes. My findings suggest that same-generation friendships can serve as a protective mechanism for immigrant youth, which may help explain the existence of an immigrant health paradox.

Tobacco use among Latinx adolescents: exploring the immigrant paradox.

BACKGROUND: Research suggests that an immigrant paradox exists where those who were not born in the United States (1st generation) have significantly better health than those who were born in the U.S. (2nd generation or more). The aim of the current study was to examine the immigrant paradox with respect to tobacco-related perceptions and parenting influences in smoking initiation among Latinx adolescents. METHODS: Data came from the 7th and 10th grade Healthy Passages™ assessments of Latinx participants in three U.S. urban areas (N = 1536) who were first (18%), second (60%), and third (22%) generation. In addition to demographics, measures included perceived cigarette availability and peer smoking, intentions and willingness to smoke, and general monitoring by parents. Parents reported on generational status and their own tobacco use. The primary outcome was participant's reported use of cigarettes. RESULTS: By 10th grade, 31% of Latinx youth had tried a cigarette, compared to 8% in 7th grade. After controlling for age, gender, and socioeconomic status, regression analyses indicated that there were no significant differences related to generational status in cigarette smoking initiation in either 7th or 10th grade. Youth tobacco-related perceptions, general parental monitoring, and parental tobacco use predicted Latinx adolescent cigarette use initiation by 10th grade. CONCLUSIONS: Latinx adolescents might not have deferential smoking rates based on generation status, suggesting that the immigrant paradox concept may not hold for smoking initiation among Latinx adolescents. Rather, factors influencing cigarette initiation generally in adolescents as a group appear to apply to Latinxs as well.

We have come a long way, baby: "Explaining positive adaptation of immigrant youth across cultures".

Immigrant youth are and will continue to be a diverse and important part of Western nations. In this context, the study of immigrant youth adaptation has burgeoned. The papers of this special section represent a shift from a deficit-based to a strength-based approach to immigrant youth. They focus on unpacking the immigrant paradox, often based on longitudinal, multilevel data. In this commentary, we discuss how the research findings and themes that emerge from these papers contribute to our understanding of the processes of development and acculturation, of the importance of individual differences and the role of context for immigrant youth adaptation. These studies show that we have come a long way … but that we still have a long way to go.

The immigrant paradox on internalizing symptoms among immigrant adolescents.

Understanding the immigrant paradox on health outcomes among UK's immigrant adolescents will greatly complement the research on immigrants that has already been established there by economists and interdisciplinary fields. This study used the first Longitudinal Study of Young People in England 2004-2010 database (N = 15,770) to determine a) whether there was evidence of the immigrant paradox on internalizing mental health symptoms between first generation (n = 753) and second plus generation (n = 3042) 14/15 year old immigrant adolescents in England and b) whether differences (if any) were moderated by ethnicity group membership (Black African, Black Caribbean, Indian, Pakistani, Bangladeshi, Asian Other, White Immigrant). Findings demonstrate that overall first generation adolescent immigrants had statistically fewer internalizing symptoms as compared to second plus generation, and that this was especially true for Black African adolescents. Effect sizes measures however indicated that these differences were negligible. Implications for protective factors and future studies are briefly discussed.

An "immigrant paradox" for adolescent externalizing behavior? Evidence from a national sample.

PURPOSE: Recent decades have witnessed a rise in the number of immigrant children in the United States (US) and concomitant concerns regarding externalizing behaviors such as crime, violence, and drug misuse by immigrant adolescents. The objective of the present study was to systematically compare the prevalence of externalizing behaviors and migration-related factors among immigrant and US-born adolescents in the US. METHOD: Data on 12 to 17 year olds (Weighted N in thousands = 25,057) from the National Survey on Drug Use and Health (NSDUH) R-DAS between 2002 and 2009 were used. The R-DAS online analytic software was employed. Prevalence estimates and 95 % confidence intervals were calculated adjusting for the complex survey sampling design. RESULTS: Compared to their US-born counterparts, immigrant adolescents-particularly those between the ages of 15 and 17 years-are significantly less likely to be involved in externalizing behaviors. In addition, later age of arrival and fewer years spent in the US were associated with reduced odds of externalizing behavior. Supplementary analyses indicate that the link between nativity and externalizing behavior may be primarily driven by differences between US-born and immigrant youth who self-identify as non-Hispanic black or Hispanic. Immigrant adolescents are also more likely to report cohesive parental relationships, positive school engagement, and disapproving views with respect to adolescent substance use. CONCLUSIONS: This study extends prior research on the "immigrant paradox" to externalizing behavior among adolescents using a nationally representative data source. Findings highlight the importance of examining age, age of arrival, duration, and race/ethnicity in the study of nativity and externalizing.

