According to the U.S Census Bureau (2017), approximately one in every seven residents in the United States is immigrant. The literature provides evidence that immigrants have better mental and physical health outcomes when compared to U.S. residents. This phenomenon is referred to as the Immigrant Health Paradox (IHP). This study examined the IHP phenomenon by analyzing the data from a clinic that served an uninsured and under-insured population. While controlling for individual-level characteristics (age, gender, income, race, and preferred language), neighborhood-level characteristics such as Neighborhood Concentrated Disadvantage (NCD), and Neighborhood Immigrant Density (NID), this study examined the association between being an immigrant and treatment attendance, and mental health diagnosis. In addition, this study examined whether being an immigrant is associated with the lower likelihood of having a mental health diagnosis and higher treatment attendance. Secondary data was obtained that merged datasets from publicly available census data and electronic medical records (EMRs) from a clinic serving an uninsured and underinsured population. The data was merged by utilizing the ArcGIS software. Overall, the results of the study supported the IHP by showing that being an immigrant was associated with higher treatment attendance and lower incidence of mental health disorders. In addition, living in residential neighborhoods with higher immigrant density was associated with better mental health outcomes for both immigrants and non-immigrants. Recommendations for future studies include further examination of the reasons behind higher treatment attendance of immigrants compared to non-immigrants, and how high treatment attendance plays a role in IHP.
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Doctor of Philosophy (Ph.D.)
College of Community Innovation and Education
School of Public Administration
Public Affairs; Social Work
Length of Campus-only Access
Doctoral Dissertation (Open Access)
Sualp, Kenan, "The Influence of Neighborhood Structural Characteristics on Treatment Attendance and Mental Health: Comparing Immigrants and Non-Immigrants" (2021). Electronic Theses and Dissertations, 2020-. 568.