1. health and fitness

IMMIGRANT NEIGHBORHOOD CONCENTRATION,
ACCULTURATION AND OBESITY AMONG YOUNG
ADULTS
HIROMI ISHIZAWA
The George Washington University
ANTWAN JONES
The George Washington University
Researchers repeatedly find that immigrants are healthier than their native-born counterparts. Among immigrant children, however, findings are mixed. Moreover, the effect of neighborhood
context on obesity has not been fully examined. Using the National Longitudinal Study of Adult Health,
this study investigates the linkages between acculturation, neighborhood characteristics, and obesity
among young adults, including the potential for residing in an immigrant neighborhood, to mediate the
adverse effects of low neighborhood socioeconomic conditions on obesity. Consistent with the unhealthy
assimilation model, an immigrant health advantage is found for first generation Asians. Conversely, a
greater likelihood of being obese is found for second and third and higher generation Hispanics relative
to third and higher generation Whites. Further, a high concentration of immigrants and linguistically
isolated households appear to work as a buffer against health risks that relate to obesity, particularly in
poor neighborhoods.
ABSTRACT:
Although showing signs of leveling, the obesity rate continues to be high in the United States (Levi
et al., 2013). Approximately 17% of children aged 2–19 and 35% of individuals aged above 20 are
obese (Fryar, Carroll, & Ogden, 2012; National Center for Health Statistics, 2013). More importantly,
the racial and ethnic disparities in obesity persist. In particular, Hispanics have higher obesity rates
compared to non-Hispanic Whites among children as well as adults (Fryar et al., 2012; Ogden,
Carroll, Kit, & Flegal, 2013). Such disparities are significant because racial and ethnic minority
populations are increasing at a faster rate than non-Hispanic Whites, which is partly attributable to
the increase in the number of children of immigrants (Humes, Jones, & Ramirez, 2011). Immigration
from Latin America and Asia increased after the passage of the Immigration and Nationality Act
of 1965, and a sizable proportion of the children of post-1965 immigrants are in their transition to
young adulthood. Given that children of immigrants represent a large proportion of U.S. population
growth, their health in early adulthood (and as they age) will have a significant impact on the nation
as a whole.
Research examining racial and ethnic health disparities consistently finds that immigrants enjoy
better health outcomes than their native-born counterparts across numerous indicators (Cunningham,
Ruben, & Narayan, 2008). Much of the earlier work on immigrant health argues that ethnic health
disparities are primarily due to differences in diet and food preparation, exercise habits, and other
behaviors that are risk factors associated with morbidity and mortality (Markides & Coreil, 1986).
Although immigrants may enjoy better health than native-born populations, this advantage declines
Direct correspondence to: Hiromi Ishizawa, Department of Sociology, The George Washington University, 409 Phillips Hall,
801 22nd Street NW, Washington, DC 20052. E-mail: ishizawa@gwu.edu.
JOURNAL OF URBAN AFFAIRS, Volume 00, Number 0, pages 1–14.
C 2015 Urban Affairs Association
Copyright All rights of reproduction in any form reserved.
ISSN: 0735-2166.
DOI: 10.1111/juaf.12208
2 I JOURNAL OF URBAN AFFAIRS I Vol. 00/No. 0/2015
as the length of residence in the United States increases (Cho, Frisbie, Hummer, & Rogers, 2004;
Frisbie, Cho, & Hummer, 2001). As an explanation for this relationship, some researchers argue that
unhealthy acculturation, or the adoption of unhealthy behaviors that are pervasive in mainstream U.S.
society, is a contributing factor that reverses the immigrant health advantage (Abra´ıdo-Lanza, Chao,
& Fl´orez, 2005). Together, the research suggests that health norms and behaviors in both immigrants’
countries of origin and in the United States shape the health and well-being of immigrants.
However, researchers have not fully explored one of the components that is central to the unhealthy
acculturation argument: the neighborhood context. As Fitzpatrick and LaGory (2003, p. 36) argue,
“health is a product not only of how we live, but also of where we live.” Following this argument,
neighborhoods and places of residence should be viewed as “risk spaces” and “resource spaces.”
Any hazards and risks that impact health are unevenly distributed across places. For instance, health
risks related to location include building deterioration, which is predominantly concentrated in socioeconomically disadvantaged areas. Further, race/ethnic minorities are more likely to reside in
low-quality neighborhoods than Whites (Osypuk, Galea, McArdle, & Acevedo-Garcia, 2009). On
the other hand, neighborhood resources such as neighborhood-based supportive social networks and
accessible health care facilities and services protect residents from local hazards and risks impacting their health. The advantages and disadvantages of neighborhoods also have a time dimension.
