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Immigrants and Host Country. What is the cost of acculturation?

Immigrants and Host Country. What is the cost of acculturation?. M Maldonado. Immigrants. Traditional belief is that immigrants are at higher risk of mental health problems This is thought to be due to the effects of migration, economic deprivation and loss (Escobar et al, 2000)

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Immigrants and Host Country. What is the cost of acculturation?

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  1. Immigrants and Host Country. What is the cost of acculturation? M Maldonado

  2. Immigrants • Traditional belief is that immigrants are at higher risk of mental health problems • This is thought to be due to the effects of migration, economic deprivation and loss (Escobar et al, 2000) • At times, they have been thought to be “defective” or backwards. • Industrialized countries are increasingly “multicultural”

  3. Immigrants • Have higher risk factors than host population: • Poverty • Lack of access to health care, insurance • Fewer visits to health care professionals

  4. Immigrants • In the US Latinos are increasing in number steadily • By 2050 they will be 25% of the US population • The majority of Hispanics in the US are of Mexican origin • In some states they reach 25 to 30% of the population

  5. Immigrants • Degree of “acculturation” • Embracing new values, new language, new costumes and ways of behaving • For Mexican immigrant women, more “acculturation” means worse outcomes in terms of health and mental health ( substance use, alcohol abuse, etc.)

  6. Acculturartion measures • Language used at home, e.g. Spanish or English • Language familiarity and preference • Child rearing preferences • Electronic media interest • Ethnic pride and idetity • Food, music, generational proximity

  7. Acculturation measures • Coworkers • Ethnicity of neighbors and close friends • Cultural heritage and celebrations • Music • Childhood cultural characteristics • Cultural exposure. Bicultural involvement

  8. Acculturation • Measuring degree of acculturation in Latinos (Burnam et al. 1987) • Epidemiological Catchment Area study , of rates of psychopathology in US. Related to Latinos: • Less acculturated people, less prevalence of alcohol and drug abuse, phobia, antisocial personality • Is there a selective effect of migrators?

  9. Acculturation • Rates of mood disorder in Latino population • Rates lower in Mexican born people vs. US born Latino persons (Kessler et al, 1994) • Lower prevalence of substance abuse in the Mexican born population

  10. Prevalence studies. Mexican American prevalence survey (Vega et al, 1998) • 3000 adults in California • CIDI instrument (Composite Int. Diag.Interv.) • Rates of psychopathology are twice for US born individuals • For women rates of alcohol and drug abuse are 7x for US born women

  11. Healthy immigrant effect in women • In US Latino women who adhere to their traditional culture have more “positive health behaviors” (Ventura et al, 1997) • Less use of drugs and alcohol • Less complications during childbirth • Better perinatal health outcomes compared with more acculturated Latino women, diabetes, hypertension

  12. Effect for immigrant women • Less acculturation (foreign born) means: • Lower rate of “small for gestational age babies” (3% Mexican born vs. 14% for US born women) • Lower rates of prematurity • Lower infant mortality for foreign born than US born women (Collins et al, 2001)

  13. Latinos in California. • 3000 adults in California • CIDI instrument (Composite Int. Diag.Interv.) • Rates of psychopathology are twice for US born individuals • For women rates of alcohol and drug abuse are 7x for US born women vs. those born in Mexico

  14. Acculturation • Adoption of “new ways” , language, beliefs, practices, while abandoning the old or traditional ones. • Is acculturation adaptive? Is acculturation beneficial for the health of pregnant women?

  15. Women and pregnancy • In US Latino women who adhere to their traditional culture have more “positive health behaviors” (Ventura et al, 1997) • Less use of drugs and alcohol • Less complications during childbirth • Better perinatal health outcomes compared with more acculturated Latino women, diabetes, hypertension

  16. Pregnancy and domestic violence. Pregnant Latina Women (Matson and Rodriguez, 1999) • 150 women, immigrant and US Born, rural and urban • Highest rate of domestic violence in US born rural Latina (highest level of acculturation)

  17. Latina women • More acculturated young Latina women • Start intercourse earlier in age • Higher rate of non-marital births (Loue, 1987

  18. US Mexico border study of adolescents (Pumariega et al, 1992) • 4000 adolescents, 11 to 18 years old • Rates of depression and distress (Panamerican Youth Inventory and Center for Epidemiologic Studies Depressive Scale) • Rate of drug abuse was 4x higher in US born adolescents (21% vs 5%) • Higher levels of distress and suicidal ideation in US born teenagers. • Other studies: less risk of suicide

  19. US Mexico border study • Risk factors: More time watching television • Less time spent in family activities • Less involvement with friends • Less involvement in sports

  20. U. Of California Irvine . Disorders in primary care (Escobar et al, 1998) • 1500 adolescents several groups • Mexican and Central American born : • Lower levels of posttraumatic disorder, depression, panic disorder • Better levels of physical functioning • Higher rates of “somatization”

  21. Acculturation. Turkish children in Germany • Less acculturation meant: • Lower rates of asthma • Lower rates of allergic sensitization • Lower rates of atopy • (Gruber et al, 2002)

  22. Acculturation and diet • Less acculturated Latinos in US • “healthier diet” • Less consumption of fat, saturated fat, sodium ,more consumption of fiber and vitamines • More consumption of vegetables • Regular eating of breakfast

  23. Acculturation and “heatlh behaviors” • Less acculturation of Latinos in US • Higher use of seat belt • Higher level of immunization of children

  24. asimilation TRANSCULTURATION ISOLATION AND ENTRENCHMENT

  25. Pregnancy and culture Not talking to the child or about the child Using objects to prevent negative influences ( evil eye, witchcraft, penetration by spirits, effects of envy) Massages and baths to the mother Avoidance of calling attention to pregnancy Need to be “mothered” herself.

  26. Breastfeed? Where? How? When should consistent foods be introduced? How to make food soft and pureed? What should be offered and when? Should the baby eat at night? How long to give the bottle? What variety of foods? Feeding the infant

  27. Feeding the infant • Baby should sleep alone? • Baby should sleep with mother? • What to do if the baby wakes up? • What to do if the baby cries? • Hammock, box, crib, mother’s bed, side bed, “motorcycle bed” • Should baby be swaddled?

  28. Possible protective effects • Role of “familismo”: social support and collective loyalty • Extensive social networks • Culturally based respect for parents and for parenting role? • Greater social support and control

  29. Protective effects? • Support network of extended family , traditional roles, use of cultural markers and language (Escobar et al, 2000) • Social control exerted over health related behaviors such as drug and alcohol use • Less isolation during pregnancy and delivery

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