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The More They Become Like Us

As immigrants to the United States adjust to life in a new country, their diets and habits start to resemble those of the native-born—and that's not a good thing.
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Born in war, born into a time of constant hunger and disease, my father grew up on the run. His family moved every few months ahead of the advancing enemy forces in China and later fled to Taiwan. In 1960, he set sail for the United States, where a graduate-school engineering fellowship awaited him.

At his wedding five years later, he was young and thin, his tuxedo as trim as his crew cut. He’d taken up sailing and cross-country skiing, once gliding off the front stoop of his Chicago apartment after a heavy snowstorm. His life ahead was full of possibilities that his own father never enjoyed, with health the American-born might envy, the kind of well-being that researchers have puzzled over for decades.

The immigrant-health paradox refers to the epidemiological finding that migrants are healthier than U.S.-born residents of similar racial backgrounds, with lower rates of obesity, heart disease, and infant mortality, even though many, like my father, hail from countries with higher rates of poverty and lower standards of living.

Eventually my parents embraced the wonders of processed foods served in a size and quantity they could only dream of as children. My father developed Type 2 diabetes.

In 2002, a study by the City University of New York found that recent immigrants are much less likely to be hospitalized for most major illnesses, have lower rates of mortality, and have a life expectancy four years longer than the American-born. Study after study has shown the same pattern. Last year, a paper (PDF) published in the Journal of Immigrant & Refugee Studies found that immigrants from mainland China living in New York have “a more favorable mental, cardiac, and reproductive health profile” than the city’s overall population. Another study found that foreign-born Latinos have a lower stroke rate than both American-born Latinos and non-Hispanic whites.

Perhaps only the robust and resourceful can make the journey. Then they may carry on practices that promote health, such as traditional diets, and maintain family support networks. My grandmother, our caregiver, used to stir-fry vegetables for us while my parents pursued demanding careers. As his success as a structural engineer grew, my father labored for longer hours. He worked on the Sears Tower and Bechtel projects in Saudi Arabia. He was left with little time for rest or exercise.

The longer immigrants live here, the higher the price they pay for opportunity and abundance. According to a 2002 study in Human Biology, an immigrant’s risk of smoking, obesity, and hypertension grow yearly. A person who immigrated to the U.S. within the last five years has half the risk of an American-born of getting a chronic condition. After living here for more than 15 years, a person is only 24 percent less likely to have a chronic condition.

Eventually my parents embraced the wonders of processed foods served in a size and quantity they could only dream of as children. My father developed Type 2 diabetes. Genetics and lifestyle leave Asians at high risk for the disease. Later, he was diagnosed with Parkinson’s.

“The more ‘they’ become like ‘us,’ immigrants and immigrant children fail to maintain their health advantages,” write Samuel Noh and Violet Kaspar, psychiatry professors in Toronto. Research suggests that the causes of decline are diverse—the stress of acculturation and racial discrimination, poverty, or limited health care.

Doctors say that patients with diabetes and Parkinson’s can manage both disorders, but my father struggled. Diabetes can lead to itchy lower legs—torturously hard to scratch for a man who often lost his balance. He had to watch what he ate and when he ate, to control his blood glucose and maximize absorption of the Parkinson’s medication.

Early research suggests that diabetes may be a risk factor for Parkinson’s. Environmental triggers and genetics too could play a role. My father, proud of the family’s bloodline, would never accept the idea that he had inherited Parkinson’s.

But he inherited his father’s fate. Both died after falling and hitting their heads. Despite his illness, my father seemed to have iron bones that matched an iron will. He believed he would live at least as long as his father, who moved to America after retiring and lived to be 85.

My father had an immigrant’s unwavering belief that each generation would achieve more than the last, but in the end, at 75, his dream came up a decade short.