Health disparities for recent immigrants in suburban and rural areas north of New York City

Problem Significance: In contrast to earlier migration patterns, recent immigrants have been settling in parts of the US not previously known as locations of immigrant settlement, such as suburban/rural areas with mostly homogeneous populations. Most recent immigrants tend to come from Central/South America, Asia and the Caribbean. This pattern exists in the suburban/rural counties north of New York City, known as the Lower Hudson Valley (LHV).

This paper will focus on the health of recent immigrants to the LHV. Several previous studies have reported on the “healthy immigrant effect”, where the health of recent immigrants is reported to be better than that of the native born and longer-term immigrants in the US. Most previous studies have used data from earlier migration waves and/or focused on Mexicans, Puerto Ricans or Cubans only.

Methods

Study Design: A qualitative study using telephone interviews with providers/key informants and in-person interviews with recent immigrants was conducted during 2004-2006 in 12 target communities of the LHV identified as having the greatest concentration of recent immigrants.

Participants: Fifty providers serving recent immigrants, 81 key informants working with recent immigrants (e.g., community/religious leaders), and 74 recent immigrants (in the US for 8 months – 10 years and most < 40 years old) participated in the study. Recent immigrants were recruited through a variety of locations (e.g., day laborer hiring centers, parenting/education classes).

Measures: Although many of the interview questions were qualitative in nature, questions inquiring about self-reported physical and mental health were drawn from standard questions used in national surveys. Qualitative questions asked of providers/key informants were used to corroborate the responses of the immigrants.

Results/Conclusion

More than one-third of study immigrants rated their physical and mental health as “fair/poor” (three times higher than for the US population), with two out of five reporting a health problem. Those in the US longer were almost twice as likely to report fair/poor health than more recent arrivals. Almost all immigrants found it “difficult” to live in their community and loss of family support, undocumented status, trauma of immigration, and cultural isolation were most often cited as sources of stress.

Further work should examine whether recent immigrants have health needs that are not currently being met due to linguistic/cultural barriers limiting access to health care especially in regions of the US that do not have an infrastructure in place to address the health needs of immigrants.