Although change occurs, neighborhoods are somewhat resilient to change (Sharkey, 2013). Because
of the stability that exists in neighborhoods, there may be enduring consequences to long-term
exposure to local hazards and risks, particularly in locations with high concentrations of poverty
(Sampson, 2012).
Indeed, the neighborhood has long been understood as an important aspect of immigrant adaptation
to U.S. society. According to spatial assimilation theory (Massey, 1985), residential location is a direct
reflection of the level of acculturation and socioeconomic mobility that immigrants experience. Newly
arrived immigrants who are unfamiliar with the environment first settle in a central city containing
a high concentration of people from the same country of origin, where there is limited exposure to
the host society’s culture and norms. Spatial dispersion then occurs as immigrants acculturate and
achieve socioeconomic mobility. While the presence of immigrant residential concentration among
contemporary immigrants and their descendants has been found not only in inner cities but also
in suburbs (Logan, Zhang, & Alba, 2002), the predominant pattern of immigrant neighborhoods
exhibiting low socioeconomic status (SES) suggests that residents may have a heightened exposure
to poor health risks.
On the other hand, neighborhood-based social networks may serve as protective factors (Ellen,
Mijanovich, & Dillman, 2001). For instance, social networks within immigrant neighborhoods may
be able to shape norms about accepted health-related behaviors, such as low levels of high-fat
food consumption (Osypuk et al., 2009). Further, residing in immigrant neighborhoods means that
residents may have more opportunity to share information about doctors and health care services
with neighbors who speak the same non-English language (Deri, 2005). In recognizing the role that
context of reception plays in the immigrant integration process, segmented assimilation theory posits
that children are integrated into various segments of a society, and this process is determined in
part by the type of neighborhood in which these children reside (Portes & Zhou, 1993). Past studies
have examined the effects of neighborhood context on various integration outcomes and have found
support for segmented assimilation theory (Finch, Lim, Perez, & Do, 2007; Tong, 2010; cf. Xie
& Greenman, 2011). For instance, Zhou and Bankston (1994) found that immigrant neighborhoods
benefit socioeconomically disadvantaged children by buffering them from at-risk behaviors prevalent
among native-born underclass youth. In immigrant neighborhoods, children of immigrants have
access to ethnic culture and resources that limit incorporation into poor neighborhoods. In other
words, immigrant neighborhoods may serve as a buffer that slows down acculturation with respect
to specific health norms and behaviors of the host society. In order to examine each of these
possibilities, this study uses the National Longitudinal Study of Adult Health (Add Health) to
examine the linkages between acculturation, neighborhood characteristics, and obesity among young
adults.
I Immigrant Neighborhood and Obesity I 3
ACCULTURATION AND OBESITY
Child obesity prevalence in the United States has increased since the 1980s and has occurred in
all age and race/ethnic groups (Cossrow & Falkner, 2004). Marked increases in obesity have been
seen among non-Hispanic Blacks and Mexican Americans (Hedley et al., 2004). On the other hand, a
lower or equivalent level of obesity is generally found among Asian children (Anderson & Whitaker,
2009) as well as Asian adults (Hao & Kim, 2009) compared to their White counterparts. More
specific to immigrant populations, the health literature often relies on the unhealthy assimilation
model to understand immigrant health. This theory explains the worsening of health outcomes across
immigrant generations in terms of acculturation that leads to unhealthy behaviors. Consistent with
this theory, past studies found that the likelihood of being overweight is higher for native-born than for
foreign-born children (Gordon-Larsen, Harris, Ward, & Popkin, 2003; Popkin & Udry, 1998). More
specifically, first-generation Asians and Hispanics were less likely to be obese than their secondand third-generation counterparts (Popkin & Udry, 1998). Differences in diet (Singh & Siahpush,
2002), physical activity (Singh, Stella, Siahpush, & Kogan, 2008), and parenting (Arredondo et al.,
2006; Elder et al., 2010) are mechanisms that researchers have found to help explain this generational
difference in obesity among immigrant populations.
On the other hand, many findings are inconsistent with the unhealthy assimilation model. Hispanic
children of immigrants have been found to be more likely to be overweight than Hispanic children
of native-born parents (Balistreri & Van Hook, 2009; Van Hook & Baker, 2010; Van Hook, Baker,
Altman, & Frisco, 2012). An explanation for this finding is the immigrant vulnerability hypothesis,
which argues that children of immigrants have greater vulnerability to obesity upon arrival in the
United States because their parents spend much time and resources transitioning to a new environment
(Van Hook et al., 2012). Conversely, Hamilton, Cardoso, Hummer, and Padilla (2011) found no
consistent immigrant generational pattern for overweight status by examining several race/ethnic
groups, including Asians and Hispanics. The study observed a lower prevalence of overweight status
among second generation Hispanics, compared to both the first and third generations. On the other
hand, a higher prevalence of being overweight was found for second generation Asians compared to
their first and third and higher generation counterparts. Still, other studies have found a curvilinear
relationship between generational status and obesity. Specifically, obesity and overweight prevalence
are highest among first and third and higher generation Asians and lowest among second generation
Asians, a result mainly attributable to physical inactivity in the first and third generations (Singh,
Kogan, & Stella, 2009).
