All ETDs from UAB

Advisory Committee Chair

Magdalena Szaflarski

Advisory Committee Members

Mieke B Thomeer

Bulent Turan

Sylvie Mrug

Document Type

Dissertation

Date of Award

2021

Degree Name by School

Doctor of Philosophy (PhD) College of Arts and Sciences

Abstract

Using data from the 2003 New Immigrant Survey, I examined the association between visa status and acculturation with physical, mental, and self-rated health among immigrants residing in the United States. The primary predictor variable in the study is immigrant visa status. The outcome variables of interest include physical health as any morbidity (chronic diseases), mental health as depressed (as defined by the DSM-IV) and self-rated health (poor self-rated health). Using logistic regressions, I found those with unfavorable visa statuses have worse mental, physical, self-rated health compared to the favorable visa holders. I used inverse odds ratio weighted (IORW) mediation method to test for the mediating role of acculturation in the associations between visa status and health. These analyses indicated that having a favorable visa status is related to higher language acculturation. Additionally, higher levels of both language and diet acculturation are related to better mental health and self-rated health. However, when acculturation is measured as diet change, higher levels of acculturation are associated with higher levels of any morbidity. The IORW analyses indicate that accounting for language acculturation resulted in a significant change in coefficient for the association between visa status and self-rated and mental health, indicating a significant mediation effect. Language acculturation explains a significant amount of the association between visa status and mental health and self-rated health, though visa status is still a statistically significant predictor of health. Next, I test the moderation hypothesis whether the association between visa status and health varies by acculturation, measured as English language proficiency and diet change. When acculturation is measured with English language proficiency, lower acculturation is more detrimental for unfavorable visa holders compared to those with more favorable visas. This means that the associations between visa status and self-rated health is greater for those without resources, in this case English language proficiency, except for unlimited family and limited family visa holders in this study. Improving English language ability among immigrants with unfavorable visa status may help to reduce disparities in health by visa status, especially among those with a refugee visa.

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