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February 25th, 2011 by bisi Leave a reply »

In the interest of full disclosure, for the past few weeks I have been trying to avoid the topic of eating disorders for two main reasons: first, from what I have learned in past classes it is a very Western issue and I am trying to focus on international issues that affect women’s mental health; secondly, it would not be enlightening for me as I have done several research projects on eating disorders and from what I have interpreted, this blog should help us investigate topics that we have not had a chance to delve into. (Disclaimer: This is in no way means that our society, especially media, isn’t significantly influencing the outcomes of eating disorders in young women, nor does this mean that eating disorders are not an important issue in women’s health.) However, I noted that much of the research reveals that in the instances that immigrant women in the US and or women outside of the Western world had eating disorders, it was often correlated with a recent change in their ideology—a change often motivated by an influx of western ideals on beauty. As I mulled this over, I realized that there was still room for another pertinent blog topic. I began to wonder what other issues immigrant women faced with migration into new countries, often having ideology and ethos dissimilar from their own and how that affected their health outcomes.

Immediately, I found research showing that while individuals often “migrate to improve their well-being…migration [tended to be] a stressful process, with potentially negative impacts on mental health.”  (Stillman, 677) In essence, immigrants, often women, from developing nations threatened with war, poverty or disenfranchisement in their own country were fleeing or leaving of their own free will to more developed countries that offered them more freedom and more material wealth, but with a caveat: their mental health. Now sometimes these immigrant women are already facing mental health issues such as schizophrenia, which is often correlated with migration as it is (Stillman, 678), and they are able to find help in the country they migrate to. In fact, Stillman et. al concluded that at the end of the day it was important to put migrant women’s mental health into perspective—it would certainly be worse if they stayed in their home country. (Stillman, 687)

I, however, would like to argue otherwise. Developed nations that immigrant women migrate to may afford them better interventions, but how can this be so when immigrants often are impoverished and the impoverished often face difficulties in access to healthcare. My argument isn’t that they should stay in their home country, but rather maybe we shouldn’t be so quick to think that their mental health is golden by just migrating to a more developed nation.

I decided to test my theory by looking at a few empirical studies. The first by Leu et. al looked at the age in which Asian immigrants migrated and the subsequent outcome  of their social status and on their mental health in adulthood. While SES did play a role in social mobility, SES did not make a difference in mental health for this who immigrated before 25. (1161) If we think about it, often up until 21 humans are still very impressionable as our minds are still being pruned and we are still highly influenced by our peers, so it only makes sense that those that immigrate younger and around this age are not only facing the stress of immigration but also the affects of having to establish a social identity that allows them to fit in—this often leads to anxiety disorders. (Leu, 1161) In this instance, access was not an issue but we can see how immigration does not immediately equate to a well-adjusted individual.

Nadeem et. al. looked at the stigma in African and Caribbean immigrant women in their seeking behaviors for mental healthcare and found that compared to US-born white women, just like US-born black women and Latina women, poor young immigrant women were more likely to report concerns relating to stigmatization and access. (Nadeem, 1547). Williams et. al also reported that Caribbean-born immigrants were more likely to report symptoms of depression and aggression than their US-born counterparts. If migration is supposed to be a successful self-intervention, then why these negative statistical differences?

De Anstiss et. al summarized it very well in my opinion. It is in our best interest to make sure that with material improvements we make sure that we are providing immigrants with the right information for mental healthcare access as well as making sure that younger immigrants are equipped with the proper coping interventions. (De Anstiss, 599)

Works Cited

De Anstiss, H., Ziaian, T., Procter, N., Warland, J., & Baghurst, P. (2009). Help-seeking for mental health problems in young refugees: A review of the literature with implications for policy, practice, and research. Transcultural Psychiatry 46(4): 584-607.

Leu, J., Yen, I.H., Gansky, S.A., Walton, E., Adler, N.E., & Takeuchi. (200The association between subjective social status and mental health among Asian immigrants: Investigating the influence of age at immigration. Social Science & Medicine 66: 1152-1164.