Drug use and service utilization among Hispanics in the United States.

PURPOSE: To examine illicit drug use and service utilization patterns of US-born and foreign-born Hispanics in the United States. METHODS: Hispanic respondents 18 years and older in the NESARC were categorized as being of Mexican (n = 3,556), Puerto Rican (n = 785), Cuban (n = 346), Central American (n = 513), or South American (n = 381) origin. We examined lifetime prevalence of drug use and substance abuse treatment utilization patterns for US-born and Hispanic immigrants across subgroups. RESULTS: Lifetime prevalence of drug use was greater among US-born Hispanics than Hispanic immigrants after controlling for age, gender, income, education, urbanicity, parental history of drug use problems and lifetime DSM-IV mood/anxiety disorders. Both US-born and immigrant Hispanic drug users were less likely than non-Hispanic white drug users to have utilized any form of substance abuse treatment (US-born AOR = 0.89, immigrant AOR = 0.64) and more likely to have utilized family or social services (US-born AOR = 1.17, immigrant AOR = 1.19). Compared to US-born Hispanic drug users, Hispanic immigrant drug users were less likely to have used any form of substance abuse treatment (AOR = 0.81) and were more likely to have utilized family or social services (AOR = 1.22). CONCLUSION: Strategies to increase engagement and retention of Hispanic drug users in substance abuse treatment include increasing access to linguistically and culturally competent programs that address unmet family and social needs. Further studies examining differences in drug use and service utilization patterns within Hispanic subgroups are needed.

Meta-Analysis of Acculturation and Suicide-Related Outcomes: A Test of the Immigrant Paradox.

OBJECTIVE: This meta-analysis aimed to systematically test the relation between acculturation and suicide-related outcomes among immigrants, with attention to key methodological (i.e., measure of suicide-related outcome, measure of acculturation) and demographic (i.e., race, gender, age, geographic region, publication year) moderators. METHOD: We conducted a meta-analysis of 72 independent samples from 50 studies (38 peer-reviewed articles, 12 dissertations) representing more than 1.4 million immigrants. Participants' age ranged from 11.20 to 74.70 years (M = 29.96, SD = 15.07). Random effects models were used for both main and moderation analyses. RESULTS: We found significant positive associations between acculturation and suicidal ideation, but not suicide attempts and deaths. We also found a significant and positive effect of acculturation on suicide-related outcomes when acculturation was measured by psychological scales, but not by generation status, length of residence in the host country, and proficiency in the host country's language. More acculturated Latinx immigrants were at higher risk for suicide-related outcomes, whereas a reverse pattern was found among Asian immigrants. Meta-regressions revealed that the moderating effects of participants' age and publication year were also significant. CONCLUSION: Our results show partial support for the immigrant paradox but suggest that the relation between acculturation and suicide-related outcomes is complex and multifaceted. We discuss the implications of our findings and recommendations for research and prevention.

Weaving culture with consequence: Immigrant status and child maltreatment outcomes in early adulthood.

