Pre-migration experiences of victimization and chronic disease among foreign-born people Restricted; Files Only

Sugihara, Marie (Spring 2018)

Permanent URL: https://etd.library.emory.edu/concern/etds/tt44pm866?locale=en
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Abstract

Background: Stressful events may have long-term implications for health and may be particularly common among immigrants. However, victimization as pre-migration stressor has rarely been studied as a risk factor for the development of chronic diseases except for mental illnesses among immigrants.

Objective: This study examines whether pre-migration victimization is associated with post-migration chronic diseases, specifically cardiovascular disease, respiratory disease, metabolic-related disease, arthritis, and cancer.

Methods: We used the New Immigrant Survey, a nationally representative longitudinal study of adult immigrants who obtained lawful permanent residence in the U.S. from June 2003 to June 2004. The adult sample consisted of 8573 respondents. First, correlation analysis between experiences of pre-migration victimization and each chronic disease was conducted using two-sample t-tests and χ2 tests. The victimizations analyzed were harm due to political beliefs, race, ethnicity or gender; incarceration; physical punishment; confiscation or damage of property; loss of a job; and threats. A bivariate regression model was made to assess the odds ratios for each chronic disease and experience of victimization. Multivariate logistic regression models were used to assess and adjust for potential confounders.

Results: 6.7% of immigrants reported that they had experienced some victimization event. People from Europe/Central Asia, Sub Saharan Africa, and the Middle East/North Africa most often reported such experiences. Significant associations were observed in the bivariate model of cardiovascular disease (OR 1.38 [95%CI 1.05-1.81]), metabolic-related disease (OR 1.42 [95%CI 1.17-1.73]), arthritis (OR 2.06 [95%CI 1.45-2.92]), and cancer (OR 2.67 [95%CI 1.13-6.32]). Victimization was significantly associated with having cardiovascular disease,  arthritis, and cancer, controlling for age, age-squared, gender, country of origin, employment, education, marital status, and years of residence in the U.S. (cardiovascular disease: OR 1.41 [95%CI 1.04-1.92], arthritis: OR 2.10 [95%CI 1.43-3.07], cancer: OR 3.32 [95%CI 1.36-8.10]), but not with respiratory disease and metabolic-related disease.

Conclusion: Pre-migration victimization was associated with developing cardiovascular disease, arthritis, and cancer but not with respiratory disease and metabolic-related disease. The result may have a significant implication as it points to the need to understand the health conditions of immigrants looking at both pre-and post-migration characteristics as a part of their life course.

Table of Contents

CHAPTER 1: INTRODUCTION     1

CHAPTER 2: LITERATURE REVIEW/BACKGROUND           4

1. IMMIGRANTS IN THE UNITED STATES               4

1-1. Population characteristics           4

1-2. Victimization 5

1-3. Migration stress            7

2. IMMIGRANTS’ HEALTH             8

2-1. How we consider immigrants’ health and what has been discussed     8

2-2. Prevalence and discussion about chronic health condition among immigrants             10

3. HOW TRAUMATIC STRESSFUL EVENTS CAN AFFECT HEALTH CONDITION IN GENERAL POPULATION                14

4. VICTIMIZATION AND HEALTH CONDITION IN IMMIGRANT POPULATIONS 16

5. AIM OF THIS STUDY  18

CHAPTER 3: METHODS 20

1. STUDY POPULATION AND DATA SOURCE       20

1-1. Study Population          20

1-2. The New Immigrant Survey       20

1-3. The sampling method and data collection for NIS-2003-1    21

2. DATA WORK  23

2-1. Obtaining NIS-2003-1 dataset   23

2-2. Variables used               24

3. DATA ANALYSIS           33

4. ETHICAL CONSIDERATIONS  35

CHAPTER 4: RESULTS    36

1. DESCRIPTION OF STUDY POPULATION PARTICIPANTS            36

2. BIVARIATE LOGISTIC REGRESSION MODELS FOR CARDIOVASCULAR DISEASE, RESPIRATORY DISEASE, METABOLIC-RELATED DISEASE, ARTHRITIS, AND CANCER    38

3. MULTIVARIATE LOGISTIC REGRESSION MODELS FOR CARDIOVASCULAR DISEASE, RESPIRATORY DISEASE, METABOLIC-RELATED DISEASE, ARTHRITIS, AND CANCER CONTROLLING FOR SELECTED CHARACTERISTICS   39

4. ASSESSING INTERACTION       40

CHAPTER 5: DISCUSSION/CONCLUSION/RECOMMENDATION  42

1. MAIN FINDINGS           42

2. OTHER RELEVANT FINDINGS                47

3. LIMITATIONS AND FUTURE DIRECTIONS        49

4. STRENGTHS  50

5. CONCLUSION                51

APPENDICES     52

REFERENCES     58

FIGURES & TABLES

Fig. 1. The conceptual framework for chronic disease among immigrant population              78

Table 1. Percentage of immigrants having experienced victimization in their home country        66

Table 2. The prevalence of diseases by category among those who had vs. had not experienced victimization             67

Table 3. Characteristics of immigrants who reported that they had or had not experienced any type of victimization by themselves or members of their immediate family  68

Table 4. Bivariate logistic regression models for predicting cardiovascular disease, respiratory disease, metabolic-related disease, arthritis, and cancer with exposure to victimization            70

Table 5. Multivariate logistic regression models for predicting cardiovascular disease, respiratory disease, metabolic-related disease, arthritis, and cancer controlling for selected characteristics with the exposure of victimization 71

Table 6. The association between victimization and each chronic disease by years of residence in the U.S. controlling for age, age squared, country of origin, employment, education, marital status, and gender           76

Table 7. The association between victimization and each chronic disease by gender controlling for age, age squared, country of origin, employment, education, marital status, and years of residence in the U.S.        77

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