Relevance of the “Immigrant Health Paradox” for the Health of Arab Americans in California

Abstract

Objectives. To assess the validity of the immigrant health paradox among Arab Americans in California. Methods. We used data from the 2003 to 2017 California Health Interview Survey (n = 1425). We used survey-weighted χ² and logistic regression analyses to compare Arabs by immigrant generation on socioeconomic indicators, health behaviors, and health outcomes. Results. Second-generation Arab Americans had higher odds of binge drinking (adjusted odds ratio [AOR] = 3.26; 95% confidence interval [CI] = 1.53, 6.94) in the past year than did first-generation Arab Americans. Third-generation Arab Americans had greater odds of receiving the influenza vaccine in the past year (AOR = 3.29; 95% CI = 1.09, 9.98) than did second-generation Arab Americans. Third-generation Arab Americans had increased odds of being overweight or obese when compared with first- (AOR = 2.59; 95% CI = 1.02, 6.58) and second-generation Arab Americans (AOR = 3.22; 95% CI = 1.25, 8.29), respectively. Conclusions. Alcohol use increased across immigrant generations, and we observed no differences in health outcomes, other than obesity. The immigrant health paradox does not appear to apply to Arab Americans in California; mechanisms that generate health in this population should be studied further. (Am J Public Health. Published online ahead of print October 17, 2019: e1–e6. doi:10.2105/AJPH.2019.305308)