Are immigrant enclaves healthy places to live? The Multi-ethnic Study of Atherosclerosis

Abstract

The growing size and changing composition of the foreign born population in the USA highlights the importance of examining the health consequences of living in neighborhoods with higher proportions of immigrants. Using data from the Multiethnic Study of Atherosclerosis in four US cities, we examined whether neighborhood immigrant composition was associated with health behaviors (diet, physical activity) among Hispanic and Chinese Americans (n=1902). Secondarily we tested whether neighborhoods with high proportions of immigrants exhibited better or worse neighborhood quality, and whether these dimensions of neighborhood quality were associated with healthy behaviors. Neighborhood immigrant composition was defined based on the Census 2000 tract percent of foreign-born from Latin-America, and separately, percent foreign-born from China. After adjustment for age, gender, income, education, neighborhood poverty, and acculturation, living in a tract with a higher proportion of immigrants was associated with lower consumption of high-fat foods among Hispanics and Chinese, but with being less physically active among Hispanics. Residents in neighborhoods with higher proportions of immigrants reported better healthy food availability, but also worse walkability, fewer recreational exercise resources, worse safety, lower social cohesion, and lower neighborhood-based civic engagement. Associations of neighborhood immigrant composition with diet persisted after adjustment for reported neighborhood characteristics, and associations with physical activity were attenuated. Respondent-reported neighborhood healthy food availability, walkability, availability of exercise facilities and civic participation remained associated with behaviors after adjusting for immigrant composition and other covariates. Results show that living in an immigrant enclave is not monolithically beneficial and may have different associations with different health behaviors.

A Local Area Analysis of Racial, Ethnic, and Neighborhood Disparities in Breast Cancer Staging

“…The authors used data from 13 SEER areas and found that both lower mean neighborhood income and increasing percentage of Latino residents were associated with higher odds of advancedstage breast, cervical, and colorectal cancer, suggesting that lack of access to screening in poor neighborhoods and cultural isolation may contribute to staging disparities. In contrast, other studies suggest that neighborhoods/ areas with a large concentration of Latino populations may actually confer a protective effect on select health outcomes (32,33). More research is needed that includes both national and local SEER samples to more accurately characterize the cancer burden experienced by Latinas in general, and specific Latino subgroups (e.g., Mexicans or Puerto Ricans) that may have varying risk factors for cancer.…”

Restrained mobility in a high-accessible and migrant-rich area in downtown Beijing

“…Segregation of these neighborhoods is detrimental for the cultural, language, and social assimilation of immigrants, especially recent ones [11,58]. A U.S. study found that immigrants living in ethnic enclaves had better access to daily necessities but exhibited less physical activity, less recreational participation, and a lower level of social cohesion and civic engagement [59].Therefore, gaining access to key social and economic resources outside the enclave is crucial for new immigrants' assimilation.…”

Prevalence of Complementary and Alternative Medicine in Immigrants

“…Citizenship status is known to be associated with insurance status and access to conventional care [22] and has also been analyzed in studies of other health outcomes in immigrant population [8,23,24]. Immigrant status has been shown to be protective in relation to some positive health behaviors, such as lower consumption of high-fat foods [25,26]; however, immigrant status has also perpetuated poor health care access through structural constraints such as residential segregation [26,27]. Few have studied CAM use among immigrants using a nationally representative sample.…”