Further, research has found that acculturation does not necessarily lead to unhealthy behaviors
(Creighton, Goldman, Pebley, & Chung, 2012). A recent study indicates that the association between
acculturation and health varies by socioeconomic characteristics of immigrants (Ra, Cho, & Hummer,
2013). For example, among Korean immigrants, a longer duration of residence in the United States
is related to better health and positive health behaviors among the highly educated. While findings
on the association between acculturation and obesity are mixed, the effect of neighborhood context
on obesity has not been fully examined among immigrant populations (Finch et al., 2007; Osypuk,
Diez-Roux et al., 2009).
NEIGHBORHOOD, UNEVEN DEVELOPMENT, AND OBESITY
While much research has focused on the effects of individual characteristics on various health
outcomes, broader contextual circumstances have also been found to influence these outcomes
(Diez-Roux, 2007; Jones, 2013). Obesity is not an exception. Socioeconomic characteristics of neighborhoods are associated with obesity prevalence (McLaren, 2007; Parks, Housemann, & Brownson,
2003). Residents in socioeconomically disadvantaged neighborhoods are more likely to be obese
compared to residents of more affluent neighborhoods (Law, Power, Graham, & Merrick, 2007). It is
likely that these socioeconomically disadvantaged neighborhoods also have a lower quality built environment, leading to poor health behavior outcomes (Lovasi, Neckerman, Quinn, Weiss, & Rundle,
4 I JOURNAL OF URBAN AFFAIRS I Vol. 00/No. 0/2015
2009; Taylor et al., 2007). For instance, the lack of physical resources such as parks, playgrounds, and
supermarkets are associated with sedentary behavior, poor diet, negative neighborhood perceptions,
and low levels of utilization of and knowledge about the neighborhood (Gordon-Larsen, Nelson,
Page, & Popkin, 2006).
The quantity and quality of health-related physical structures is a function of the socioeconomic
status of a neighborhood. In general, city amenities such as proximity to medical facilities or farmer’s
markets are strategically placed in neighborhoods that are socioeconomically stable or on the verge of
turning into areas of high socioeconomic status, while socioeconomically disadvantaged areas do not
have access to these amenities. Developers, in turn, feel that profit margins are low in disadvantaged
neighborhoods, which guides their decision not to place amenities in those areas that need it the most
(Harvey, 1989; Smith, 2008). In addition, the policy decisions within cities, such as exclusionary
zoning and suburban subsidization, contribute to uneven development (Squires & Kubrin, 2005). In
fact, consistent with spatial assimilation theory, neighborhoods with high immigrant concentrations
are characterized by poor quality with respect to walkability, safety, and availability of recreational
exercise resources (Osypuk, Diez-Roux et al., 2009). Therefore, the effect of residing in immigrant
neighborhoods on health is of particular theoretical and practical interest because it is usually the
first point of reception for immigrant families and thus shapes the kind of experience they have in
the United States.
HYPOTHESES
The following hypotheses are derived from the two major theoretical arguments that link immigration to health:
1. Unhealthy assimilation model: The lower likelihood of obesity among Asian and Hispanic
young adults decreases across immigrant generational status.
2. Segmented assimilation theory: Higher immigrant and linguistically isolated household concentrations of the neighborhood in which young adults reside during adolescence correlate
with a lower likelihood of obesity.
3. Segmented assimilation theory: The negative effect of residing in socioeconomically disadvantaged neighborhoods on the likelihood of obesity is lessened in neighborhoods with higher
immigrant concentrations.
DATA AND METHODS
The current research relies on the National Longitudinal Study of Adult Health (Add Health),
which is a nationally representative sample of adolescents in Grades 7–12 who were followed from
1994 to 2009. The data are ideal to test the segmented assimilation theory and unhealthy assimilation
model because of the large sample size, the inclusion of neighborhood-level characteristics, and the
collection of major health behavior indicators. At the first wave of data collected in 1994–1995, there
were 20,745 adolescents in the core sample, with an oversampling of various Asian and Hispanic
groups, such as Chinese, Cuban, and Puerto Rican (UNC Carolina Population Center, 2013). By the
third wave (2001–2002), 15,197 respondents had been retained.
