Selective migration and infant mortality among Puerto Ricans

OBJECTIVE

This study examines the implications of migration to the United States for infant mortality among Puerto Rican mothers born in Puerto Rico. The roles of selective migration and duration of US residence are assessed.

METHOD

Using survey data collected from mothers of infants sampled from computerized birth and infant death records of six US vital statistics reporting areas and Puerto Rico, we estimate logistic regression models of infant mortality among the sampled infants. These models provide a baseline for comparison with fixed-effects models based on all births within each mother's history.

RESULTS

Logistic regression models for sampled infants show that the risk of infant mortality is lower for migrant women than for nonmigrant women in Puerto Rico until the migrants have lived in the United States for a substantial period of time. Fixed-effects models indicate that once unmeasured stable characteristics of the mother are controlled, early migrants do not differ from nonmigrants with respect to the risk of infant death. Both sets of models demonstrate that as mothers' exposure to the US mainland increases, the risk of infant mortality rises.

CONCLUSIONS

Selective migration plays a role in the relatively low risk of infant mortality among recent Puerto Rican migrants to the United States. Migrants appear to be selected on qualities that contribute to favorable health outcomes for their offspring, but those qualities are later lost with exposure to life in the United States.

What does skin color have to do with infant health? An analysis of low birth weight among mainland and island Puerto Ricans

This study investigates the relationship between maternal skin tone and low birth weight among Puerto Ricans, a group with a complex ancestry and skin tones that range from very light to very dark. Using data from a representative sample of Puerto Rican mothers, we assess whether skin tone has different implications for low birth weight in three geographic areas (Puerto Rico; New York City; other eastern states). The analysis shows that skin tone is unrelated to low birth weight in Puerto Rico and New York City. However, in the other eastern states in our sample, mothers with dark skin have a high risk of bearing a low birth-weight infant, relative to mothers with light skin. We interpret our findings in light of differences in the social meaning of phenotypic differences across locales.

Structure, process, and satisfaction with obstetricians: an analysis of mainland Puerto Ricans

This study examines various dimensions of satisfaction with obstetricians among mainland Puerto Ricans using data from a survey administered to a representative sample of 1,219 Puerto Rican mothers. The results indicate that the majority of Puerto Rican women are satisfied with their obstetricians, but they are not typically "extremely" satisfied. Moreover, satisfaction is influenced by the structure of care, the process of care, and the outcome of care. Two aspects of process that are especially important are the continuity and content of care. Although satisfaction is not generally associated with the ethnicity or the gender of physicians, some evidence suggests that patients who utilize public facilities or lack continuity of care tend to be more satisfied if they have a female physician.

Poverty, prenatal care, and infant health in Puerto Rico

Using data from a survey administered to a representative sample of mothers who gave birth in Puerto Rico in 1994-95, we investigate whether prenatal care and infant health outcomes are associated with family poverty and neighborhood poverty. The results show that infant health outcomes are unrelated to both family poverty and neighborhood poverty, despite the association of family poverty with the adequacy of prenatal care and the content of prenatal care. However, the poverty paradigm does receive some support using measures of participation in government programs that serve the low-income population. Women who rely on the government to fund their medical care are more likely than women who rely on private health insurance to have an infant death. They are also less likely to receive the highest levels of prenatal care. Nonetheless, targeted government programs can have an ameliorative impact. The analysis shows that participants in the Women, Infants, and Children (WIC) program are more likely than non-participants to receive superior levels of prenatal care and are less likely to have negative infant health outcomes.

Poverty, insurance, and well-baby care among mainland Puerto Rican children

Using data from the Puerto Rican Maternal and Infant Health Study, we investigate the implications of family income and insurance status for well-baby care among mainland Puerto Ricans. Given the socioeconomic disadvantage of Puerto Ricans, it is critical to understand the extent to which low income and lack of health insurance create barriers to well-baby care and result in low utilization. The analysis shows that the income-to-needs ratio is related to barriers to well-baby care, and a key intervening factor is insurance status. The odds of reporting any barriers to care are lowest among those with both adequate income and private health insurance. Access to insurance is also vital in achieving adequate well-baby care. Uninsured children receive inadequate care more often than children with public or private insurance, especially when their income is also low. Children with public insurance are as likely as children with private insurance to receive an adequate number of well-baby visits, despite the fact that their mothers report more barriers to care.

