Mortality among young immigrants to California: injury compared to disease deaths

According to a variety of indicators, immigrants are in better health than the U.S.-born population. Little research, however, has investigated foreign- and U.S.-born differentials in mortality. We investigated adolescent and young adult immigrants' risk of death due to disease and injury, the leading cause of death of young persons in the United States. The death certificates of 15- to 34-year-old California residents who died from 1989 through 1993 comprised the study population. Disease and injury deaths were identified using ICD-9 codes on the California Master Mortality data files. Frequencies and gender-standardized rates and risk ratios were calculated by nativity (U.S., non-U.S.) and by ethnicity and nativity. Immigrants are represented appropriately in unintentional injury deaths but underrepresented in suicides and overrepresented in homicides among 15- to 34-year-old California residents. Hispanics appear to account for the foreign- and U.S.-born differences in suicide and homicide. By contrast, immigrants constitute a lower proportion of disease deaths than expected. Empirical data about health risks to immigrants are needed to develop informed policy. These data indicate that young immigrants, at least in terms of mortality, do not constitute a burden in that they are at lower or similar risk of death than U.S.-born youth. Homicide is the sole exception to this pattern.