Executive Summary: "The Differential Effect of Foreign-Born Status of Low Birth Weight by Race/Ethnicity and Education" by Dolores Acevedo-Garcia, Mah-j Soobader, and Lisa F. Berkman

Acevedo-Garcia, Soobader, and Berkman investigate whether foreign-born status confers a protective effect against low birth weight (LBW) and whether this protective effect varies across racial or ethnic groups and by socioeconomic status (SES) within these groups.  The researchers pay particularly close attention to the interaction effect of socioeconomic status and nativity on LBW, which they suggest is closely related to the ‘epidemiologic paradox,’ a salient term in immigrant health that denotes that, despite having lower SES, foreign-born women tend to have better birth outcomes than US-born women. They also test for an interaction effect between foreign-born status and education.

        National data from 1998 indicates that the protective effect of immigrant status is particularly strong among black and Hispanic women.  Foreign nativity represents a reduction in the risk of LBW by approximately 23% among black and Hispanic women, whereas foreign nativity does not have a protective effect among white women, and has an adverse effect among Asian women. The effect of foreign-born status is especially protective among women with low education, and decreases with increased education.

        Prior research has suggested that protective cultural factors and social support among (largely Latino) immigrants may explain the protective effect of foreign nativity.  Another plausible explanation is that foreign-born women may be selected for being healthy.  Acevedo-Garcia, Soobader, and Berkman suggest that additional research is needed to weigh and separate out these possible mechanisms.  

        Why, for example, do foreign-born Hispanic women with limited education have low rates of LBW?  Is the social environment experienced by this group less disadvantaged than that experienced by their counterparts from other racial or ethnic groups?  These findings also beg the question of whether the favorable birth-weight outcomes among first-generation immigrants persist among the second generation.