1. TOWARD AN UNDERSTANDING OF THE RELATIONSHIP BETWEEN FAMILY, MIGRATION, AND U.S. LATINOS’ PHYSICAL HEALTH Georgiana Bostean, University of California, Irvine gbostean@uci.edu

2. Latino Familism  “The sense of family is what saves Latinos. Solid family ties are essential for preserving health,” (Andalo 2004) - President of the Interamerican College of Physicians and Surgeons:

3. Latino Health Outcomes  Epidemiological (or, Hispanic) Paradox  Immigrants, particularly Latino, have better health than U.S.-born Whites (Markides and Coreil 1986; Hummer et al. 2007; Vega and Amaro 1994) Differs by health measure and ethnic sub-group  Explanations:  Selective migration  Acculturation Family relations

4. Latino Familism Core value of Latino cultures (Zinn 1992)  Loyalty, reciprocity, and solidarity (Cortes 1995)  Traditional family-orientation (Sabogal et al. 1987)  Strong family networks (Alvirez et al. 1981)  Availability of social support (Vega 1990)  Variations by sub-group (Dilworth-Anderson & Marshall 1996)

5. Latino Familism  Immigrants and familism  Family may be a haven in a heartless world, or its headquarters (Rumbaut 1997)  Migration experience Cohesion Shared experience Conflict Stress, dissonant acculturation, gender norms/roles  Ethnic sub-group differences in family relations and in migration context

6. Family and Health  Large literature on marital status and health  Social support  Social control over behaviors (Umberson 1987)  Negative effects of poor family relations/dissolution  Positive relation psychological health (Ryan 2007; Russell 2009)  Both subjective measures and quality of relationships matter marital status, household size, living arrangements

7. Latino Familism & Health  Lower substance use  Moderates deviant peer influence on behavior probs (German et al. 2009)  Relationship to mental health (Rivera et al. 2008; Mulvaney-Day et al. 2007)

8. Present Study  Contributions:  Examine family relationships, the predictors of both conflict & cohesion  Analyze how family factors are related to multiple physical health outcomes

9. Research Aims  1. Analyze nativity and ethnic differences in family context  What factors predict cohesion and conflict?  (e.g., are immigrants more familistic, are there ethnic differences in the nativity effect?)  Are migration-contextual factors related to family cohesion and conflict among immigrants?  2. Examine the relationship between family context (cohesion and conflict) and physical health  Are cohesion & conflict related to health net of subjective family measures (marital stat, hh size, language)?  Are family factors related to health differently for immigrants and U.S.-born?

10. Methods  Data  2002-2003 National Latino and Asian American Survey  Measures  Family Context (scale)  Health (dichotomous)  Analyses  Negative zero-truncated Poisson (for scales)  Logistic regression (for health outcomes)  Stata 10.1, weighted to be nationally-representative

11. Dependent Variables  Physical Health  Chronic conditions  “Has a doctor or health professional ever you that you have”  Diabetes, high blood pressure, heart disease, cancer  Self-rated physical health  “How would you rate your overall physical health - excellent, very good, good, fair, or poor?”  Activity limitation  “Was there ever a time in the past 30 days when health-related problems caused you difficulties with mobility, such as standing for long periods, moving around inside your home, or getting out of your home?”

12. Independent Variables  Family Context  Marital status, household size & structure, language spoken with family  Family cohesion (scale 10-40, alpha=.93 Spanish int.,.92 English) loyalty, respect, enjoying spending time together, perceived support from family, as well as family interfering with personal goals  Family conflict (scale 5-15, alpha=.89 Spanish interview,.76 English) “too close to family interfered with goals,” “Argue with family over different customs,” “Lonely and isolated due to lack of family unity,” “Family relations less important to people close to you,” “Personal goals conflict with family.”

13. Independent Variables  Migration context  Had to move from origin (Wanted to)  Very/somewhat difficult visit origin (Not at all/not very)  Returned to origin in last 12 mos. (Did not return in last 12 mos.)  Limited contact with family & friends in origin  Felt guilty for leaving family or friends in origin  Controls  Age, sex, hh income, education

14. Sample Characteristics: Health % * * * Significant difference at least at.05 alpha level

15. Sample Characteristics: Family Context %

16. % * * * Significant difference at least at.05 alpha level

17. Findings: Cohesion & Conflict  Cohesion & Conflict  Nativity difference explained by language spoken w/ family  Among immigrants, migration context is related to ConflictCohesion Had to move from origin (Wanted to) Very/somewhat difficult visit origin (Not at all/not very) Returned to origin in last 12 mos. (Did not return) Limited contact with family & friends in origin Felt guilty for leaving family or friends in origin

18. Findings: Health Poor/Fair Self-rated HealthActivity LimitationChronic Conditions U.S.-bornImmigrants Nativity Diff.U.S.-bornImmigrants Nativity Diff.U.S.-bornImmigrant Nativity Diff. Sociodemographic factors Ethnicity (Mexican) Cuban0.7920.368***0.8491.4290.4141.808***†† Puerto Rican0.8041.0261.538*1.851*0.9062.775***††† Other0.6960.536***0.6921.0981.1471.129 Family-related factors Household size0.9470.9351.0340.813***††1.121*1.046 Married/Cohabiting (Unmarried)0.7841.0700.9861.0680.9341.312 Language spoken w/ family (Spanish all /most ) English & Spanish equally1.2120.9981.1931.4411.806**0.693† English all/most of the time1.0190.321***†††1.694*2.082*1.5700.541† Family conflict scale1.0171.0501.215 *** 1.126*0.9731.213***††† Family cohesion scale0.9790.9751.0141.0280.9631.018† n7411602 7411603 7411603

19. Limitations  Causality unclear  Family relationsHealth  HealthFamily relations Don’t know with who respondent migrated Family cohesion/conflict measures– which family members are included?

20. Conclusions Cohesion & Conflict:  Language spoken with family is strongly related to cohesion and conflict  Migration factors do affect family relations among immigrants

21. Conclusions Health:  Conflict related to health more strongly  Health measure matters  Nativity differences in the relation btwn family factors and chronic conditions

22. Thank you for your attention! Georgiana Bostean Department of Sociology University of California, Irvine Gbostean@uci.edu I would like to acknowledge NSF and the UCI Center for the Study of Latinos in Society for their support