To ensure adequate sample size, the analyses are restricted to Hispanics and Asians of all generational statuses with third and higher generation White young adults as the comparison group.
The final analytic sample contains 10,063 young adults. Immigrant generational status is categorized as follows: first generation is assigned to those who were born abroad and have at least one
foreign-born parent; second generation are those born in the United States with at least one foreignborn parent; and third and higher generation are those born in the United States with native-born
parents. The data are not disaggregated further by subgroup because, with the exception of Mexican and Mexican Americans, none of the subgroups have a large enough sample size for further
analysis.
I Immigrant Neighborhood and Obesity I 5
Dependent Variable
Body mass index (BMI) is assessed at Wave III when the majority of respondents are in their late
teens to 20s. Respondents were asked to report their weight and height. Because the respondents were
over 18 at survey date, an unstandardized BMI is calculated using the conventional BMI equation
(Centers for Disease Control and Prevention, 2011). As the dependent measure, a dichotomous
variable is employed, with a BMI of at least 30 indicating obesity.
Independent Variables
Acculturation
Much debate exists in the literature regarding the measurement of acculturation as unidimensional
or multidimensional (Chun, 2003), but two measures have been used in much research to approximate
a potential change in cultural patterns consistent with the host society (Sam & Berry, 2006). As defined
above, immigrant status is partitioned out as first generation, second generation, and third and higher
generation. In addition, household language is often used as a dimension of acculturation. If a young
adult grew up in a household where a non-English language is used, it is coded as one and used as
the reference category.
Family Characteristics
Following the work of Bearman and Moody (2004), a composite measure for family socioeconomic
status uses parent education and occupational status as of Wave I, which ranges from one (low family
SES) to 10 (high family SES). The two household structure variables are: (1) whether a young
adult lived in a two-parent household, a single-parent household, or other household structure (e.g.,
extended family members present in a household) and (2) the number of siblings in a household.
To account for any genetic linkage between parents and offspring, a variable for a family history of
obesity measures whether the respondent’s biological mother or father was obese.
Young Adult Characteristics
The sedentary behavior scale sums the number of hours per week the respondent watches TV,
watches videos, and plays computer games. Thus, higher scores on this scale correspond to higher
levels of sedentary behavior. The scale is standardized around a mean of zero such that positive
values correspond to sedentary behavior and negative values indicate more of an active lifestyle. The
Cronbach’s α for this measure is .6, which is considered an acceptable result for internal consistency
of the items in the scale (Kline, 2000). Because breastfeeding is negatively associated with obesity
(Armstrong & Reilly, 2002), a measure is included for whether or not the respondent was breastfed.
Age in months and gender are also included as controls in the analyses.
Neighborhood Characteristics
To help test the segmented assimilation thesis, three variables on the characteristics of neighborhoods where the respondent resided during adolescence (Wave I) are used. These two variables are
taken from 1990 U.S. Census, which was attached to Add Health data. The geographic unit is the
census tract. The first two variables are (1) the logged median household income within the respondent’s neighborhood, and (2) the immigrant neighborhood scale. The immigrant neighborhood scale
is constructed from two variables: the proportion of foreign-born residents and the proportion of
persons aged 5 years and older who live in linguistically isolated households. These two measures
yield a Cronbach’s α of .9, indicating strong internal consistency between the items. Again, the scale
is standardized around a mean of zero such that positive values correspond to higher immigrant and
linguistically isolated households.
6 I JOURNAL OF URBAN AFFAIRS I Vol. 00/No. 0/2015
A dichotomous measure is used to indicate whether a respondent lived in a socioeconomically
advantaged or disadvantaged area. Different methods are available to categorize socioeconomic status
of the neighborhood. Tong (2010) used median household income: disadvantaged neighborhoods are
those with median household incomes lower than overall median household income across all
neighborhoods included in the data, and advantaged neighborhoods are those with median household
incomes higher than overall median household income. A second threshold relies on the poverty
rate. Kneebone, Nadeau, and Berube (2011) describe neighborhoods with a poverty rate between
20% and 40% as high poverty neighborhoods and with a poverty rate higher than 40% as extreme
poverty neighborhoods. This approach suggests categorizing neighborhoods as advantaged (poverty
rate lower than 20%) and disadvantaged (poverty rate higher than 20%). The two approaches yield
similar results, and results using the poverty rate are presented below (results using median household
income are available upon request).
Methods
Logistic regression is used to model whether or not a young adult is obese at the third wave
of data collection. The first model predicts the likelihood of being obese by including measures
of acculturation (immigrant generational status and non-English language use) and race /ethnicity.
The second model predicts obesity by interacting race/ethnicity and immigrant generational status.
