Pre-migration experiences of victimization and chronic disease among foreign-born people Public
Sugihara, Marie (Spring 2018)
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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