227299 Open-System Immigrant Health Conceptual Model

Monday, November 8, 2010 : 3:00 PM - 3:15 PM

Sinziana Seicean, MD MPH , Department of Pulmonary, Critical Care and Sleep Medicine, Case Western Reserve University, Cleveland, OH
Andreea Seicean , Epidemiology and Biostatistics, Case Western Reserve University, Bay Village, OH
Duncan Neuhauser, PhD , Epidemiology & Biostatistics, Case Western Reserve Universtiy, Case Western Reserve University, Cleveland, OH
Jeffrey Longhofer, PhD , School of Social Work, Rutgers University, New Brunswick, NY
Despite growing evidence of significant changes in physical and mental status of immigrants after settling in the country of immigration, there is a lack of theory –driven frameworks centered on immigrant health. Public health research in the U.S. uses individual-centered acculturation conceptual models created by social scientists. Focusing on the ability of individuals to “acculturate” is supported by the Rational Choice Theory. The implication is increased risk of “victim-blaming explanations” for poor immigrant health outcomes feeding into growing public cynicism. The aim of this study is to offer a non-acculturative redirection in immigrant health research by proposing an Open-System Conceptual Model driven by Critical Realism Theory. This conceptual framework is centered on the proportion of lifetime spent by immigrants (PLI) within the U.S. as a predictor of changes in individual health. Consistent with other health behavioral models, predictors of health status include age, gender, social determinants of health vulnerability (SDHV), health related behaviors risk factors (HBF), and an error term. We propose acculturation to be a component of SDHV. PLI is no longer used as a proxy measure of acculturation. We propose latent unmeasured variables of poor health outcomes including : identity vulnerability at the ontological level; “perpetual mourning ” around the loss of individuals , relationships and spaces in the country of origin; and the self-perception of discrimination and “othering” processes related to social stigmatization. The model focuses on health outcomes at an individual level while incorporating social dynamics and historical context through open-system representation.

Learning Areas:
Public health or related public policy
Public health or related research

Learning Objectives:
Define the need of theory-driven frameworks centered on immigrant health Describe the risks and implications of using individual-centered acculturation conceptual models in public health immigrant research. List theories from congruent fields sustaining the proposed conceptual model Explain the advantages and limitations of the new proposed conceptual model in the context of Critical Realism theory

Keywords: Immigrants, Theory

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Postdoctoral Fellow and a Doctoral Candidate in the Division of Health Policy at CWRU with the doctoral dissertation work focused on immigrant health. Interest in conceptual models and philosophical methodology sustaining health research. Previous experience as speaker as invited lecturer, and teaching experience. Research interest in conceptual modeling.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.