The Arab American Dream?

The American Dream promises every generation will do better than the last. But as early as 1986, researchers found that immigrants to the US tend to be healthier than their children and grandchildren. This pattern, commonly referred to as the healthy immigrant paradox, holds for most immigrant groups including those from Latin America, South America, and Asia. Recently, researchers found Arab Americans may be an exception to the pattern.

To assess health across Arab American generations, Nadia Abuelezam and colleagues explored data from the California Health Interview Survey from 2001 to 2017. The researchers concluded that this data provided little evidence for the healthy immigrant paradox among Arab Americans living in California. First-, second-, and third-generation Arab Americans had about the same chance of developing diabetes, hypertension, and heart disease. The third-generation was slightly more likely to be classified as obese than the first- and second-generations, but the second-generation had the same likelihood of obesity as the first.

Though most immigrant groups tend to become less healthy the longer they live in the US, Arab Americans living in California remain healthy across generations.

Three explanations have been offered for the healthy immigrant paradox. First, immigrants are a particularly healthy group of people. Immigrants self-select into a difficult life transition and must pass medical exams required for visas. Second, when immigrants become unhealthy, they move back to their home countries. Third, immigrants bring healthy habits with them to the US. They tend to avoid risky behavior because of fear of deportation or the criminal justice system.

But these Arab Americans living in California did not fit the healthy immigrant paradox pattern. Early Arab Americans immigrated from stable countries for economic opportunity, whereas recent immigrants came to escape conflict. The first-generation immigrants in this sample might be unhealthier than expected because they were coming from stressful environments. First-generation Arab Americans faced substantial stigma and discrimination particularly in the wake of 9/11. Second- and third-generations may have experienced less discrimination than their immigrant parents and grandparents.

Though most immigrant groups tend to become less healthy the longer they live in the US, Arab Americans living in California remain healthy across generations. Further research is needed to understand the health risks and protective factors among this growing minority population.

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