Nonresponse in follow-back surveys of ethnic minority groups: an analysis of the Puerto Rican Maternal and Infant Health Study

OBJECTIVES

This study documents the levels and sources of nonresponse in the first large-scale maternal-infant health survey administered to representative samples of Puerto Rican mothers on both the U.S. mainland and the island of Puerto Rico.

METHODS

The data source is the Puerto Rican Maternal and Infant Health Study, which was administered to a vital records-based sample of 2763 mothers of infants. An additional 805 women were nonrespondents. Nonresponse is examined as a function of several characteristics measured from vital records using logistic regression.

RESULTS

The response rate for this survey compares favorably to response rates for similar surveys. Although nonresponse is not associated with most characteristics measured from vital records, it is higher among mainland residents and mothers of infants who died. The absence of significant associations is due to opposite relationships between several covariates and the failure to locate and refusal. For example, nonresponse in the birth sample is not associated with migration, despite the difficulty of locating migrants. The lower likelihood of locating migrants is offset by their willingness to participate.

CONCLUSIONS

Selectivity due to nonresponse is minimal. Nevertheless, researchers who design "binational" surveys should be aware of setting-specific circumstances that affect the ability to locate sampled individuals and secure their cooperation.

Migration, social support and perinatal health: an origin-destination analysis of Puerto Rican women

Using pooled origin-destination data from the Puerto Rican Maternal and Infant Health Study, we investigate linkages between migration, social support, and perinatal health. We document differences in social support between three groups of Puerto Rican women: non-migrant women in Puerto Rico, first-generation migrants to the U.S. mainland, and mainland-born women. The role of social support in producing differences in perinatal health outcomes between the groups is assessed. The analysis shows striking differences in social support between island and mainland women, but little systematic variation among mainland women by generation of U.S. residence. The lower level of social support available to mainland women is not reflected in the health outcomes examined, which do not generally worsen with migration to the United States (with the exception of maternal smoking). Nonetheless, we show that social support has important implications for stress, which in turn increases the risk of poor health behavior and compromised infant health.

Prenatal care among Puerto Ricans on the United States mainland

Recent public health initiatives in the USA identify the improvement of maternal and infant health outcomes among ethnic minorities as a national priority. Prenatal care is emphasized in these initiatives as a crucial intervention for reducing the risks of adverse outcomes. We investigate the barriers to prenatal care and the adequacy of prenatal care among mainland Puerto Ricans using data from a follow-back survey of a representative sample of mothers. The results show that barriers to prenatal care and the adequacy of prenatal care cannot be reduced solely to financial problems or problems associated with migration. Rather, attention to the social and the psychological circumstances surrounding the pregnancy (e.g. pregnancy wantedness) is required.

From austerity to prosperity? Migration and child poverty among mainland and island Puerto Ricans

Analyses of migrants' economic circumstances typically use the native-born in the destination as a comparison group. We use the 1990 Census Public Use Microdata Samples for the United States and Puerto Rico to demonstrate the benefits of a comparative approach that includes data from both the origin and the destination. Specifically, the primary objective is to determine how and why the risk of child poverty is associated with migration from Puerto Rico to the United States. The results show that migration reduces the risk of child poverty, partly because better jobs are available on the mainland. Employment, human capital, family structure, and public assistance cannot completely explain observed differences. The results also show that the economic benefits of migration continue for the native-born on the mainland and that return migration to Puerto Rico is associated with impoverishment.

From austerity to prosperity? Migration and child poverty among mainland and island Puerto Ricans

Analyses of migrants’ economic circumstances typically use the native-born in the destination as a comparison group. We use the 1990 Census Public Use Microdata Samples for the United States and Puerto Rico to demonstrate the benefits of a comparative approach that includes data from both the origin and the destination. Specifically, the primary objective is to determine how and why the risk of child poverty is associated with migration from Puerto Rico to the United States. The results show that migration reduces the risk of child poverty, partly because better jobs are available on the mainland. Employment, human capital, family structure, and public assistance cannot completely explain observed differences. The results also show that the economic benefits of migration continue for the native-born on the mainland and that return migration to Puerto Rico is associated with impoverishment.

