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theses

The literature on the well-established “immigrant health paradox” shows that recent immigrants have lower morbidity and mortality than their U.S.-born counterparts, including non-Hispanic whites, despite their socioeconomic disadvantage and exposure to racism. However, there is also evidence that the immigrant health paradox only holds when using symptom- and diagnosis-based measures of health, but does not hold when using subjective, self-rated measures of health. In particular, Latino immigrants tend to rate their overall health worse than U.S.-born Latinos and non-Hispanic whites controlling for chronic conditions. Previous research also shows that being interviewed in Spanish rather than English is associated with worse self-rated health, controlling for chronic conditions, among Latinos. Altogether, being a recent immigrant and/or being interviewed in one’s native language seem to lead to worse self-rated health, but the mechanism is poorly understood. Using survey data from nationally representative samples of Mexican American adults, Chinese American adults, and children and their mothers, this dissertation expands the literature on the immigrant health paradox and self-rated health. In particular, this works directly investigates discrepancies between diagnostic criteria and self-rated health in the particular realm of mental health as it pertains to Mexican American and Chinese American adults, who have not been studied as widely as Latinos. This work also examines whether the tendency of negative self-rated health among Latino adults is passed on to their children. The results show that Mexican American adults have a general tendency of rating their mental health worse if interviewed in Spanish despite not meeting criteria for psychiatric disorders, which aligns with patterns found in the literature of self-rated overall health. Similar patterns are found among Chinese American adults, with interviews in Chinese leading to worse self-rated mental health without psychiatric conditions. Another important finding from this dissertation shows that Mexican-origin children tend to rate their own overall health worse than their white counterparts, controlling for a variety of conditions. Although Mexican-origin children seem to mimic their Mexican mothers’ tendency for negative self-ratings of health, the children’s self-rated health ratings were not as negative as their Mexican mothers’ ratings of the children’s health when mothers were interviewed in Spanish. Altogether, these findings indicate that language of interview may represent cultural understandings of health in which English triggers understandings of health that align to the presence or absence of symptoms as it is understood in the United States, whiles native languages of Mexicans and Chinese lead to more holistic concepts of health where symptoms do not fully define their experiences of health or illness.

ETD_8495

Ph.D.

Includes bibliographical references

by Kelly Kato

doi:10.7282/T31R6TNQ

ETD doctoral

The author owns the copyright to this work.