The Health Toll of Immigration
By Sabrina Tavernise, NY Times, May 18, 2013
BROWNSVILLE, Tex.—Becoming an American can be bad for your health.
A growing body of mortality research on immigrants has shown that the longer they live in this country, the worse their rates of heart disease, high blood pressure and diabetes. And while their American-born children may have more money, they tend to live shorter lives than the parents.
The pattern goes against any notion that moving to America improves every aspect of life. It also demonstrates that at least in terms of health, worries about assimilation for the country’s 11 million illegal immigrants are mistaken. In fact, it is happening all too quickly.
"There’s something about life in the United States that is not conducive to good health across generations," said Robert A. Hummer, a social demographer at the University of Texas at Austin.
For Hispanics, now the nation’s largest immigrant group, the foreign-born live about three years longer than their American-born counterparts, several studies have found.
Why does life in the United States—despite its sophisticated health care system and high per capita wages—lead to worse health? New research is showing that the immigrant advantage wears off with the adoption of American behaviors—smoking, drinking, high-calorie diets and sedentary lifestyles.
Here in Brownsville, a worn border city studded with fast-food restaurants, immigrants say that happens slowly, almost imperceptibly. In America, foods like ham and bread that are not supposed to be sweet are. And children lose their taste for traditional Mexican foods like cactus and beans.
For the recently arrived, the quantity and accessibility of food speaks to the boundless promise of the United States. Esther Angeles remembers being amazed at the size of hamburgers—as big as dinner plates—when she first came to the United States from Mexico 15 years ago.
"I thought, this is really a country of opportunity," she said. "Look at the size of the food!"
Fast-food fare not only tasted good, but was also a sign of success, a family treat that new earnings put in reach.
"The crispiness was delicious," said Juan Muniz, 62, recalling his first visit to Church’s Chicken with his family in the late 1970s. "I was proud and excited to eat out. I’d tell them: ‘Let’s go eat. We can afford it now.’ "
For others, supersize deals appealed.
"You work so hard, you want to use your money in a smart way," said Aris Ramirez, a community health worker in Brownsville, explaining the thinking. "So when they hear ‘twice the fries for an extra 49 cents,’ people think, ‘That’s economical.’ "
For Ms. Angeles, the excitement of big food eventually wore off, and the frantic pace of the modern American workplace took over. She found herself eating hamburgers more because they were convenient and she was busy in her 78-hour-a-week job as a housekeeper. What is more, she lost control over her daughter’s diet because, as a single mother, she was rarely with her at mealtimes.
Robert O. Valdez, a professor of family and community medicine and economics at the University of New Mexico, said, “All the things we tell people to do from a clinical perspective today—a lot of fiber and less meat—were exactly the lifestyle habits that immigrants were normally keeping.”
"I’d love to have my wife at home taking care of the kids and making sure they eat right, but I can’t afford to," said Camilo Garza, a 34-year-old plumber and maintenance worker whose grandfather immigrated from Mexico. "It costs money to live in the land of the free. It means both parents have to work."
As a result, his family eats out almost every night, leaving his dining table abandoned.
"It’s a decoration," said Mr. Garza, who is overweight and a smoker. "It’s a place where we set groceries before sticking them in the refrigerator."
The lifestyle takes its toll. The county in which Brownsville is situated, Cameron, has some of the highest rates of obesity and diabetes in the country. The numbers are made worse by a lack of physical activity, including walking. Immigrants said they felt so conspicuous during early attempts to walk along the shoulder of the roads that they feared people would suspect they were here illegally. Ms. Angeles recalled that strolling to a dollar store provoked so many stares that she felt like “a bean in rice.”
"In Mexico, we ate healthily and didn’t even know it," said Ms. Angeles, who has since developed diabetes. "Here, we know the food we eat is bad for us. We feel guilty. But we eat it anyway."
Health habits in Mexico are starting to look a lot like those in the United States. Researchers are beginning to wonder how long better numbers for the foreign-born will last. Up to 40 percent of the diet of rural Mexicans now comes from packaged foods, according to Professor Valdez.
"We are seeing a huge shift away from traditional diets," he said. "People are no longer growing what they are eating. They are increasingly going to the market, and that market is changing."
Joseph B. McCormick, the regional dean of the University of Texas School of Public Health in Brownsville, said, “The U.S. culture has crept across the border.”
But at least for now, the older generation is still enjoying its advantage. In the De Angeles snack bar, a favorite meeting place for elderly Brownsvillians, one regular who is 101 still walks across the bridge to Mexico. Maria De La Cruz, a 73-year-old who immigrated to the United States in her 40s, says her secret is raw garlic, cooked cactus and exercise, all habits she acquired from her father, a tailor who died at 98.
"He had very pretty legs, like mine," she said, laughing. "You want to see them?"