Migration and premarital childbearing among Puerto Rican women

This paper examines the relationship between migration and premarital childbearing in a highly migratory Latino subgroup, Puerto Rican women. Using pooled origin-destination data from surveys conducted in Puerto Rico and in the New York metropolitan area, we find that first- and second-generation migrants to the u.s. mainland face substantially higher risks of conceiving and bearing a first child before marriage than do nonmigrants in Puerto Rico. This pattern is due largely to the relatively early transition to sexual activity among mainland women. Given the negative long-term consequences of premarital childbearing for women and their children, our findings call into question the assumption that migrants necessarily experience only positive outcomes as a result of the assimilation process.

Migration and premarital childbearing among Puerto Rican Women

This paper examines the relationship between migration and premarital childbearing in a highly migratory Latino subgroup, Puerto Rican women. Using pooled origin-destination data from surveys conducted in Puerto Rico and in the New York metropolitan area, we find that first- and second-generation migrants to the U.S. mainland face substantially higher risks of conceiving and bearing a first child before marriage than do nonmigrants in Puerto Rico. This pattern is due largely to the relatively early transition to sexual activity among mainland women. Given the negative long-term consequences of premarital childbearing for women and their children, our findings call into question the assumption that migrants necessarily experience only positive outcomes as a result of the assimilation process.

Migration and the Latino family: the union formation behavior of Puerto Rican women

This study examines the transition to first union among Puerto Rican women. I argue that understanding the behavior of mainland Puerto Ricans requires attention to family patterns in Puerto Rico and to the dynamics of migration between Puerto Rico and the United States. The study therefore is based on pooled data from comparable surveys undertaken in the two settings. These data allow for event history analyses that compare the union formation behavior of migrants with that of nonmigrants, and consider the role of migration in producing the observed union patterns. Multivariate models show that migrants are more likely than nonmigrants to form unions early and to enter informal unions. Additional analyses show that selective migration plays a role in producing this pattern. Overall the findings demonstrate the importance of using data from both origin and destination locales for understanding the behavior of migrant groups.

Migration and the Latino Family: The Union Formation Behavior of Puerto Rican Women

This study examines the transition to first union among Puerto Rican women. I argue that understanding the behavior of mainland Puerto Ricans requires attention to family patterns in Puerto Rico and to the dynamics of migration between Puerto Rico and the United States. The study therefore is based on pooled data from comparable surveys undertaken in the two settings. These data allow for event history analyses that compare the union formation behavior of migrants with that of nonmigrants, and consider the role of migration in producing the observed union patterns. Multivariate models show that migrants are more likely than nonmigrants to form unions early and to enter informal unions. Additional analyses show that selective migration plays a role in producing this pattern. Overall the findings demonstrate the importance of using data from both origin and destination locales for understanding the behavior of migrant groups.

Generation, ethnicity, and marriage: Historical patterns in the Northern United States

Immigration was a prominent feature of American life during the early decades of the twentieth century. About 40% of the white population was of foreign birth or parentage, and immigrants were increasingly from diverse national origins. Using data from the Public Use Microdata Sample of the 1910 U.S. Census, we examine generational and ethnic differences in marital timing. The analysis reveals a striking pattern of delayed marriage among native whites with foreign parents, but marked ethnic variation in the extent of marriage delay within the second generation. We hypothesize that locational factors, especially diverse economic opportunities, were important in shaping this marriage pattern. Separate multilevel analyses are conducted for females and for males living in urban and in rural places. Although significant effects for a variety of contextual factors are found, generational and ethnic differences in nuptial timing persist in multivariate models.

Generation, ethnicity, and marriage: historical patterns in the northern United States

Immigration was a prominent feature of American life during the early decades of the twentieth century. About 40% of the white population was of foreign birth or parentage, and immigrants were increasingly from diverse national origins. Using data from the Public Use Microdata Sample of the 1910 U.S. Census, we examine generational and ethnic differences in marital timing. The analysis reveals a striking pattern of delayed marriage among native whites with foreign parents, but marked ethnic variation in the extent of marriage delay within the second generation. We hypothesize that locational factors, especially diverse economic opportunities, were important in shaping this marriage pattern. Separate multilevel analyses are conducted for females and for males living in urban and in rural places. Although significant effects for a variety of contextual factors are found, generational and ethnic differences in nuptial timing persist in multivariate models.

Patterns of Entry into Cohabitation and Marriage Among Mainland Puerto Rican Women

This paper adds to our limited knowledge of racial and ethnic variation in union formation by describing and analyzing the first unions of mainland Puerto Rican women. Retrospective history data show that Puerto Ricans have shared in the post-l970 shift toward cohabitation. Puerto Rican women, however, are much more likely to enter informal first unions than the general population, and have a low propensity to transform informal unions into legal marriages. The paper examines the influence of family background and current activities on union timing and type. The relationship between partner attributes and the choice between formal and informal coupling is also considered.

