ON THE BASIS OF VISA TYPE: THE ASSOCIATION OF VISA TYPE AND HEALTH AMONG U.S. IMMIGRANTS 公开
Dunajcik, Alicia (Spring 2020)
Published
Abstract
OBJECTIVE
Each year, millions of people immigrate to the U.S. Experiences of legal permanent residents before migration may influence one’s selected visa type, and experiences during and after immigration may be influenced by visa type. Due to limited prior research, it is unknown if health for each visa group is different due to unique immigration-related circumstances. This study aims to determine if an association between visa type and health exists using self-reported health status, overall chronic conditions, diabetes, high blood pressure, lung conditions, heart conditions (including stroke), arthritis, and psychiatric conditions.
METHODS
This association was explored using the New Immigrant Survey (NIS), a cohort of 8,573 immigrants who gained permanent residence in 2003. Visa information for immigrants was provided by the U.S. Immigration and Naturalization Services (INS), and health outcomes were reported by individuals. This study used multivariate logistic regression to determine the odds of each chronic condition and odds of having fair or poor self-rated health by visa group. Regression controlled for confounding by employment status, sex, marital status, health insurance coverage, smoking status, geographic region of origin, U.S. region of residence, education, age, and time spent in the U.S.
RESULTS
For both self-rated health and overall chronic conditions, a significant association by visa group was found. For self-rated health, refugee and legalization visa holders had the highest odds of fair or poor health [Refugee Odds Ratio = 2.74 (p<0.001), Legalization Odds Ratio = 1.94 (p<0.001); reference=family sponsored]. Refugee and legalization visa holders also had the highest odds of overall chronic conditions [Refugee Odds Ratio = 1.81 (p<0.001), Legalization Odds Ratio = 1.58 (p=0.001)]. Findings for diabetes, high blood pressure, lung conditions, heart conditions, arthritis, and psychiatric conditions mirrored what was seen for overall chronic conditions.
CONCLUSIONS
This association suggests that refugee and legalization visa holders are in worse overall health at the time of gaining permanent residence. Existing health programs for these groups is limited and largely focused on infectious diseases. Methods including health screenings for legalization visa holders and expanding mental health and chronic disease resources for refugees may improve health of these groups.
Table of Contents
INTRODUCTION 1
LITERATURE REVIEW 3
IMMIGRANTS IN THE UNITED STATES 3
Migration 3
Legal Immigration Definitions 3
Immigration Process 4
Benefits of Immigration 5
Naturalization Process and Benefits 5
VISA TYPES 6
Family Sponsored 6
Employment 7
Refugees, Asylum Seekers, and Parolees 7
Diversity 8
Legalization 9
IMMIGRANT CHARACTERISTICS 9
2003 Immigration Profile 9
Political Considerations 10
HEALTH OF IMMIGRANTS 12
Healthy Immigrant Effect 12
Healthy Immigrant Effect by Visa Type 13
HEALTH OUTCOMES 14
Self-Rated Health 15
Chronic Health Conditions 15
