Healthy Adolescent Lifestyles: Should Native-Born American Adolescents Adopt an Immigrant Lifestyle?

Background: The immigrant paradox refers to the notion that despite immigrants severe economic and social disadvantage, they tend to be healthier than the native-born in the host country. There is currently little research that directly compares native-born children to immigrant children on healthy lifestyle behaviors, such as food consumption and physical activity. In the United States, more than one third of children and adolescents are overweight or obese, and this rate is increasing rapidly. Therefore, it is important to analyze the health behaviors between the two groups to determine if one group exhibits a healthier lifestyle over the other. It is hypothesized that immigrant children lead healthier lifestyles, such as more physical activity, and healthier food consumption, compared to native-born children.

Method: The study utilized data from the Healthy Behavior in School Children (HBSC, 2009-2010), a multi-stage and nationally representative survey of students in grades five through to grade ten (N=12,642). The data also identified whether the child was native-born or an immigrant (N=1,068). Measures used to assess healthy lifestyle choices for adolescents included, BMI days physically active, fast food consumption, soft drink consumption, vegetable consumption, and fruits consumption.  Propensity score matching methods was used, to match native-born children to immigrant children, based on the following demographic variables, age, sex, gender, and family affluence. The optimal matching method with a 0.10 caliper was used, as it yielded the best results in finding the set of matches that minimizes the total distance between all matched pairs. Multiple linear regression and Poisson regression was conducted using R software.

Results: Immigrant children were found to have lower BMI scores than native-born children (-0.68, p< 0.001). Immigrant children also consumed less fast-food (-0.30, p< 0.001), and soft-drinks though non-significant (-.13, p=0.2).  Immigrants did consume more fruit (0.21, p<0.05) and vegetables (.13, p=.2), the latter failed to reach statistical significance.  On the other hand, immigrants were found to be less physically active compared to native-born children (-0.10, p<0.001).

Conclusion: These results add to the literature of the immigrant paradox, that immigrants despite being socially and economically disadvantaged are generally healthier than native-born Americans. Although this study finds that immigrant children are slightly healthier, in terms of BMI score and food consumption, immigrant children are less physically active than native-born children. A combination of both healthy eating and physical activity is encouraged for children to remain healthy, in order to combat the childhood obesity epidemic in the United States. Future programs and initiatives could include targeting immigrant children and encouraging them to eat similar to their immigrant parents, rather than their American friends at school or in the community, who are more prone to eating fast food, may help to prevent obesity in the immigrant community. For those neighborhoods that are co-ethnic, where there is a mix of native-born and immigrant families, education on the immigrant lifestyle could be beneficial for native-born families, as well as being able to bring a multi-cultural community together.