Immigrant health and immigrant neighborhoods.

Multiple studies have shown that first-generation immigrants have a lower BMI as compared with second- and third-generation immigrants and that the number of years since immigration is associated with increased BMI.  These studies are interpreted to suggest that, over time, immigrants adopt ‘obesogenic’ lifestyles in the U.S., characterized by dietary and physical activity patterns favoring a positive energy balance, and thus gain weight. Among Hispanics, increasing duration of residence in the USA, higher generation since immigration and other measures of increased acculturation to the US are associated with diets that are lower in rice, beans and fruit and higher in sugar and sugar-sweetened drinks.

We are interested in the question of whether the neighborhood context within which an immigrant settles influences dietary patterns and BMI. Residence in areas with large numbers of immigrants, and among others from one’s own ethnic group, is associated with access to groceries and restaurants selling familiar home-country foods, and may promote healthier diets. We theorize that such neighborhoods may provide both normative and material support for maintenance of home-country dietary patterns, and in effect, slow the process of dietary acculturation

Our initial work showed that U.S. born Hispanics had a higher BMI than foreign-born Hispanics and that BMI increased with time since moving to the U.S. [1].   At the neighborhood level, the percent of residents who were linguistically isolated, a measure of how many residents in the neighborhood do not speak English well, was significantly associated with lower BMI. Suggesting that living in an immigrant enclave protected against higher BMI.  In addition, the association between nativity and BMI was weaker among Hispanics living in neighborhoods with higher levels of linguistic isolation than among those living in neighborhoods with lower levels of linguistic isolation.  In study of Hispanic women, we found that after adjusting for the woman’s place of birth and their preferred language to use at, living in a more linguistically isolated neighborhood was significantly associated with eating a healthier diet [2].  Again these results suggest that living in an immigrant enclave slows the process of dietary acculturation.

Results from a mixed method study showed that foreign-born, Hispanic women distrusted and were dissatisfied with food purchased in supermarkets [3].  They felt that produce and meats in supermarkets was not fresh, was likely to be contaminated with chemicals and had poor flavor.  Their descriptions of what constituted healthy food aligned with the organic farming, slow food and locavore movements, food systems they reported experiencing in their countries of origin.  These women reported that they preferred to shop at farmers markets and live small animal markets in NYC [3].

Recent analyses of the NYC Public School children taking part in the FITNESSGRAM program show that foreign born children have a lower prevalence of obesity than their U.S. born peers. Among Hispanic children the association between nativity and higher BMI was consistent regardless of whether the child was born in the Mexico, the Caribbean, Central or South America.  However, neighborhood linguistic isolation is not associated with body-size among Hispanic children in these analyses.

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