January 22, 2021

By Greg Richter

The United States is often depicted as a “melting pot,” in which diverse cultures and ethnicities come together to form the rich fabric of our Nation.

Despite some progress in achieving this ideal, three recent papers from researchers at Drexel University's Dornsife School of Public Health discuss continued inequalities and growing challenges faced by many immigrants in the U.S. while offering opportunities for a creative refocus of present efforts to help close these gaps.

Structural Racism Establishes Inequalities That Grow Throughout an Immigrant’s Life

In the American Journal of Preventive Medicine, lead author Brent A. Langellier, PhD, and Jessie Kemmick Pintor, PhD, assistant professors in the Dornsife School of Public Health, and colleagues detail the effects of structural racism on the health of immigrants in the U.S.

The authors provide evidence that chronic exposure to racism leads to worsening health over time among immigrants, particularly among those who are Black or Latinx.

The authors look at allostatic load – a comprehensive measure of the body’s response to stressors during a lifespan – in both immigrants and non-immigrants across racial/ethnic groups to put a spotlight on health disparities among groups.

In their study, Allostatic Load Among U.S.- and Foreign-Born Whites, Blacks, and Latinx, the authors studied the 2005-2018 National Health and Nutrition Examination survey and found that allostatic load increases with age among all groups, but at much steeper rates among Black immigrants of both genders and Latina immigrants.

The researchers argue that these findings should inform new laws to close these gaps and address structural inequities, such as access to safe housing, education, health care or healthy food.

Immigrants May Be Losing Culinary Traditions, at the Cost of Health

A recently published study in the journal Preventing Chronic Disease found immigrants may be losing their culinary traditions. Jim Stimpson, PhD, a professor in the Dornsife School of Public Health, Langellier and colleagues studied the eating behaviors of immigrants in the U.S. and found a troubling trend:

As immigrants spend more time in the U.S., less time is spent preparing and eating meals—and more time is spent eating while doing something else, such as watching television.

“The mounting evidence suggests that U.S. culture may influence immigrants to adopt unhealthy behaviors and, by extension, be at greater risk of chronic disease,” the authors note.

In their study, Time Spent Eating, by Immigrant Status, Race/Ethnicity, and Length of Residence in the United States, the team looked at responses from 192,486 adults in the U.S. from the American Time Use Survey, which gave self-reported information on how respondents spend their time during a given 24-hour period.

They also note that future research should employ a randomized controlled intervention to encourage participants to spend more time preparing meals, eat less processed foods, and maintain other healthy habits.

Unauthorized Immigrants Spend Less on Healthcare Than Authorized Immigrants or U.S.-Born Individuals

Using the novel approach of machine learning, Stimpson, Professor Alex N. Ortega, PhD, and colleagues studied survey data from 47,199 respondents of the Los Angeles Family and Neighborhood Survey and the 2016-17 Medical Expenditure Panel Survey to predict health care use and spending among unauthorized and authorized immigrants and those born in the U.S.

In contrast with some perceptions that unauthorized or undocumented immigrants are a financial burden on our Nation’s healthcare system, this cross-sectional study found that unauthorized immigrants incurred considerably less expenditures per person on healthcare than other groups. Average annual health costs were $1,629 for unauthorized immigrants, $3,795 for authorized immigrants, and $6,088 for those born in the U.S.

“Contrary to much political discourse in the US, this cross-sectional study found no evidence that unauthorized immigrants are a substantial economic burden on safety net facilities such as emergency departments,” the authors write.

Their study, Comparison of Use of Health Care Services and Spending for Unauthorized Immigrants vs Authorized Immigrants or US Citizens Using a Machine Learning Model, was published JAMA Network Open.

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Drexel University's Dornsife School of Public Health was founded on the principle of health as a human right and the recognition of the importance of social justice as a means to achieve health for all.

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