Over the past 20 years, the United States has experienced one of the largest waves of immigration in its history. Understanding the health status and needs of immigrants is important because of their growing numbers and their contribution to the health of the nation, but it is challenging because of gaps in national databases, the heterogeneity of immigrant populations, and uncertainty about how migration affects health. Healthy People 2010 outlines the nation's public health objectives for the current decade. It includes ten leading health indicators (LHIs) chosen because of their importance as public health issues, their ability to motivate action, and the availability of data to measure their progress. In this paper, we discuss the health of immigrants from the perspective of these LHIs, as they provide a framework for anticipating some of the future health needs of immigrants and help define priority areas for research and action. INTRODUCTIONOver the past 20 years, the United States has experienced one of the largest waves of immigration in its history. Understanding the health status and needs of immigrants is important because of their growing numbers and their contribution to the health of the nation, but it is challenging because of gaps in national databases, the heterogeneity of immigrant populations, and uncertainty about how migration affects health. The health status and health needs of immigrants are poorly understood. Until recently, most health research did not collect data on nativity and immigration status. When immigration status was collected, many studies grouped all Asians or Latinos together, despite marked differences within subgroups with respect to culture, socioeconomic status, health status, and patterns of immigration.The effect of immigration on health is controversial. Some studies have shown that immigrants enjoy superior health compared to the U.S. born, despite higher 358KANDULA KERSEY LURIE rates of poverty and poorer access to health care (1,23,100,102). Others find that some groups experience much higher rates of disease and poor health than previously suspected (36,101,112). As immigrants adopt traditional American health behaviors over time, their health status begins to converge with that of the general U.S. population (20,63,66,90,96,101,112). Yet the literature on how acculturation affects health is often difficult to interpret because there are few validated and consistent measures of acculturation (57). Data on immigrant health status are also often difficult to interpret because of uncertain impact of selection biases [e.g., immigrants to the United States may represent the most healthy and motivated individuals, thus able to make the long journey to the United States (1, 34); they live healthier lifestyles, with fewer risk-taking behaviors and better diets (57); and they return to their native country prior to dying and therefore are not counted in U.S. death records or vital statistics (57)]. Healthy People 2010 outlines the nation's public health objecti...

The prevalence of IDA in early childhood is significantly larger in low-income infants and toddlers living in VLFS households. Asian, Hispanic and African-American children have elevated prevalences of ID and IDA. Breast-feeding may be associated with elevated ID and IDA, while participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) may be protective for ID.

Abstract. Objectives:Little is known about the prevalence and health effects of hunger among ED patients. The objectives of this study were to determine the prevalence of hunger among patients in a large urban ED and to examine whether it has adverse health effects. Methods: A survey about hunger, choices between buying food and buying medicine, and adverse health outcomes related to food adequacy over the preceding 12 months was administered to a convenience sample of adult non-critically ill ED patients from afternoon and evening shifts. The study was conducted in the ED of Hennepin County Medical Center in Minneapolis, Minnesota. Results: Of the 302 eligible patients who were asked to participate, 297 (98%) agreed. Eighteen percent reported not having enough to eat at least once in the preceding 12 months: 14% reported that they had ''gotten sick'' as a result of not being able to afford their medicine, resulting in an ED visit or hospital admission 50% of the time. Predictors of making choices about buying food vs medicine include having a chronic health condition, lack of private health insurance, having a reduction in food stamps, having an annual income less than $10,000, and lack of alcohol use. By patient report, a reduction in food stamps was a predictor of ED visits and hospitalizations as a result of making choices about buying food over medicine. Conclusion: The ED patients in this urban setting have high rates of hunger and many must make choices between buying food and medicine, which patients report results in otherwise preventable ED visits and hospitalization. Loss or reduction of food stamps is associated with increased hunger and increased perceived adverse health outcomes as a result of not being able to afford medicine.

Objective: To measure rates of hunger and food insecurity among young US-born Latino children with Mexican immigrant parents (Latinos) compared with a nonimmigrant non-Latino population (non-Latinos) in a low-income clinic population. Design, setting and subjects: A repeated cross-sectional survey of 4278 caregivers of children ,3 years of age in the paediatric clinic of an urban county hospital for a 5-year period from 1998 to 2003. A total of 1310 respondents had a US-born child with at least one parent born in Mexico. They were compared with a reference group comprised of non-Latino US-born participants (n ¼ 1805). Child hunger and household food insecurity were determined with the US Household Food Security Scale. Results: Young Latino children had much higher rates of child hunger than nonLatinos, 6.8 versus 0.5%. Latino families also had higher rates of household food insecurity than non-Latinos, 53.1 versus 15.6%. Latino children remained much more likely to be hungry (odds ratio (OR) ¼ 13.0, 95% confidence interval (CI) ¼ 5.9-28.7, P , 0.01) and in household food-insecure households (OR ¼ 6.6, 95% CI ¼ 5.2-8.3, P , 0.01) than non-Latinos