Patterns of entry into cohabitation and marriage among mainland Puerto Rican women

This paper adds to our limited knowledge of racial and ethnic variation in union formation by describing and analyzing the first unions of mainland Puerto Rican women. Retrospective history data show that Puerto Ricans have shared in the post-1970 shift toward cohabitation. Puerto Rican women, however, are much more likely to enter informal first unions than the general population, and have a low propensity to transform informal unions into legal marriages. The paper examines the influence of family background and current activities on union timing and type. The relationship between partner attributes and the choice between formal and informal coupling is also considered.

Agricultural Opportunity and Marriage: The United States at the Turn of the Century

This article focuses on the marriage behavior of rural white males in the United States at the turn of the century. The principal goal of the analysis is to assess the role of agricultural opportunity in determining nuptial timing and prevalence. The major issue addressed is whether restricted opportunity in farming retarded entry into marriage. Overall, the findings suggest that rural young men were less likely to enter marriage when local opportunity in agriculture was poor. One mechanism through which the local opportunity structure influenced nuptiality was occupational choice. Young men who entered nonagricultural pursuits or who were employed as farm laborers were far less likely to have married than young men who became farmers.

Agricultural opportunity and marriage: the United States at the turn of the century

This article focuses on the marriage behavior of rural white males in the United States at the turn of the century. The principal goal of the analysis is to assess the role of agricultural opportunity in determining nuptial timing and prevalence. The major issue addressed is whether restricted opportunity in farming retarded entry into marriage. Overall, the findings suggest that rural young men were less likely to enter marriage when local opportunity in agriculture was poor. One mechanism through which the local opportunity structure influenced nuptiality was occupational choice. Young men who entered nonagricultural pursuits or who were employed as farm laborers were far less likely to have married than young men who became farmers.

The effect of marital status at first birth on marital dissolution among adolescent mothers

The sequencing of marriage and first birth was expected to play an important role in the stability of marriage among adolescent mothers. We hypothesized that adolescent women who married prior to conception would have the lowest rates of marital disruption, followed by those who married between conception and birth. Adolescent women who gave birth prior to marriage were expected to suffer the highest rates of marital dissolution. The results provide partial support for our hypotheses. There is little difference in the probability of separation between adolescent mothers who had a postmarital conception and those who had a premarital conception but married before the birth. Having a premarital birth, however, significantly increases the probability of marital dissolution. We also hypothesized that marital status at first birth would have less effect on the probability of marital dissolution for blacks than for whites. This, too, is generally supported by our findings. Among black females, those with a premarital birth are the first to suffer a marital disruption, but by the end of ten years there is little difference in the probability of separation among the three marital status groups. In contrast, among white females, those with a premarital birth are the first to experience a disruption, and this differential persists over all subsequent marriage duration intervals. Thus, the sequencing of marriage relative to birth has similar short term effects for whites and blacks, but the effect for blacks is evident only in the short term. Ten years after the marriage, black adolescent mothers have similar rates of marital stability regardless of the sequencing of marriage. This is consistent with the findings of previous research and with our hypothesis; with the black family pattern of lower rates of marriage, higher rates of illegitimacy and higher divorce rates, the sequencing of marriage has no long lasting consequences on marital stability. Finally, our predicted decline in the effect of marital status at first birth over historical time also finds partial support. For white females there has been a change in the effect of marriage-first birth sequencing on separation over time. In the period encompassed by the women in our study, white adolescent mothers who married subsequent to the birth have been the most likely to experience a separation at all marriage duration intervals, but this differential narrows as age at interview declines. Among black females there has been no change in the effect of a premarital birth over time.(ABSTRACT TRUNCATED AT 400 WORDS)

The effect of marital status at first birth on marital dissolution among adolescent mothers

The effect of the sequencing of marriage and first birth on marital dissolution among adolescent mothers is investigated. We compare three groups who had a first live birth before age 20: those married before becoming pregnant, those married between conception and birth, and those who did not marry before the birth. The analysis demonstrates that teenage mothers are less likely to experience a separation if they marry before rather than after the birth. Among those marrying before the birth, there is little difference between those who marry before or after becoming pregnant. The effects of marital status at first birth are shown to vary by race, marital duration, and historical time.