Untangling the ‘health paradox’ among adolescent girls: the role of immigration status, depression, and decision-making

ABSTRACT

The ‘health paradox’ is a phenomenon in which immigrants report better health than their native-born counterparts despite experiencing numerous adversities. This study examines the ‘health paradox’ among adolescent girls in the U.S. and evaluates the understudied pathways and conditions in the immigration status-health link, including the role of emotional (i.e. depressive symptoms) and cognitive (i.e. decision-making) domains. Drawing on Wave I (1994–1995) and Wave II (1996) of a nationally representative longitudinal study of adolescents (Add Health), a series of regression models was conducted to explore the relationship between girls’ immigration status and health (N = 6,543). Further, mean centered multiplicative terms and the KHB decomposition procedure were used to assess the moderating and mediating effects of depressive symptoms and decision-making. Results reveal that, in general, foreign-born girls enjoy better health as compared to their native-born counterparts, which is partially explained by their fewer depressive symptoms. Importantly, however, the experience of higher levels of depressive symptoms appears to decrease immigrant girls’ resilience. The ability to be thoughtful and reflective when making choices serves as a health protective factor among girls overall, suggesting the need to foster adolescent girls’ decision-making skills to improve their health. Policy recommendation based on our findings are discussed.

KEYWORDS:

• Immigrant
• health paradox
• depression
• health
• decision-making
• adolescents

Acknowledgments

This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill and funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. Information on how to obtain the Add Health data files is available on the Add Health website (https://addhealth.cpc.unc.edu/). No direct support was received from grant P01-HD31921 for this analysis.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Anastasiia Timmer

Anastasiia Timmer is an assistant professor at the Department of Criminology and Justice Studies, California State University-Northridge.

Cathrine Jacobsen

Cathrine Jacobsen is a graduate student at the Department of Sociology, California State University-Northridge.