Nadeem, E., Lange, J.M., Edge, D., Fongwa, M., Belin, T., & Miranda, J. (2007). Does stigma keep poor young immigrant and US-born black and latina women from seeking mental health care?. Psychiatric Services 58(12): 1547-1554.

Stillman, S., McKenzie, D., & Gibson, J. (2009). Migration and mental health: Evidence from a natural experiment. Journal of Health Economics 28: 677-687.

Williams, D.R., Haile, R., Gonzalez, H.M., Neighbors, H., Baser, R., & Jackson, J.S. (2007). The mental health of black Caribbean immigrants: Results from the national survey of American life. American Journal of Public Health 97(1): 52-59.

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5 comments

  1. hannahky says:

    The beginning of your post made me interested to know how eating disorders and body image in particular can affect immigrant women. I thought of the film Desert Flower, based on the true story of Waris Dirie, who came from a childhood in a nomadic Somali family to London. She began a profession as a model and also became an anti-FGM activist. I only saw the trailer for the film, but it seems to me that she struggled also with the western idea of the perfect body and with the way that photographers and industry-people treated her, as a model. But, we can also remember the problems she faced at home… and we must, as you say, wonder which is worse.

  2. Elise says:

    I wonder when will it be “cool” or “in vogue” to take care of yourself – not just on the outside (looking fit, eating healthily, acting happy and stable), but on the INSIDE (mentally, emotionally, spiritually, and physically)?!

  3. Elise says:

    Thank you for this post , Bisi. I, too, find myself holding back from incorporating eating disorders into my discussions of international women’s health because it is something so familiar to us, and I often draw connections between eating disorders, body image, and any issue involving women! I love that you looked at the positive and negative aspects of immigration to Western countries. This reminded me of something I learned, while participating in the “Cross Cultural Body Panel” earlier this year. A Latina girl explained that she had always been comfortable with her body and admired her mother and aunts’ full figures until she came to the US. Here, she felt pressure to be thin, diet, go to the gym, and critique her appearance. Furthermore, in many countries, food is the central organizing force of the day; take “siesta” after a big lunch in Europe, for example. Or our use of food to celebrate, reward, bribe children, and make ourselves feel good. Coming from a culture where food was part of celebration and fun, to America, where it is a touchy subject – you’re either too fat or too thin, too healthy or too junk-foody, etc, must be difficult….Yet, if we think about beauty concerns and body dissatisfaction, we see that with skin color (tanning in the US, whitening/bleaching in Asia and in African American populations) is also a huge source of discomfort and psychological distress. I wonder how we can make mental health services less stigmatized for poor immigrant women, when they are so often seen as signs of weakness, weirdness, or liabilities, even among wealthy Americans.

  4. labrian says:

    Interesting to see whether US women immigrating to other countries experience a reversal of these norms. Do women in America who’ve struggled with issues pertaining to weight suddenly experience of mental stress around eating and weight? That would probably be a pertinent counterfactual against which to compare your research. Though, I could definitely see the research bearing true; culture and what ‘people’ — whoever those people end up being — think of you, has such an impact on a woman’s mental health, and probably does impact patterns of eating.

  5. kjewett says:

    What an interesting topic. I have overlooked the link between mental health care access and immigration, but it is a very important topic worth investing time, research, and money into. As you said, while a developed country may offer greater resources and opportunities, the mental stress of immigration that leads to worsening mental health impairs the immigrant’s productivity after they’ve arrived in the new country. How can we increase their access to health care, specifically in assisting their mental health? One nuance to this discussion which maybe pertains more to immigration in this country is when immigrants arrive illegally. Where do we draw the line for health care access? Immigrants come to developed countries to expand their economic means, but when they don’t jump through all the legal hoops, can we support them equally as we do those who arrive legally? Something to consider.
    Great post, thoughtful topic, and interesting associations between stigma and health care access.

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