BACKGROUND: Child maltreatment is associated with a host of negative consequences over the life course, the most concerning of which is violence. Nevertheless, many abused and neglected youth do not grow up and commit violence. Meanwhile, research consistently finds an immigrant paradox, where foreign-born nativity is protective against a range of negative life outcomes. It may be that immigrants to the U.S. are more resilient to child maltreatment and less likely to engage in violence later in life. OBJECTIVE: This study contributes to the literature on victimization and the immigrant paradox by determining whether the effect of child maltreatment on later violence varies between immigrants and non-immigrants. PARTICIPANTS AND SETTING: The present study uses a subsample of 964 foreign- and 12,808 native-born persons from Waves I and III of the National Longitudinal Study of Adolescent to Adult Health. METHODS: Logistic regression models are specified and interaction terms are used to determine moderating effects of immigrant status on the link between child maltreatment and later violence. RESULTS: Findings indicate that child maltreatment significantly increased the odds of violent behavior in early adulthood by nearly 64 %, and this result was not moderated by immigrant status. Supplemental analyses continued to show generality in maltreatment effects. CONCLUSIONS: The idea that child maltreatment is less harmful among foreign-born persons, or that they are able to "bounce back" from this form of victimization due to their unique multicultural assets, is not evidenced here. Key policy implications include a need for culturally competent victim services.

COVID-19 related distress and sleep health among trauma-exposed South Asians: Does generational status matter?

The COVID-19 pandemic has resulted in substantial changes in individual and socio-economic factors that may negatively impact sleep health. We examined associations between COVID-19 related distress and sleep among trauma-exposed South Asian adults in the United States. Since a health advantage among foreign-born individuals has been previously noted in the literature (the 'immigrant paradox'), we also explored if generational status (number of generations one's family has been in the U.S.) moderated associations between COVID-19 related distress and sleep health. Participants were 196 trauma-exposed South Asian adults residing in the U.S. (54% male, 63% U.S.-born citizens, average age = 34.51 years), who completed measures of generational status, COVID-19 related distress, trauma exposure, sleep-related impairment (SRI), and sleep disturbances. Greater COVID-19 distress was associated with more sleep disturbances (b = 0.15, p < 0.001) and SRI (b = 0.24, p < 0.001). Generational status was not associated with sleep, nor did it modify associations between COVID-19 distress and sleep. Findings highlight the potential importance of developing interventions to reduce stress and sleep difficulties during the pandemic. Our results did not support the immigration paradox. Future studies are needed to better understand the role of generational status on sleep health across immigrant subgroups.

Exploring familial factors in the migrant mortality advantage among domestic migrants in later life: Zeeland, the Netherlands, 1812-1962.

Many historical and contemporary studies have shown that migrants enjoy survival advantages over non-migrants, even if they originate from higher mortality regimes and have a lower socio-economic and educational status compared to non-migrants in the destination area. This so-called migrant mortality advantage or healthy migrant effect is explained in various ways. One of the main explanations refers to selection effects in the area of origin in the sense that healthier individuals are more likely to move compared to less healthy individuals. So far life-course analysis on the healthy migrant effect were focused on the survival chances of individual migrants compared to non-migrants. However, kin members of migrants might also enjoy survival advantages, given that health and mortality are often clustered in families due to shared environments, behaviors, resources, and household dynamics. We study whether kin members of migrants within the Dutch province of Zeeland also enjoy survival advantages. Although we find a mortality advantage for the migrating men and women in our sample, we find no mortality advantage for their siblings or offspring. However, there was a gendered effect of familial migration in the sense that women, contrary to men, had higher mortality risks if their siblings and parents migrated.

Meta-Analysis on the Relation Between Acculturation and Alcohol Use Among Immigrant Youth.

PURPOSE: We empirically examined the relation between acculturation and alcohol use in immigrant youth, with attention to demographic and methodological moderators. METHODS: We identified 43 studies (38 empirical studies published in peer-reviewed journals and 6 dissertations) yielding 66 independent samples and 118 effect sizes. The total sample size was 61,851 immigrant youth from birth to 25 years of age (M = 937.14, standard deviation = 1,271.24) with a mean age of 15.50 years (standard deviation = 2.46). RESULTS: The average effect size for the fixed effects model was .04 with a 95% confidence interval of .03-.05, which was significantly different from zero (p < .001). The average effect size for the random effects model was .05 with a 95% confidence interval of .02-.08, which was significantly different from zero (p = .002). Location of the study, age of participants, type of measurements used to assess acculturation and alcohol use, and publication year were significant moderators. CONCLUSIONS: This meta-analytic review supported the immigrant paradox in which acculturation puts immigrant youth at risk for alcohol use. Several demographic and methodological factors also moderated this relation in a significant way. Important implications are discussed.