The Immigrant Advantage: What We Can Learn from Newcomers to America about Health, Happiness and Hope

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The health advantage observed among immigrants has often been linked to “the immigrant selection hypothesis” that suggests a positive selection of healthy immigrants into the receiving country at individual and national levels [ 12]. Regarding the individual level, immigrants are suggested to be a self-selected segment of the population of the country of origin, with better health and social outcomes relative to non-immigrants in the sending country [ 12, 22]. At the national level, the positive selection process occurs through strict migration policies, such as points-based systems in the immigrant-seeking countries (e.g. Canada and Australia), that favor/screen for healthy, well-educated immigrants [ 23]. These perspectives, however, fail to take into consideration refugees and undocumented immigrants’ situations, which often do not involve a positive self-selection at either the individual or national level. Previous HIE research has also attributed the observed health advantage among immigrants to their resilience, suggesting that newcomers, particularly those who are positively selected, have the motivation and determination to succeed, effectively navigating the destination country’s key resources and community assets that help sustain their overall health and well-being [ 24, 25]. Resilience is suggested to be a dynamic process that encompasses continuous positive adaptation against adverse life events [ 26, 27]. A broader definition for resilience includes the structural and wider community protective factors and processes/mechanisms that contribute to favourable outcomes despite continuing stressors that place communities and individuals’ mental health and psychological well-being at risk [ 28, 29]. Years Since Immigration Effect, Acculturation and Cumulative Stress Theories and Social Suffering Better skilled workforce. In the UK, immigrants working in the economy are more likely to have more educational and skilled qualifications. For example, just 20% of UK citizens finished education at 21 or later. But 53% of new immigrants were educated until 21 or later. (LSE study 2012) Immigration allows an economy to attract high skilled professionals to fill in job vacancies and contribute to higher tax revenues. Labor laws have not caught up to the modern practices of immigration. Even when people are in a new country legally, it is easier to report them to the police as a possible illegal immigrant than fulfill an obligation. Filing false charges, refusing to pay owed wages, and even physical abuse is more common within immigrant circles than it is within the native population. The Mercury News reviewed union elections and found that in at least 50% of campaigns involving a majority of undocumented workforces, threats were made to call immigration over the unionizing activities.

Palloni, A., & Arias, E. (2004). Paradox lost: Explaining the hispanic adult advantage. Demography, 41(3), 385–415. https://doi.org/10.1353/dem.2004.0024.Sixty-one search terms, including generalized ones, that reflect the main concepts of this review (mental health and HIE/Immigrant Paradox) were employed and combined utilizing Boolean operators OR/AND (Online Appendix Table S1). Five automated databases were searched from inception to January 2021: PubMed, Medline, Embase, PsycINFO and Sociology Database. The research was restricted to human studies published in the English language. A manual search of the bibliography of potentially pertinent articles was also carried out. Study Selection Juárez S, Ploubidis GB, Clarke L. Revisiting the “low BirthWeight paradox” using a model-based definition. Gac Sanit. 2014;28:160–2. Immigrants come to make a new life for themselves. Many contribute to their local economies without question. There is an initial investment that communities must make, however, to help these families establish themselves. Children must be educated. Healthcare services must be offered. There is no guarantee that immigrating families will stay in those communities, which means the investments being made may never earn dividends. Mood, C. (2010). Logistic regression: Why we cannot do what we think we can do, and what we can do about it. European Sociological Review, 26(1), 67–82. https://doi.org/10.1093/esr/jcp006. The numbers are large. Some 214 million people are international migrants, living in a different country from the one in which they were born.

