Some had no choice about where they settled. In considering the health and adjustment of immigrants and refugees, it is important to consider why they left their home country and what drew them to the United States. Migration within North America should also be considered. For example, some groups have been forced to relocate, such as the Japanese who experienced internment during World War II and the American Indians who were pushed off their ancestral lands. A radical change in environment is stressful when undertaken for any reason, but perhaps more so because of economic or social necessity, such as farmworkers who migrate to follow the crops or African Americans who leave the rural south to find work in northern cities.
People often confuse the terms race and ethnicity.
Racial mixing has given the concept of race little biological significance. Epidemiology also links race to increased disease risks, e.g., increased rates of hypertension and low birth weight among African Americans. However, it is likely that the social context of racism or poverty is as much to blame for higher risks as biology, because these factors expose people to economic and environmental risks and influence interpersonal experiences. Ethnicity refers to a socially, culturally, and politically constructed group of individuals that holds a common set of characteristics not shared by others with whom its members come in contact. These typically include but are not limited to common ancestry, a sense of historical continuity, common language, religion, and interactions with people of the same group.