Contextualizing immigrants' lived experience: story of Taiwanese immigrants in the United States.

Abstract: Immigration involves extensive changes in living environments. Nonetheless, the predominant approach in the health science literature has been to utilize individual characteristics (including ethnic background) to explain and predict immigrants' lived experiences and health outcomes. Contexts, particularly the larger societal contexts by which immigrants are constituted, are generally ignored. Data from a critical ethnography regarding immigrants' experiences with language, occupation, and economic survival in the United States are utilized to illustrate that immigrants' lives are inseparable from the larger societal contexts, such as immigration policy, Western imperialism, and structural discrimination. The implications for practice, education, and research are discussed. Key Words: Immigration Policy, Western Imperialism, Structural Discrimination, The United States, Social Justice Immigration refers to a process by which an individual or group moves across national boundaries and settles in a new country. It is a physical transition that involves changes in life style and other multiple aspects of the living environment. Six interwoven areas that require immigrants to adjust were documented in the literature (e.g., Aroian, 1990; Baider, Ever-Hadani, & DeNour, 1996; Chrisman, 1981; Graves & Graves, 1974; Lipson, 1992). They are loss, novelty, occupational adjustment and economic survival, language, social network and interaction, and assimilation to the mainstream culture. Some areas may be resolved in a short period of time after immigrants' arrival; some require longer-term adjustment and learning before immigrants can feel in control of their lives. Like many other transitions, immigration promotes marginalization and vulnerability (Meleis, 1996). The process of adaptation to and resettlement in the new country is stressful and threatens the physiological health, mental health and overall well-being of immigrants (e.g., Baider et al., 1996; Hull, 1979; Lipson, 1992; Short & Johnson, 1997). Most of the studies in the health science literature use individual characteristics (including the ethnic background or culture) of immigrants to explain their findings. Contexts in which immigrants' everyday lives are embedded usually are ignored in conceptual frameworks and analyses. It is particularly true with historical, sociocultural, economic, and political contexts. Although some researchers have tended to couch immigrants' experiences in the context of their "culture," they either treat this concept as factual or use it as a catch-all category to explain and account for all of the observed immigrants' experiences. The former runs "the risk of essentializing and categorizing people" (Anderson, 2000, p. 145); and the latter deflects our attention from social or institutional factors (e.g., race, class, gender, political structure) that closely relate to each individual's opportunities, vulnerability, privilege, and health outcomes (McGrath, 1998). As Butterfield (1990) argued, when "nurses [and other health professionals] understand the social, political, and economic influences that shape the health of a society, they are more likely to recognize social action as a nursing [or clinician's] role and work on behalf of populations" (p. 1). The purposes of this paper are to use data from a critical ethnography (Tsai, 2001) to illustrate how immigrants' experiences are interconnected with the larger societal context (e.g., policies, economic structure, social structure, ideologies) of the receiving country in which they settle and to raise our consciousness about the social reality of immigrants' everyday life. Language, occupation, and economic survival will be used as examples. A brief description of the study is presented first. Description of the Study This critical ethnography took place in the northwest region of the United States (U.S.) between 1998 and 2000. …