CALIFORNIA : Cultural Assimilation Is Bad for Your Health

California’s Latinas, the women most likely to be poor and lack health insurance, have an infant mortality rate 10% lower than Anglo women and 50% lower than African American women. A country’s infant mortality rate has long been considered a primary indicator of its level of progress or lack thereof. While there is no doubt that poverty and inadequate health care take their toll on the quality of a community’s health, the extraordinarily low infant-mortality rates of Latinas shed light on a long-overlooked determinant of human well-being: culture.

Most Asians and Latinos--Chinese, Filipinos and Mexicans--who migrate to California have considerably healthier babies and live several years longer than their kinfolk back home. The United States is clearly better for their health. In fact, California’s Asian and Latino populations have lower overall death rates, a medical measure of a group’s health, than do Anglos and African Americans, according to a Blue Cross-sponsored study.

Asian women live longer than any other segment of California society. Latino men live, on average, four and a half years longer than Anglo men. Asians suffer from virtually all major diseases at lower rates than any other group. Latinos have considerably lower age-adjusted rates of death from all three major contemporary killers: heart disease, cancer and stroke.

To be sure, the two groups have weaknesses in their health profiles. Latinos, for instance, die disproportionately of cirrhosis and diabetes. Asians have a higher rate of tuberculosis than any other group in California. Overall, however, the two are the only groups in the state who have met the major population health goals set for the year 2000 by the state Department of Health Services. A combination of auspicious living conditions and beneficial health behavior are responsible for these positive outcomes.

Before the great advances in public-health standards and modern medicine a half century ago, infectious diseases were among America’s major health concerns. Today, the chief threats--heart disease, cancer and stroke--are largely brought on by lifestyle. Henrik Blum, a public-health pioneer, was the first to assert that the social/cultural networks of meaning and affection that mold individual behavior are, by far, the most important of the four major determinants of health in the post-industrial era. (Medical care, genetic predisposition and environment are the other three).

Two generations ago, patients were more or less passive beneficiaries of progress. Today, health is largely in the hands of individuals and the cultural norms and customs that shape their behavior. Dietary habits and cultural attitudes toward drugs, cigarettes and alcohol, as well as an individual’s self-image and the role he or she plays in a social support network, are all important.

While researchers have long looked at race, class and socioeconomic status when studying Americans’ health, they are only beginning to examine how cultural factors are relevant. The mores and customs of California’s predominately foreign-born Asian and Latino adult populations are chiefly imported from the old country. Studies show that cultural norms make immigrant Latinas much less inclined to drink alcohol, take drugs or smoke during pregnancy than are Anglo or African American women. Cultural/religious prescriptions and proscriptions on behavior urging self-discipline, responsibility to others and faith protect people from threats to their health.

The cultural mores linked to social well-being are frequently the same as those that benefit health. In the past, immigrants’ “old-world” ways lost their influence as each successive generation “Americanized.” The gradual erosion of culturally rooted attitudes has been linked to increased mortality rates among culturally assimilated Asian Americans, as well as a slackening in study habits among third-generation Asian American youth. U.S.-born Latinas, who have higher incomes and greater access to prenatal care than immigrant women, have had higher infant mortality rates than their foreign-born counterparts. Teachers in Los Angeles’ elementary schools say third-generation Mexican American children are much more likely to have disciplinary problems than immigrant children.

The American culture that immigrants must adapt to is not as robust and ascendant as it once was. The sad reality is that cultural assimilation has become bad for your health. While the “huddled masses” have never had it easy, the version of American culture that many of today’s immigrants come to know first is the poisonous combination of dysfunction, decay, automatic weapons and drugs that characterizes inner cities.

Anglo family formation and labor-force participation rates have declined steadily over the past 40 years. In California, Asians and Latinos are considerably more likely to form traditional families than are Anglos and African Americans. A functioning family structure has recently been acknowledged to be important in both individuals’ and society’s health.

Asians and Latinos, the largest and fastest-growing immigrant groups, are reaching critical mass at the very time mainstream America is questioning its fundamental values. Arbiters of values and behavior have taken center stage in both Anglo and African America. But the real culture wars are not the rhetorical battles being fought on Capitol Hill, but those that occur daily in immigrant households, for whom culture is not an abstraction but a matter of immediate physical and social well-being.

While immigrants strive to assimilate into American civic life, they are becoming less and less willing to give up the cultural attitudes and ways of life that nurture them. They learn English. They naturalize. They gradually step off the bus and drive alone to work.

But despite the rise of xenophobia in politics, there may not have been any time in the history of the United States when immigrant families were more able to connect their past, present and future. Momentum, huge numbers and the long arm of foreign-language electronic media have changed the cultural ecology of places like California and turned the assimilation process on its head.

The Irish and Italian immigrants before them could not have imagined the cultural continuity today’s immigrants enjoy. The new immigrants are able to negotiate America on their own terms. Traditional mores inform their American lives.

Of course, some immigrants and their families will continue to fall into the limbo between the old and the new worlds. Global migration will always be fraught with danger. But the larger, transplanted cultures from the South and East are taking deeper root in U.S. soil than those that have gradually eroded into annual parades or quaint ethnic tourist enclaves. Rather than further Balkanizing a fragile society, the values Asians and Latinos bring and maintain in the United States provide the glue that keeps any social fabric together.

Congressional Republicans recently backed off on their proposal to deny student aid to permanent resident aliens because university officials successfully contended that the subsequent loss of Asian immigrants would be a blow to their institutions. Mayor Richard Riordan told the Spanish-language newspaper La Opinion that his city would have an immediate economic depression if Latino immigrants, who have the highest labor-force participation rate of any group, were to suddenly disappear. The positive contributions of both groups derive from their unique cultural attitudes. And while attitudes change and diversify over time, the cultural strengths immigrants bring with them no longer have to be abandoned in order for them, their children and grandchildren to become true Americans. And that’s good news for our country’s health.