The third model introduces the individual-level and neighborhood-level variables to investigate any
changes in the association between race/ethnic immigration generational status and obesity. A final
model assesses the effect of interacting the immigrant neighborhood scale and the socioeconomically
disadvantaged neighborhoods dichotomous measure to examine whether the effect of residing in
immigrant neighborhoods on obesity varies by neighborhood type.
Because the data were collected using a clustered, stratified sampling design, the svy command
in Stata 13.1 is used to account for design effects. Prior research using these data suggests that the
design effects and the hierarchical nature of the data (with individual and census tract level measures)
can be appropriately controlled for with the svy command (Grilli & Pratesi, 2004; Rabe-Hesketh &
Skrondal, 2006).
RESULTS
Figure 1 presents obesity prevalence among young adults by race/ethnicity and immigrant generational status. As expected, overall obesity is more prevalent among Hispanics (21%) and least among
Asians (11%) compared to third and higher generation Whites (17%). Consistent with the unhealthy
assimilation model, the percentage of obesity increases across immigrant generations among Asian
as well as Hispanic young adults, albeit the difference is starker among Asians.
The characteristics of young adults by race/ethnicity are shown in Table 1. Surprisingly, the
percent of family history of obesity is the highest among third and higher generation Whites (22%),
followed by Hispanics (16%) and Asians (8%). Several characteristics of Hispanics suggest the
higher prevalence of obesity relative to Asians: they are more likely to have lower levels of family
socioeconomic status and reside in socioeconomically disadvantaged neighborhoods. By contrast,
Asian young adults have similar levels of family socioeconomic status as third and higher generation
Whites. Further, they are more likely to reside in two-parent households, be breastfed, and reside
in higher socioeconomic status neighborhoods. According to past work, these characteristics make
Asian young adults less likely to be obese. It is important to point out, however, that Hispanic
young adults are more likely to have grown up in immigrant neighborhoods, as the mean immigrant
neighborhood scale takes a value of .85 for the group.
Table 2 shows the results of the logistic regression analysis predicting obesity. The results are
presented as odds ratios such that values above unity denote positive effects and those below unity
negative effects. The results from Model 1 show that the likelihood of being obese varies by immigrant
generation. First generation young adults are less likely to be obese compared to the third and higher
I Immigrant Neighborhood and Obesity I 7
25%
22.2%
20%
PERCENT OBESE
17.4%
21.7%
20.9%
20.5%
17.7%
15%
11.2%
11.1%
1st
2nd
3rd+
Generaon Generaon Generaon
All
10%
7.7%
5%
0%
3rd+
1st
2nd
3rd+
Generaon Generaon Generaon Generaon
White
All
Hispanic
Asian
FIGURE 1
Distribution of Obesity at Wave III by Race/Ethnicity and Immigrant Generational Status (N = 10063)
Source: National Longitudinal Study of Adult Health.
TABLE 1
Weighted Descriptive Statistics by Race/Ethnicity
Total Sample
Mean or %
SE
Immigrant generational status
First Generation
9.17%
Second Generation
12.99%
Third+ Generation
77.84%
Acculturation
Non-English language
8.59%
spoken at home
Family characteristics
Socioeconomic Index
5.63
Number of siblings
1.36
Household Structure
Two Parent
77.87%
One Parent
18.20%
Other
3.93%
Family history of obesity
20.85%
Young adult’s characteristics
Sedentary behavior
−0.06
scale
Breastfed
43.62%
Age (in years)
22.29
Female
48.93%
Neighborhood characteristics
Median household
$31184.84
income
Immigrant neighborhood
−0.16
scale
Disadvantaged
19.88%
neighborhood
Unweighted N
%
White Sample
Mean or %
SE
Hispanic Sample
Mean or %
SE
Asian Sample
Mean or %
SE
—
—
—
0.00%
0.00%
100.00%
—
—
—
23.72%
41.86%
34.42%
—
—
—
42.42%
40.72%
16.86%
—
—
—
—
0.05%
—
44.33%
—
42.84%
—
(0.12)
(0.03)
5.89
1.26
(0.12)
(0.03)
4.17
1.78
(0.14)
(0.07)
5.88
1.62
(0.25)
(0.14)
—
—
—
—
78.58%
17.81%
3.61%
22.50%
—
—
—
—
72.73%
21.65%
5.62%
15.97%
—
—
—
—
82.27%
13.84%
3.90%
7.59%
—
—
—
—
(0.02)
−0.06
(0.02)
−0.04
(0.02)
−0.06
(0.03)
—
(0.12)
—
43.04%
22.26
49.42%
—
(0.13)
—
44.26%
22.44
47.44%
—
(0.23)
—
51.78%
22.41
45.28%
—
(0.26)
—
(948.85)
$31446.93
(1047.92)
$28241.51
(1474.61)
$36771.56
(1738.84)
(0.07)
−0.38
(0.01)
0.85
(0.31)
0.40
(0.11)
—
16.35%
—
40.12%
—
15.88%
—
10,063
100.00%
6,915
68.72%
Source: National Longitudinal Study of Adult Health, Waves I and III.
