Beyond acculturation: Immigration, discrimination, and health research among Mexicans in the United States

Evidence suggests that, despite their lower socio-economic status, certain health outcomes are better for first-generation Mexican immigrants than their US-born counterparts. Socio-cultural explanations for this apparent epidemiological paradox propose that culture-driven health behaviors and social networks protect the health of the first generation and that, as immigrants acculturate, they lose these health-protecting factors. However, the prominence granted to acculturation within these explanations diverts attention from structural and contextual factors, such as social and economic inequalities, that could affect the health of immigrants and their descendants. The aim of this study is to offer a conceptual redirection away from individual-centered acculturation models towards a more complex understanding of immigrant adaptation in health research. To this end, 40 qualitative in-depth interviews were conducted with first- and second-generation Mexican immigrant women in Southeastern Michigan. The women's narratives highlighted a key process linked to their integration into US society, in which the second generation experienced a more pervasive and cumulative exposure to othering than the first generation. The findings point to othering and discrimination as potential pathways through which the health of immigrants and their descendants erodes. The paper concludes by proposing a conceptual model that locates othering processes within a structural framework, and by drawing implications for research on immigrant health and on discrimination and health. (C) 2007 Elsevier Ltd. All rights reserved.