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    Immigration And Health USA
    Immigration And Health USA
    Immigration And Health USA
    Ebook176 pages2 hours

    Immigration And Health USA

    By adesuyi leslie ajayi

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    Immigration to the USA: Who is coming from where?
    The United States of America is a complex country comprising the indigenous American Indians, unwilling African migrants' descendants, European colonists- the first real immigrants, and the more recent wave of global immigrants. The United States has the highest rate of immigration in the world! More people seek to enter and live within the US than all other countries of the world combined! This situation comes with both its perils and opportunities. The attraction of the US to people of other countries is an everlasting testimony to the genius of the American founding fathers whose proclamation of life, liberty, pursuit of happiness as human inalienable rights, lit an eternal fire and revolution in the human spirit. In addition to the aforesaid, the magnificent splendor of the American landscape, the range of opportunities, the breadth of its diversity and the almost unfettered potential for self actualization has made the US an irresistible magnet, and a global tapestry of cultures. The American magnet has attracted some of the most gifted minds to these shores. [The acclaimed genius, Albert Einstein, was a German immigrant, who became a US citizen]. America arguably has the best mode of government in the face of this planet, it still has the most vibrant economy, most advanced scientific - manufacturing capacity, and remains the only global military superpower. The open secret of the continued American success and dominance, from science to sports, lies in the ability to re-adapt the qualities of its population through a carefully controlled immigration policy.

    Immigrants generally arrive in the United States with less disease burden compared to their corresponding US ethnic and socioeconomic counterparts - interesting... This "healthy immigrant" syndrome may represent both selections of healthy people for immigration approval, and positive health practices in the region of nativity. The immigrant can stay healthy by adopting a strategy of intelligent assimilation into the American society, while maintaining healthy practices, psycho-linguistic, cultural and family ties to their native land.
    Brain drain, brain gain or brain circulation?

    One major consequence of leaving the region of nativity is the loss of highly trained manpower to the host country (brain drain). This loss, affects many professional groups, but has attracted attention with the out-migration of health professionals, especially physicians and nurses. This is because of the alleged adverse impact of the out-migration on the health personnel and services from the "donor" or "source' country. The United States already employs half of all the English- speaking doctors in the world, and plans to employ 1 million more health caregivers over the next 15 years.

    Education or skills acquisition will position the immigrant to be able to obtain a job, or be self-employed in a way that will provide health insurance coverage for the family breadwinner and the dependents. This is imperative, if a family member suffers from a chronic medical disease. Immigrants should make the fringe benefit of family health insurance coverage a priority criterion in accepting job offers, and should also obtain the same, even as self-employed people.
    Diet is a major factor in healthy living and our health is to a large extent a reflection of what we eat and how we eat it. Diet is also geographical, varying vastly according to the region of nativity.
    "Eating out" at a restaurant is a commonplace American lifestyle and a stark symbol of acculturation to the Western mode of existence. America has diverse and delicious cuisine that has a gustatory appeal to many diners. An extreme view of the situation is that in some families, home cooked food is no longer available or the skills to prepare it, is perhaps extinct.

    LanguageEnglish
    Publisheradesuyi leslie ajayi
    Release dateMay 7, 2012
    ISBN9781476403564
    Immigration And Health USA
    Author

    adesuyi leslie ajayi

    IMMIGRATION AND HEALTH USA by ADESUYI LESLIE AJAYI & ABIMBOLA T. AJAYI. The author Adesuyi Leslie Ajayi, MD, PhD is a Professor of Medicine and Biomedical sciences and has worked in universities in the United States, United Kingdom, the Carribeans and Nigeria. He has published over 100 peer reviewed journal articles and other books, including " Diasporan Medicine ". Dr Ajayi is a recent U.S. immigrant and citizen and has drawn upon his personal and professional experiences in writing this book. Dr Ajayi belongs to many professional bodies in his fields and has won several national and international accolades for his research and publications. Abimbola T Ajayi is an Attending Pediatrician and physician with over 25 years experience practicing in the United States, United Kingdom and Nigeria. She is a recent U.S. immigrant and citizen and a Fellow of the American Academy of Pediatrics. She is married with children to Dr A Leslie Ajayi.

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      Book preview

      Immigration And Health USA - adesuyi leslie ajayi

      Immigration and Health

      Impact of migration on the health, and health disparities of ethnic populations

      By

      Adesuyi A Leslie Ajayi, M.D., Ph.D., FWACP, FBPharmacolS

      Professor of Biomedical Sciences, Dept of Health Studies, Chicago State University, Chicago, Illinois. Adjunct Professor of Medicine, Department of Medicine, Baylor College of Medicine, Houston, Texas.

      and

      Abimbola T Ajayi M.D., FAAP, FMCR

      Attending Pediatrician, Edgebrook Pediatric Clinic, Houston, Texas.