2,205
21.91%
943
9.37%
8 I JOURNAL OF URBAN AFFAIRS I Vol. 00/No. 0/2015
TABLE 2
Logistic Regression Results Predicting Obesity: Odds Ratios
Model 1
Model 2
Immigrant generation status (Third+
generation)
First generation
.65∗
Second generation
.92∗
Race/Ethnicity (White)
Asian
.72
Hispanic
1.39∗
Race/ethnic immigrant generational status (White, third+ generation)
Asian, first generation
.39∗∗
Asian, second generation
.59
Asian, third+ generation
1.22
Hispanic, first generation
.99
Hispanic, second generation
1.33∗
Hispanic, third generation
1.32∗
Acculturation
Non-English language spoken
1.07
1.04
Family characteristics
Socioeconomic Index
Number of siblings in household
Household Structure
(Two parent)
One parent
Other
Familial history of obesity
Young adult’s characteristics
Breastfed
Sedentary behavior scale
Age
Female
Neighborhood characteristics
Median household income
Immigrant neighborhood scale
Disadvantaged neighborhood
Immigrant neighborhood scale ×
Disadvantaged neighborhood
Constant
.21∗∗∗
.21∗∗∗
F statistics
4.85∗∗∗
3.85∗∗∗
Note: Reference categories are in parentheses.
Model 3
Model 4
.56
.90
1.69
1.29
1.49∗
1.35∗
.51
.83
1.29
1.24
1.43∗
1.32∗
.97
.99
.94∗∗∗
.96
.94∗∗∗
.96
.96
.84
2.68∗∗∗
.96
.84
2.69∗∗∗
.74∗∗∗
1.23∗∗∗
1.01∗∗∗
.74∗∗∗
1.22∗∗∗
1.01∗∗∗
1.07
1.07
.82
.87∗
1.32∗
.80
.99
1.27
.84∗
.24
13.51∗∗∗
.31
12.62∗∗∗
∗ p < 0.05; ∗∗ p < 0.01; ∗∗∗ p < 0.001.
generations, which is consistent with the unhealthy assimilation model. In addition, in accord with
past findings, Hispanic young adults had a higher likelihood of being obese compared to third and
higher generation Whites. Model 2 provides further clarification by showing that the association
between immigrant generational status and obesity varies by race/ethnicity. Second and third and
higher generation Hispanics are more likely to be obese compared to third and higher generation
Whites. On the other hand, first-generation Asians are less likely to be obese compared to third and
higher generation Whites.
When individual-level (characteristics of family and young adult) and neighborhood-level variables are added in Model 3, the higher likelihood of being obese remains for second and third and
higher generation Hispanics, while the coefficients for first generation Asians become nonsignificant. Further, the odds ratio for second generation Hispanics (1.49) is slightly higher than for third
and higher generation Hispanics (1.35), suggesting a curvilinear association between immigrant
generational status and obesity among Hispanics. Two neighborhood-level variables are significant. The results show that higher scores on the immigrant concentration scale (percentages of
I Immigrant Neighborhood and Obesity I 9
immigrant population and linguistically isolated households) are associated with a lower likelihood
of being obese. Further, residing in socioeconomically disadvantaged neighborhoods is associated
with a higher likelihood of being obese. The odds ratios for all other statistically significant independent variables are of the expected size. Sedentary behavior and family history of obesity are
positively associated with the odds of being obese, and family socioeconomic status is negatively
associated with obesity risk.
The final model in Table 2 shows the odds ratios predicting obesity with an interaction between the
immigrant neighborhood scale and the socioeconomic disadvantage neighborhood measure. While
the main effects are no longer significant, the interaction itself is. The coefficient suggests that
the likelihood of being obese is lower as the immigrant neighborhood scale increases with that
effect being highest for adolescents living in socioeconomically disadvantaged neighborhoods. As
expected, this result is consistent with the immigrant neighborhood effect being stronger in poor
neighborhoods.
DISCUSSION AND CONCLUSIONS
The primary objectives of this study were to investigate the association between acculturation,
neighborhood characteristics, and obesity among young adults, and to examine the potential for
residing in an immigrant neighborhood to mediate the adverse effects of low neighborhood socioeconomic conditions on obesity. While past research has mainly examined the effects of individual
or family characteristics on obesity among children of immigrants, little is known about the role of
neighborhood characteristics in understanding obesity across immigrant generations. To our knowledge, no previous study examines how neighborhood characteristics during adolescence influence
the likelihood of obesity as youth make their transition to adulthood. Therefore, this study informs
the literature on immigrant health by examining neighborhood characteristics during adolescence as
indicators of cumulative risks and resources.
