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IJE Advance Access first published online on May 18, 2006
This version published online on June 9, 2006

International Journal of Epidemiology, doi:10.1093/ije/dyl089
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2006; all rights reserved.
Accepted April 4, 2006

Original paper

Trends and disparities in socioeconomic and behavioural characteristics, life expectancy, and cause-specific mortality of native-born and foreign-born populations in the United States, 1979-2003

Gopal K. Singh 1 * and Robert A. Hiatt 2

1 Maternal and Child Health Bureau, Health Resources and Services Administration, US Department of Health and Human Services, 5600 Fishers Lane, Room 18-41, Rockville, MD 20857, USA
2 UCSF Comprehensive Cancer Center, University of California, San Francisco, UCSF Box 0981, San Francisco, CA 94143-0981, USA

* To whom correspondence should be addressed.
Gopal K. Singh, E-mail: gsingh{at}hrsa.gov


   Abstract

Background Immigrants are a growing segment of the US population. In 2003, there were 33.5 million immigrants, accounting for 12% of the total US population. Despite a rapid increase in their numbers, little information exists as to how immigrants' health and mortality profile has changed over time. In this study, we analysed trends in social and behavioural characteristics, life expectancy, and mortality patterns of immigrants and the US-born from 1979 to 2003.

Methods We used national mortality and census data (1979-2003) and 1993 and 2003 National Health Interview Surveys to examine nativity differentials over time in health and social characteristics. Life tables, age-adjusted death rates, and logistic regression were used to examine nativity differentials.

Results During 1979-81, immigrants had 2.3 years longer life expectancy than the US-born (76.2 vs 73.9 years). The difference increased to 3.4 years in 1999-2001 (80.0 vs 76.6 years). Nativity differentials in mortality increased over time for major cancers, cardiovascular diseases, diabetes, respiratory diseases, unintentional injuries, and suicide, with immigrants experiencing generally lower mortality than the US-born in each period. Specifically, in 1999-2001, immigrants had at least 30% lower mortality from lung and oesophageal cancer, COPD, suicide, and HIV/AIDS, but at least 50% higher mortality from stomach and liver cancer than the US-born. Nativity differentials in mortality, health, and behavioural characteristics varied substantially by ethnicity.

Conclusions Growing ethnic heterogeneity of the immigrant population, and its migration selectivity and continuing advantages in behavioural characteristics may partly explain the overall widening health gaps between immigrants and the US-born.

Keywords: Immigrant; ethnicity; mortality; life expectancy; cancer; cardiovascular; cause of death; socioeconomic; health behaviour; cancer screening; morbidity; time trend.
The originally published version of this article was incorrect. The values for HIV/AIDS in Table 6 were incorrectly aligned. The publisher apologizes for this error.
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