      Copyright © 2008, 2012 Adesuyi A. Leslie Ajayi and Abimbola T. Ajayi

      Smashwords Edition

      This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each recipient. If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please purchase your own copy. Thank you for respecting the hard work of this author.

      All rights reserved. No part of this book may be used or reproduced in any manner whatsoever without written permission, except in the case of brief quotations embodied in critical articles or reviews. Please do not participate in or encourage the piracy of copyrighted materials in violation of the author’s rights. Purchase only authorized editions.

      First published by AuthorHouse 9/10/2008

      DEDICATION

      To the memory of Adegboyega Q Adigun, MD

      TABLE OF CONTENTS

      Preface

      Acknowledgments

      Chapter 1

      Immigration to the United States: Who is coming from where?

      Chapter 2

      Consequences of leaving the region of nativity: adverse physical, mental health and sociocultural effects

      Chapter 3

      Adverse health effects of acculturation to the American lifestyle

      Immigrant health status and National health risk - exposure

      Chapter 4

      Mortality by Ethnicity and Ethnic Disparities in Health Outcomes

      Chapter 5

      Ethnic Variation In Efficacy And Adverse Effects Of Drug Therapy

      Chapter 6

      Impact Of Immigration On Women, Pregnant Women And Children

      Chapter 7

      Health Maintenance And Promotion For Immigrants

      Chapter 8

      Travel Medicine

      Chapter 9

      Synthesis and Recommendations

      PREFACE

      The United States of America is a nation of immigrants, with virtually all humanity represented in its diverse population. This great diversity makes it unique among the nations of the world, and poses great opportunities and challenges, especially with regard to health care. As Immigrants, and as health care professionals, we recognize and appreciate the enormity of the challenges. We also recognize the opportunities for "natural experiments' afforded by following the health transition of diverse peoples from the land of their nativity to the USA.

      This book Immigration and health is written from the perspective of the immigrant (and family), with a view to making the transition and residence in the USA, a healthy experience. From the perspective of the health care professional or providers, it enlightens them of the dynamics, acculturative stress and biomedical factors which determine the health outcomes of the most recent arrivals to the US melting pot. Equipment with this knowledge hopefully will lead to a more culturally sensitive and mechanistically targeted health intervention.

      The book should also be of immense utility to health care planners in government and in the private sector. It should enable a greater reach to the currently medically underserved members of the American population, and increase their access and utility both of preventive and curative health services. Further, the American public will be better apprised of the holistic health of their new neighbors, and recent arrivals, and potentially contribute to making the settling down process for immigrants less arduous. Finally, it is hoped that the ethnic disparities (be it cultural or biological) reported in this referenced book, will spur hypotheses that will be eminently testable by health and medical research, to push forward the frontiers of knowledge.

      AAL Ajayi & ATAjayi

      ACKNOWLEDGEMENTS

      We gratefully acknowledge the computer technical support, as well as the literature search contributions of our daughter. Demi Ajayi, SB (Hons), MS. We thank Dr Titilayo Colette Abiona MD, MPH for her useful discussions and public health perspectives to the work.

      CHAPTER 1

      Immigration to the USA: Who is coming from where?

      The United States of America is a complex country comprising the indigenous American Indians, unwilling African migrants' descendants, European colonists- the first real immigrants, and the more recent wave of global immigrants. The United States has the highest rate of immigration in the world! More people seek to enter and live within the US than all other countries of the world combined! This situation comes with both its perils and opportunities. The attraction of the US to people of other countries is an everlasting testimony to the genius of the American founding fathers whose proclamation of life, liberty, pursuit of happiness as human inalienable rights, lit an eternal fire and revolution in the human spirit. In addition to the aforesaid, the magnificent splendor of the American landscape, the range of opportunities, the breadth of its diversity and the almost unfettered potential for self actualization has made the US an irresistible magnet, and a global tapestry of cultures. The American magnet has attracted some of the most gifted minds to these shores. [The acclaimed genius, Albert Einstein, was a German immigrant, who became a US citizen]. America arguably has the best mode of government in the face of this planet, it still has the most vibrant economy, most advanced scientific - manufacturing capacity, and remains the only global military superpower. The open secret of the continued American success and dominance, from science to sports, lies in the ability to re-adapt the qualities of its population through a carefully controlled immigration policy.

      The US population was roughly 290 million in the year 2002 A.D l. It exceeded 300 million in the year 2006 AD ². However, most of the available analysis is based on the 1997 Census Brief¹. Website for the Census bureau is also provided for updates ². About 10% of the present US population is -foreign born (Foreign nativity) and thus are immigrants. Children of American citizens who are born abroad are not regarded as immigrants, but are also natives. l The 27 million American immigrants today is the highest absolute number in American history, out numbering in population all but 35 countries of the world !!!. More recent figures for 2010 census, has the US population at 310 million. The ethnic distribution was as follows, Whites-64.7%, Hispanics -16%, Blacks-12.2%, Asians 4.5%, American Indians 1.5%, Pacific Islanders 0.8%, and 1.5% claim 2 or more mixed ethnicities.

