Immigration, Health, and New York City: Early Results Based on the U.S. New- Immigrant Cohort of 2003

1. Introduction Every year, several hundred thousand persons become legal permanent residents (LPRs) of the United States, (1) averaging 781,848 in the 1991-95 period, 771,307 in the 1996-2000 period, and 944,884 in the 2001-04 period. (2) They include new arrivals to the United States (some coming for the very first time) as well as persons already living in the United States, having come earlier on a temporary visa or without documents and now achieving the coveted LPR status. Mingled with their hopes and dreams are the personal characteristics that propelled the move--the peculiar migrant energy--and the myriad faculties, experiences, attributes, and skills that will shape the immigrant trajectory. Immigrants settle in one point within the vast U.S. geography. Classically, there are four great reception areas: the two coasts, Chicago, and the southern border. New York City was the gateway for the great migrations of the turn of the twentieth century, and it remains a major destination for new immigrants. (3) Repeatedly, the city has been shaped and reshaped by the distinctive characteristics of successive waves of new immigrants; new immigrants, in turn, like their native-born counterparts who arrive from Seattle and Iowa City and Laredo, have found in New York City both haven and spur. Among the things immigrants bring with them to the United States is their health set: the combination of health levels and health behaviors. This paper has the twofold objective of exploring immigrant health and doing so with an emphasis on New York City. We make use of a new data source, the New Immigrant Survey (NIS)--the first longitudinal survey of a nationally representative sample of new legal immigrants to the United States--drawing information from Round 1 of its fiscal year 2003 cohort, known as NIS-2003. (At this writing, the data from Round 1 are being prepared for initial public release in 2005, and plans are under way for fielding Round 2.) An important additional objective of this paper is to make known the availability of this new data source, which will enable researchers to address a wide variety of topics, from language acquisition and identity formation to religion dynamics, not to mention the staples of studies of immigration, such as selectivity, emigration, and naturalization. Two questions dominate the study of immigrant health: 1. What is the health status of a new immigrant? 2. What is the immigrant's health trajectory over the life course? The first question, the selection question, encompasses all factors and mechanisms in both origin and destination countries that influence who migrates--including, for example, origin-country skill prices and destination-country visa allocation regimes--some of which are, directly or indirectly, attentive to matters of health. The second question, variously called the assimilation or incorporation question, focuses on the health-relevant aspects of the receiving country environment and the immigrant's resources and behaviors in the new country. At first blush, the immigrant health problem considers health at arrival and examines subsequent health. For example, a popular story in recent years has been that of a healthy person immigrating to the United States and subsequently acquiring some of the bad eating habits associated with American fast food, leading to health decline. Migration is complicated, however, and we argue that a more faithful approach would incorporate the health effects of the migration process itself, which may begin long before "arrival" and may differ for immigrants facing different migration-relevant environments, such as different visa regimes (Kasl and Berkman 1983; Vega and Amaro 1994; Jasso 2003; Jasso et al. 2004). For example, navigating the visa application process may be quite stressful, illegal immigrants are constantly in fear of discovery and deportation, some legal immigrants have "conditional" visas for two years after admission to legal permanent residence, and immigrants may face prejudice. …