First, the study investigated the association between immigrant generational status and obesity
for two race/ethnic groups, Hispanics and Asians. The findings are generally consistent with the
unhealthy assimilation model (Gordon-Larsen et al., 2003; Popkin & Udry, 1998). The results show
that first-generation Asians are less likely to be obese compared to third and higher generation
Whites, but no difference is found for higher immigrant generational status Asians. For Hispanics,
while the likelihood of being obese is higher for the second and third and higher generation compared
to third and higher generation Whites, first-generation Hispanic young adults are not significantly
different from third and higher generation Whites. These patterns are consistent with recent research
(Creighton et al., 2012) and may support the protective culture hypothesis which emphasizes the
link between group-specific immigrant behavioral norms and immigrant health (Scribner, 1996).
However, Hamilton et al. (2011, p. 809) argue that “the protective role of co-ethnic communities is not
necessarily culturally-specific but may be specific to the first generation.” Indeed, net of individualand neighborhood-level characteristics, the first-generation health advantage among Asians become
statistically nonsignificant.
Second, this study identified some effects of neighborhood context on obesity. In support of segmented assimilation theory, higher values on the immigrant neighborhood scale are associated with
lower levels of obesity. This finding suggests that a high concentration of immigrants serves as a
buffer against the risk of obesity, which is consistent with the second hypothesis. This relationship
between immigrant concentration and obesity is particularly strong in socioeconomically disadvantaged neighborhoods, thus supporting the third hypothesis. This finding speaks to past work that
found immigrant neighborhoods are more likely to have better access to healthy foods despite having
low-quality neighborhood amenities including fewer physical activity resources and worse walkability (Osypuk, Diez-Roux et al., 2009). This finding underscores the importance of the neighborhood
context.
Overall, the findings of this study not only show the important role of neighborhoods where
young adults grow up, but also contribute to the literature by showing that residing in an immigrant
neighborhood mediates the adverse effects of low neighborhood socioeconomic conditions on obesity.
10 I JOURNAL OF URBAN AFFAIRS I Vol. 00/No. 0/2015
The findings of this study contribute to the broader body of literature that argues that maintaining
ethnic culture can actually facilitate upward assimilation (Feliciano, 2001; Portes & Rumbaut, 2001).
Although this study did not find a positive effect of non-English language on obesity, growing up
in immigrant neighborhoods, indicating the maintenance of ties to an ethnic community, appears to
have such a positive effect.
The results from this research have direct health policy and urban policy implications. There has
been an increased call for policy to combat the rising rates of obesity in communities of color,
particularly in neighborhoods with large Latino populations (Ramirez, Chalela, Gallion, Green, &
Ottoson, 2011). Local community engagement has been shown to be a powerful force in changing
neighborhoods into healthy places (Brisson & Usher, 2007). For instance, the Communities for
a Better Environment (CBE) organization has operated in the context of southeast Los Angeles,
and they are known to be influential in dissemination of information that benefits the community.
For instance, CBE created a knowledge map that assesses the direct risks and threats to health in
that community (Gonz´alez et al., 2007). These kind of tools can help provide communities with
health impact assessments, which contain information from both the built and social environment
that could influence urban health (Corburn, 2007). In other place-based research on obesogenic
environments, community development seems to be the mechanism that changes environments
into health-promoting places (Sadler, Gilliland, & Arku, 2012). Our findings suggest that these
communities are not inherently health-poor places. Rather, local entities can be great advocates for
placing health-promoting amenities in distressed urban areas, and they can help develop tools to help
residents find health-promoting amenities and avoid health risks, which is particularly helpful for
those who have recently migrated to the area.
This research also informs urban policy. Some U.S. urban planning efforts have evolved to producing and reproducing places that are consistent with New Urbanist development, which strives to
provide areas with well-designed, mixed-income, mixed-use, and eco-friendly places (Talen, 2013).
However, New Urbanist development has the potential to erase some of the culture and social cohesion of an already existing community within the revitalized urban enclave. In a case study of Santa
Ana, California, Gonz´alez and Lejano (2009) suggest that the barrios, which are place-based expressions of Latino culture and heritage, were going through this New Urbanist rejuvenation. However, in
the process, the Renaissance Specific Plan for redeveloping Santa Ana devotes two of 150 pages on
each barrio, and references the primary residential group (Latino, Hispanic or immigrant) only one
time. As previously discussed, immigrant communities are entrenched in the American landscape
and should not be deconstructed and destroyed, because they offer many benefits to the residents
of those places. This research also suggests that health outcomes are not necessarily enhanced for
Hispanics who live in immigrant deconcentrated neighborhoods. Immigrant neighborhoods are not
problematic for health outcomes merely because of the ethnic composition of the neighborhood (Do
& Finch, 2008). Urban policy should take a more meso-level approach to suggest ways where the
social and built environment could be enhanced to promote better health outcomes without destroying
the cultural, historical, and social fabric that is interwoven in these communities.
