Americanization a Health Risk, Study Says

In the latest in a series of studies suggesting that assimilation into American culture can have adverse health effects, a new UC Berkeley study reports that Mexican immigrants to the United States have only about half as many psychiatric disorders as U.S.-born Mexican Americans.

The finding further challenges long-held tenets in psychiatry that have portrayed migration as a damaging psychological event and acculturation, or Americanization, as an almost wholly positive phenomenon.

The new study, conducted among Mexican Americans in Fresno County and reported today in the Archives of General Psychiatry, is but the latest research suggesting that immigrants who come here to better themselves do so at the risk of increased health problems for themselves or their children.

A study released less than a week ago by the National Research Council and the Institute of Medicine, for example, reached similar conclusions about the overall health of children of immigrant families.

That panel’s 314-page study found that those children are at least as healthy as U.S.-born children--despite the fact that immigrants are more likely to live in poverty and less likely to have health insurance or regular medical care. But the health of such children tends to deteriorate the longer they remain in the United States and assimilate into American life.

Fast food, poor diets, lack of exercise and, especially, drug abuse and the breakdown of the extended family may lead to a much higher risk of psychiatric disorders, obesity, heart disease and cancer among immigrants who remain in this country for many years or who were born here, according to such studies.

Japanese immigrants to the United States, for instance, have been shown to develop a higher risk of heart disease over time because of dietary changes.

The psychiatric problems observed in the new research are “clearly a social effect, not a biological one,” said William B. Vega, a professor of public health at UC Berkeley and the lead author of the study. “Mexicans come to this country with some kind of [culturally associated] protection against mental disorder, and that breaks down very quickly in American society.”

In addition to the loss of family structure among immigrants, greater exposure to drugs of abuse plays a major role in the higher health risks. “Drug abuse is four times as high among people of Mexican descent born in the United States as among immigrants,” said Dr. Javier I. Escobar of the UMDNJ--Robert Wood Johnson Medical School in New Jersey, who wrote an editorial about the study in the same journal.

“Drug abuse itself is a psychiatric disorder,” Vega said. “Half the people with mental disorders [in the study] had co-occurring drug or alcohol abuse. Psychiatric disorders often lead to drug abuse as a coping mechanism.”

Vega and his colleagues studied 3,012 Fresno County residents, ages 18 to 59, of Mexican origin. They found that the lifetime prevalence of mental disorders was 48.1% among U.S.-born Mexican Americans, about the same incidence found among the entire U.S. population.

In contrast, they found a lifetime prevalence of such disorders of only 24.9% among recent immigrants, about the same prevalence that previous studies have found in Mexico City.

U.S. Lifestyles Pose More Risks

The longer immigrants had been in the United States, the higher their prevalence of mental disorders, Vega said. Among immigrants in the United States for less than 13 years, 3.2% had suffered major depressions, compared with 7.9% of those in the United States longer than 13 years. Among the first generation born in this country, 14.4% had such symptoms.

The increased risk appears to result “from a combination of things, but primarily the emphasis on social networks and families, social support and nurturance” in Mexico, Vega said. “That becomes eroded with time in the United States.”

“This is the land of opportunity, but it’s not good for children,” said Jose Garcia, a 38-year-old day laborer from Mexico interviewed outside a hardware store on Sunset Boulevard.

Garcia said he deliberately left his five children, ages 5 to 15, behind as he worked here and sent money back to them.

But, he added, his mental health has suffered as he struggled to make ends meet and save extra money to send home. Stresses multiplied, he said, because he is an illegal immigrant, ever apprehensive about the possibility of deportation and losing his limited livelihood.

“I often feel worn out here, on the edge of my nerves,” Garcia said.

Garcia’s concern that his children also would have suffered is well-founded, according to the authors of the National Research Council study.

Over time, their report suggested, many immigrant children tend to eschew the very factors that produced good health--insulating family structures, comparatively healthy diets, socially enforced safe behavior. Many veer toward more risky American lifestyles.

By the third generation, the study said, rates of adolescent-risk behavior--such as violence, illicit drug use and unprotected sex--approach or exceed those of peers with U.S.-born parents.

“The longer you’re in this country the more you want to eat at McDonald’s,” said Dr. Evan Charney of the University of Massachusetts Medical School, the chairman of the panel. “Your diet changes. The social support system overall is less strong as children adapt to American culture. Some of the protective things tend to be lost.”

The authors voiced the hope that the data will slow down what many view as a hasty effort to push immigrant youth toward assimilation.

“One thing our study ought to do is give us a little pause about how quickly we are trying to obliterate the ties of immigrant children to their communities and cultures,” said E. Richard Brown, who heads the UCLA Center for Health Policy Research. “Some of these ties may be protective.”

Ruben G. Rumbaut, a Cuban-born sociologist at Michigan State University who has studied assimilation for years, has found that Americanization does not necessarily bode well in areas ranging from infant and adolescent health, diet and divorce, to delinquency and educational achievement.

Recent immigrants generally have healthier children, research suggests, with fewer low-birth-weight babies and infant deaths. Experts said a major reason is that immigrant women, typically Latina or Asian, are less likely to smoke or drink than U.S.-born women.

Also, immigrants are believed to have generally healthier diets, favoring the fresh fruits and vegetables that were mainstays in their homelands.

Welfare Cuts’ Effects Unknown

Children in immigrant families are the fastest-growing segment of the nation’s young population, the study found.

Fourteen million U.S. children--one out of every five people under age 18--are immigrants or are the children of immigrants. The proportion is much higher in immigrant enclaves like Los Angeles County, where about 40% of the population is foreign-born. About three-quarters of all children in immigrant families were born in the United States.

The issue of immigrant health is especially crucial now, the experts said, since recent changes in welfare law greatly restricted noncitizens’ access to food stamps, subsidized health care, cash assistance and other public aid. The ultimate effects of these cuts on immigrants’ health is unknown.

“This is a very shortsighted policy,” Charney said.

For most immigrants, the findings come as no surprise. Many regularly lament the increased stress, the lack of extended family support, the long working hours and other factors that contrast sharply with the simpler, albeit more economically limited, lives left behind in their homelands.

“There are a lot of possibilities here economically, but one has to work hard just to pay the bills,” said Rogelio Beltran, 38, a maintenance man and native of El Salvador who has two U.S.-born children, ages 6 and 12. “Parents just don’t have as much time for their children.”