CONCEPTUAL FRAMEWORK 19
DIFFERENCES IN IMMIGRANTS BY VISA TYPE 19
MATERIALS AND METHODS 21
STUDY BACKGROUND21
Data Source 21
DATA PREPARATION AND SELECTED VARIABLES 21
Survey Weighting 21
Software and Study Assumptions 22
Variables 23
DATA ANALYSIS 27
Descriptive Models 27
Testing Modeling Assumptions 27
General Modeling Techniques 28
Self-Rated Health Model 28
Chronic Condition Models 30
RESULTS 32
PRELIMINARY ANALYSIS: MISSINGNESS RESULTS 32
DESCRIPTIVE RESULTS 33
All Immigrants33
Health Outcomes by Visa Type 34
ANALYTIC RESULTS 37
Collinearity 37
Self-Rated Health Model 38
Diagnosed Chronic Condition Models 39
DISCUSSION 43
STRENGTHS AND LIMITATIONS 46
Strengths 46
Limitations 46
CONCLUSIONS 47
Implications 47
Future Research Needs 48
REFERENCES 51
FIGURES AND TABLES 56
FIGURE A. PROPOSED CONCEPTUAL FRAMEWORK TO DESCRIBE EFFECT OF VISA TYPE ON HEALTH 56
FIGURE 1. SURVEY-ADJUSTED SELF-RATED HEALTH STATUS OF NEW IMMIGRANTS TO THE U.S. IN 2003 BY VISA TYPE 57
FIGURE 2. SURVEY-ADJUSTED PREVALENCE OF DIAGNOSED CONDITIONS AMONG NEW IMMIGRANTS TO THE U.S. IN 2003 BY VISA TYPE 58
FIGURE 3. SURVEY-ADJUSTED PREVALENCE OF INDIVIDUAL DIAGNOSED CONDITIONS IN NEW IMMIGRANTS TO THE U.S. BY VISA TYPE 59
TABLE 1. UNWEIGHTED DESCRIPTIVE HEALTH CHARACTERISTICS OF A COHORTA OF NEWLY ADMITTED LEGAL PERMANENT RESIDENTS TO THE U.S. IN 2003 60
TABLE 2. UNWEIGHTED DEMOGRAPHIC CHARACTERISTICS OF A COHORTA OF NEWLY ADMITTED LEGAL PERMANENT RESIDENTS TO THE U.S. IN 2003 61
TABLE 3. SURVEY-ADJUSTED DESCRIPTIVE HEALTH CHARACTERISTICS OF ANALYTIC SAMPLE OF NEW IMMIGRANTS IN THE U.S. IN 2003A,B 63
TABLE 4A. PAIRWISE CORRELATION COEFFICIENTS* AMONG OUTCOMES OF INTEREST 66
TABLE 4B. PAIRWISE CORRELATION COEFFICIENTS* AMONG EXPOSURES OF INTEREST 67
TABLE 5. SURVEY-WEIGHTED LOGISTIC REGRESSION MODEL(A) FOR PREDICTING SELF-RATED HEALTH STATUSA OF NEWLY ADMITTED IMMIGRANTS TO THE U.S. IN 2003 (N = 7,972) 68
TABLE 6. SURVEY-ADJUSTED LOGISTIC REGRESSION MODEL FOR PREDICTING A DIAGNOSED HEALTH CONDITION AMONG NEWLY ADMITTED IMMIGRANTS TO THE U.S. IN 2003A (N = 7,972) 69
TABLE 7. SURVEY-ADJUSTED LOGISTIC REGRESSION MODELS FOR PREDICTING EACH INDIVIDUAL HEALTH CONDITION AMONG NEW IMMIGRANTS TO THE U.S. IN 2003 (N = 7,972) 70
TABLE 7 CONTINUED. SURVEY-ADJUSTED LOGISTIC REGRESSION MODELS FOR PREDICTING EACH INDIVIDUAL HEALTH CONDITION AMONG NEW IMMIGRANTS TO THE U.S. IN 2003 (N = 7,972) 71
TABLE 7 CONTINUED. SURVEY-ADJUSTED LOGISTIC REGRESSION MODELS FOR PREDICTING EACH INDIVIDUAL HEALTH CONDITION AMONG NEW IMMIGRANTS TO THE U.S. IN 2003 (N = 7,972) 72
TABLE 8. MATRIX OF MODELED ODDS RATIOS FOR ALL OUTCOMES OF INTEREST, STRATIFIED BY VISA TYPE (N = 7,972)73
About this Master's Thesis
| School | |
|---|---|
| Department | |
| Subfield / Discipline | |
| Degree | |
| Submission | |
| Language |
|
| Research Field | |
| 关键词 | |
| Committee Chair / Thesis Advisor |
Primary PDF
| Thumbnail | Title | Date Uploaded | Actions |
|---|---|---|---|
|
|
ON THE BASIS OF VISA TYPE: THE ASSOCIATION OF VISA TYPE AND HEALTH AMONG U.S. IMMIGRANTS () | 2020-04-27 18:35:59 -0400 |
|
Supplemental Files
| Thumbnail | Title | Date Uploaded | Actions |
|---|