Several limitations to this research are worth noting. First, obesity among subgroups of Asians
and Hispanics was not analyzed due to small sample sizes. However, such subgroup analyses may
be fruitful since a recent work indicates that South Asian children have higher levels of obesity and
overweight compared to their White counterparts (Balakrishnan, Webster, & Sinclair, 2008).
Second, because Add Health data are a school-based survey, Oropesa and Landale (2009) caution
researchers regarding the inherent exclusion of migrant youth who are never enrolled in school.
Their research found that a relatively significant portion of young immigrants from Mexico had
never enrolled for school in the United States and thus were more likely to migrate to work. This
undercount of Mexican-born youth in our study may result in a biased estimate of obesity prevalence
among this group, and the direction and size of this bias is unknown.
Third, measures of parent health behaviors were not included in the study, and these would have
been useful for understanding the intergenerational transmission of culture. Because obesity among
young adults is also a function of the household context, the analyses would have been richer if
relevant measures were available.
I Immigrant Neighborhood and Obesity I 11
Finally, given that this study suggests neighborhood context is important for understanding obesity
among immigrant and nonimmigrant young adults, future research should further examine the role
of neighborhoods by including measures of the built environment that are relevant to understanding
obesity. Place-based features such as supermarket density or availability, neighborhood walkability,
proximity to primary care physicians or clinics, and parks or physical activity resources all are
related to health generally and specifically in the case of obesity. These high-quality neighborhood
amenities may be absent in low-income areas while immigrant neighborhoods may have amenities
to counterbalance some of the disadvantages. By carefully measuring and incorporating the built
environment, future research can expand upon this current endeavor.
In sum, this study suggests some potential health benefits for young adults from residing in
immigrant neighborhoods during adolescence. While those benefits are less likely to come from the
adoption of health norms and behaviors that are prevalent in the United States (i.e., acculturation),
it may be that the immigrant neighborhood is counterbalancing the negative impact that residing in
poor neighborhoods often has on this population. While past urban studies have found that immigrant
concentration adversely influences the socioeconomic adjustment of immigrants (Chiswick & Miller,
2005), the study here suggests that this spatial concentration may be more protective against obesity
than living in nonimmigrant neighborhoods for some immigrant groups. Thus, the discussion of place
in the sociology of health (Entwisle, 2007; Fitzpatrick & LaGory, 2003) needs to be expanded, and
should include how uneven development in place and the community and demographic dynamics
within neighborhoods are both unique structural risk factors that disadvantage or advantage residents
in urban areas.
ACKNOWLEDGEMENTS: A previous version of this article was presented at the 2014 Population Association of
America meeting in Boston, MA. 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.
Special acknowledgment is due to Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design.
No direct support was received from grant P01-HD31921 for this analysis. This research was partially supported by
the Robert Wood Johnson Foundation. The authors would like to thank Margarita Alegr´ıa, Benjamin Cook, Gregory
Squires, Jennifer Van Hook, Hsueh-Sheng Wu, faculty from the Center on Health, Risk and Society at American
University, and three anonymous reviewers for helpful comments.
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ABOUT THE AUTHORS
Hiromi Ishizawa is Assistant Professor of Sociology at The George Washington University. Her
main areas of research include social and family demography, immigration, sociology of language,
and urban sociology. Her primary research goal is to understand diversity in immigrants’ pathways
of incorporation into a host society. In particular, she focuses on the residential and familial contexts
in which immigrants and their children reside, and how these contexts affect how they are integrated
into American society. Beyond the United States, she conducts research on another immigrant destination country, New Zealand. Her recent publications specifically focus on residential segregation
and patterns of ethnic neighborhoods among recent immigrant groups and the indigenous Maori
population.
Antwan Jones is Assistant Professor of Sociology at The George Washington University. He has
published research on various health outcomes. However, he focuses his research on the residential
and neighborhood context in which individuals live as a way to understand health disparities among
marginalized populations. Engaged in national and international research, he has located himself in
the field of urban sociology by elucidating how residential processes and neighborhood contexts are
essential to the study of adult cardiovascular disease, child obesity and disability among the elderly.
Currently, he serves on the board of directors for the Society for the Study of Social Problems as
well as the Capital City Area Health Education Center.