Disparities in immigrant health may reflect larger problems in U.S. health care, including a need for more preventative care.
A study from Duke contradicts the assumption that immigrants become less healthy while living in the United States. Providing a reinterpretation of data from surveys by the National Institutes of Health, the research demonstrates that immigrants who may have been healthy at their arrival in the United States do not always prioritize finding preventative health care—health problems diagnosed in the United States may have been developing all along.
This leads to complicated and potentially dangerous problems down the road, said Jen’nan Read, the study’s author and associate professor of sociology and global health.
“Helping people understand their health care needs early is so important because by the time we see people—especially immigrants—in the health care system, they’re in the [later] stages [of a disease or medical problem], and they didn’t need to be there,” Read said.
Immigrants are less likely to seek medical help because they may be preoccupied with settling into a new home in a foreign country, Read said. For some, getting the help they want or need may be a difficult task to navigate. Other obstacles to seeking health care include language barriers, lack of insurance, expenses or difficulties in understanding the U.S. health system.
The data in the study shows that 3.6 percent of U.S.-born men surveyed had not seen a doctor for a period of five years. This number only grows when analyzing immigrants—6.3 percent of male Middle-Eastern immigrants and 16 percent of male Mexican immigrants had done the same.
Twenty-four percent of Middle-Eastern men and more than 46 percent of Mexican men surveyed reported to have no usual place to seek health care. This compares to 16 percent of men born in the U.S.
Mexicans and people from the Middle East represent the largest groups of immigrants in the United States. Read said she chose a relatively affluent Middle-Eastern group to compare to the less affluent Mexican demographic in order to discover how socioeconomic background affects access to health care.
The study also considered the difference between illnesses that require diagnoses and those that do not, said Megan Reynolds, a doctoral candidate in sociology and study researcher. They controlled for patient interaction with the health care system in their statistical models, attempting to see if that made a difference in how healthy they appeared.
Previous studies largely ignored the two considerations, she said.
Reynolds noted that having more information, such as the date and status of a patient’s diagnosis, from the NIH surveys would be more helpful. The specific countries of immigrants’ origin, rather than world region, would have also helped with Read and Reynolds’ results.
Immigrants, however, are not the only ones who suffer from health care disparities. Several other U.S. natives have troubles seeking preventative health care.
“It may be an issue of perspective,” said Dr. Cynthia Moylan, assistant professor of medicine. “Maybe those of us who are used to seeking medical care, even when we feel good, assume it is the right thing to do. People who are not used to that may even think that they’re [healthy] or that there’s no reason to go to the doctor.”
As patients age, they may develop serious health problems, Moylan added. If not caught early, problems that could have been easily treated can snowball into severe issues that are both expensive and difficult to treat.
“High blood pressure is the number one silent killer: You can walk around with it forever, but you would never know you had it,” Read said. “Our point is that if you get diagnosed with it early enough, you can take medication. You can’t take medication for heart attacks.”
Making access to health care easier and more affordable would be a step in the right direction, Moylan said. Having more outlying clinics may also make people more comfortable going to their providers as patients may be nervous about going to larger health clinics like Duke.
Moylan added that treating cases earlier could decrease the cost of health care in general.
“We should be able to provide health care to the people of this country at an affordable cost,” she said. “It’s sad for such a wealthy country to have that as a problem. If we can’t get people more healthy now, then the cost of medical care will just keep going up.”
The study will be published in the March issue of the Journal of Health and Social Behavior, according to a news release Feb. 21.
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