Stress-associated poor health among adult immigrants with a language barrier in the United States.

The healthy migrant hypothesis supported by the 'Hispanic paradox' suggests that immigrants are healthier than non-immigrants. To test the generalizability of this hypothesis, we studied the stress-associated health status of adult immigrants with a language barrier in the USA. Three stress-related conditions (Unhappiness, Depression, and Anxiety) and self-reported health status were ascertained from participants of the Community Tracking Study Health Survey conducted in 2003. The associations between these conditions as well as the immigrants' length of time living in the USA and health were assessed. Our results demonstrated that the three stress-related conditions were significantly associated with a dramatically elevated poor health status (Unhappiness: OR = 5.22, 95% CI: 4.43-6.14; Depression: OR = 3.03, 95% CI: 2.31-3.98; Anxiety: OR = 5.12, 95% CI: 3.53-7.41). Compared to US citizens without a language barrier, immigrants with a language barrier were more likely to report poor health (OR = 2.15, 95% CI: 1.66-2.78). After adjustment for stressors, the likelihood of reporting poor health among immigrants with a language barrier decreased significantly (OR = 1.75, 95% CI: 1.05-2.91). In addition, these immigrants were more likely to report poor health within the first 10 years of their living in the USA (<or=5 years: OR = 2.79, 95% CI: 1.94-4.02; 6-10 years: OR = 2.68, 95% CI: 1.86-3.86). In summary, immigrants who have a language barrier were generally more stressed, especially at the beginning of their lives as immigrants. The combined effect of stress and a language barrier led to poorer health in these immigrants. Thus, the healthy migrant hypothesis may not be generalizable to this population.