      The recent wave of migration to the US started around 1970 (after the passage of the Civil rights and voting rights bill of 1965, and a visible end to the Vietnam war and the draft). About 17 million of the 27 million current immigrants to the US, arrived after 1970

      About 50% (14 million) of the total foreign born (immigrant) population were from Latin -American countries. Mexico alone accounted for 7 million immigrants as of 1997, representing 50% of the Latino entrants. Other Latino countries with major US immigrant communities are Cuba, Dominican republic and El Salvador. Asian immigrant population was next 27% (nearly 7 million people) in 1997, The top countries of nativity of the migrants were Philippines, China, Vietnam, India. Europeans were 20% of the immigrant population or about 4.5 million people. This represents a downward trend from 60% of all immigrants in 1970 The recent African immigrant population was in 1997 less than 5% (less than 1.5 million) and has been exhibiting a declining trend.

      There is a wide degree of diversity in education, economic means, susceptibility to chronic diseases of acculturation and access to American Health care coverage through employment based Insurance among these immigrants. See Table 1. This heterogeneity has strong implications for future epidemiologic trends in diseases and in ethnic health disparities. The vast majority of these immigrants are concentrated in 6 major states; California (8.1 million), New York (3.6 million), Florida (2.4 million) Texas (2.2 million) New Jersey (1.2 million) and Illinois (1.1 million). These represent 70% of the total immigrant population in the USA in 1997.

      40% Americas PhD Scientists are immigrants or foreign born. Thus immigrants bring a great amount of brain power and creativity to the USA.

      Table 1: Demographic and Health–

      related characteristics of Immigrants and US-born Natives¹

      Based on the 1997 Census Bureau report.

      * Different from the Native born Americans.

      The comparison of the demographic attributes of the immigrants clearly indicate that the Latino immigrants, though the most numerous, were the least educated, the least likely to have access to the healthcare system, had the least family income, though they had the largest families. A whopping 72% of Latinos were either skilled or manual laborers, compared to only 11% of them being in managerial or professional fields. 42% of Africans were also manual or skilled laborers, with 26% in managerial or professional fields. Asians and Europeans had the proportion of laborers and managers not different from the US-born population. Thus, in terms of socio-economic factors, the Latino and the African immigrants are at the greatest risk of being shut out of the health care system, with possible dismal consequences for their long term health and medical needs. The immigration profile by region of nativity thus contributes to future disparity in health status of immigrants and possibly the US born natives of same ethnicity.

      Website of the US Census bureau, and for information on Current Population Survey (CPS) and Health Insurance Data http: www.census.gov/hhes

      Who is coming from where?

      Immigration to the USA by regions according to 1997 Census brief

      Figure 1

      Medical aspects of the Immigration and Naturalization Act (Section 212)

      Conditions for inadmissibility for visa/admission/adjustments of status

      A. Inadmissible Communicable disease

      (which disqualifies an immigrant from entry to the USA)

      1. Chancroid

      2. Gonorrhea

      3. Granuloma Inguinale

      4. AIDS/HIV has been removed

      5. Leprosy

      6. Lymphogranuloma Venereum

      7. Syphilis (infectious stage)

      8. Tuberculosis (clinically active, sputum positive)

      In 2010, the US government lifted the HIV Travel Ban which had been in effect since 1989. Restriction of HIV positive foreigners (students, workers) was not seen as an effective way to protect US natives from HIV/AIDS. 1.1 Million Americans live with AIDS, with 56,000 new infections a year. HIV positive people can now enter the USA.

      Vaccinations required of immigrants visa before adjustments of status

      1. Mumps

      2. Measles

      3. Rubella

      4. Poliomyelitis

      5. Tetanus, Diptheria toxoids

      6. Pertussis

      7. Hemophilus Influenza type B

      8. Hepatitis B

      9. Varicella*

      10. Influenza*

      11. Pneumococcal*

      Recommended additional vaccination, but discretionary *

      B. Physical /Mental disorders for inadmissibility

      1. Current physical or mental disorders, with harmful behavior associated with the disorders.

      2. Past physical or mental disorders, associated with harmful behavior that is likely to recur, or lead to other harmful behavior. [Harmful behavior that pose/posed threat to property, safety, or the welfare of the applicant or others, e.g. Alcohol-related driving incidents such as driving under the influence (DUI).]

      The Center for Disease Control (CDC) has determined that DUI leads to about 17,000 deaths/year, and 500,000 additional injuries, and $1 billion in lost or destroyed property.

      C. Drug Abuse or Addiction

      Persons who engage in non-medical use of psychoactive substances, which

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