Immigration is defined as the intentional movement of an individual to a destination country of which they do not possess citizenship. The reasons for immigration are many. Some travel to a new country to become migrant or foreign workers. Others may wish to settle in as a permanent resident, with the goal of eventually becoming a naturalized citizen. Rebecca, the nurse from the Philippines, enjoyed the greater professional independence she found once she had started work in the United States. This article contributes to the literature on disparities in perinatal health of immigrant populations by providing two main findings. First, our results on birthweight show strong population-based evidence of a large number of “healthy immigrants” residing in Spain. However, not every immigrant matches this description, as immigrant birth outcomes vary significantly depending on the origin of the immigrant mother. Ontario Human Rights Commission. Talking about Canadian experience. 2019. http://www.ohrc.on.ca/en/talking-about-canadian-experience-fact-sheet. Accessed 29 Sept 2021.Massey, D. S. (1995). The New Immigration and Ethnicity in the United States. Population and Development Review, 21(3), 631–652. Aldridge RW, Nellums LB, Bartlett S, Barr AL, Patel P, Burns R, et al. Global patterns of mortality in international migrants: a systematic review and meta-analysis. Lancet. 2018;392:2553–66. Ramraj C, Pulver A, Siddiqi A. Intergenerational transmission of the healthy immigrant effect (HIE) through birth weight: a systematic review and meta-analysis. Soc Sci Med. 2015;146:29–40.

Riosmena F, Kuhn R, Jochem WC. Explaining the immigrant health advantage: self-selection and protection in health-related factors among five major National-Origin Immigrant Groups in the United States. Demography. 2017;54:175–200. Using publicly available data from Spanish Vital Statistics for the period 2007–2017, differential birthweights among several groups of immigrants were estimated with an ordinary least squares regression. The Oaxaca–Blinder regression-based decomposition method was then applied to identify the extent to which differences in birthweight between groups corresponded to compositional disparities or to other factors. ResultsBlewett, L. A., Rivera Drew, J. A., King, M. L., & Williams, K. C. W. (2019). IPUMS Health Surveys: National Health Interview Survey, Version 6.4 [dataset]. Minneapolis, MN: IPUMS, 2019. doi: https://doi.org/10.18128/D070.V6.4 Lau A, Tsai W, Shih J, Liu L, Chin-Wei H, Takeuchi D. The immigrant paradox among Asian American women: are disparities in the burden of depression and anxiety paradoxical or explicable? J Consult Clin Psychol. 2013;81:901. Fuster V, Zuluaga P, Colantonio SE, Román-Busto J. Regional differences in low birth weight in Spain: biological, demographic and socioeconomic variables. J Biosoc Sci. 2015;47:90–104. Osypuk TL, Alonso A, Bates LM. Understanding the healthy immigrant effect and cardiovascular disease: looking to big data and beyond. Circulation. 2015;132:1522–4.

Kwak K. Age and gender variations in healthy immigrant effect: a population study of immigrant well-being in Canada. J Int Migr Integr. 2018;19:413–37.Dhadda A, Greene G. “The healthy migrant effect” for mental health in England: propensity-score matched analysis using the EMPIRIC survey. J Immigr Minor Health. 2017;20:799. Ryan G, Qureshi O, Salaria N, Eaton J. Mental health and the 2030 Sustainable Development Agenda: Global inaction on mental health is putting the brakes on development. 2018. https://globalmentalhealthcommission.org/wp-content/uploads/2018/10/UNGA_policy-brief_MHIN1.pdf.pdf. Accessed 12 June 2020. Nulliparity is also usually associated with a significantly increased risk of low birthweight. However, grand multiparity and great grand multiparity are also associated with low birthweight [ 25]. Non-linear patterns have been observed for the impact of maternal age at birth on birthweight. More specifically, several studies have shown a U-shaped relationship between maternal age and birthweight, with infants born to the youngest (younger than 15 years) and the oldest (40 years and older) mothers more at risk of low birthweights [ 26, 27]. Riosmena, F., & Dennis, J. A. (2012). A tale of three paradoxes: The Weak Socioeconomic Gradients in Health Among Hispanic Immigrants and their Relation to the Hispanic Health Paradox and Negative Acculturation, Chap 8. In J. L. Angel, F. M. Torres-Gil, & K. Markides (Eds.), Aging, Health, and Longevity in the Mexican-Origin Population (pp. 95–110). Springer: New York, NY. Juárez SP, Revuelta-Eugercios BA. Exploring the ‘healthy migrant paradox’ in Sweden. A cross sectional study focused on perinatal outcomes. J Immigr Minor Health. 2016;18:42–50.