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The Health Toll of Immigration

http://nyti.ms/10ZZR28




May 18, 2013
The Health Toll of Immigration
By SABRINA TAVERNISE
BROWNSVILLE, Tex. — Becoming an American can be bad for your health.

A growing body of mortality research on immigrants has shown that the longer they live in this country, the worse their rates of heart disease, high blood pressure and diabetes. And while their American-born children may have more money, they tend to live shorter lives than the parents.

The pattern goes against any notion that moving to America improves every aspect of life. It also demonstrates that at least in terms of health, worries about assimilation for the country’s 11 million illegal immigrants are mistaken. In fact, it is happening all too quickly.

“There’s something about life in the United States that is not conducive to good health across generations,” said Robert A. Hummer, a social demographer at the University of Texas at Austin.

For Hispanics, now the nation’s largest immigrant group, the foreign-born live about three years longer than their American-born counterparts, several studies have found.

Why does life in the United States — despite its sophisticated health care system and high per capita wages — lead to worse health? New research is showing that the immigrant advantage wears off with the adoption of American behaviors — smoking, drinking, high-calorie diets and sedentary lifestyles.

Here in Brownsville, a worn border city studded with fast-food restaurants, immigrants say that happens slowly, almost imperceptibly. In America, foods like ham and bread that are not supposed to be sweet are. And children lose their taste for traditional Mexican foods like cactus and beans.

For the recently arrived, the quantity and accessibility of food speaks to the boundless promise of the United States. Esther Angeles remembers being amazed at the size of hamburgers — as big as dinner plates — when she first came to the United States from Mexico 15 years ago.

“I thought, this is really a country of opportunity,” she said. “Look at the size of the food!”

Fast-food fare not only tasted good, but was also a sign of success, a family treat that new earnings put in reach.

“The crispiness was delicious,” said Juan Muniz, 62, recalling his first visit to Church’s Chicken with his family in the late 1970s. “I was proud and excited to eat out. I’d tell them: ‘Let’s go eat. We can afford it now.’ ”

For others, supersize deals appealed.

“You work so hard, you want to use your money in a smart way,” said Aris Ramirez, a community health worker in Brownsville, explaining the thinking. “So when they hear ‘twice the fries for an extra 49 cents,’ people think, ‘That’s economical.’ ”

For Ms. Angeles, the excitement of big food eventually wore off, and the frantic pace of the modern American workplace took over. She found herself eating hamburgers more because they were convenient and she was busy in her 78-hour-a-week job as a housekeeper. What is more, she lost control over her daughter’s diet because, as a single mother, she was rarely with her at mealtimes.

Robert O. Valdez, a professor of family and community medicine and economics at the University of New Mexico, said, “All the things we tell people to do from a clinical perspective today — a lot of fiber and less meat — were exactly the lifestyle habits that immigrants were normally keeping.”

As early as the 1970s, researchers found that immigrants lived several years longer than American-born whites even though they tended to have less education and lower income, factors usually associated with worse health. That gap has grown since 1980. Less clear, however, was what happened to immigrants and their American-born offspring after a lifetime in the United States.

Evidence is mounting that the second generation does worse. Elizabeth Arias, a demographer at the National Center for Health Statistics, has made exploratory estimates based on data from 2007 to 2009, which show that Hispanic immigrants live 2.9 years longer than American-born Hispanics. The finding, which has not yet been published, is similar to those in earlier studies.

Still, the data does not break down by generation. Ms. Arias cautioned that subsequent generations — for example, grandchildren and great-grandchildren — may indeed improve as they rise in socioeconomic status, which in the United States is strongly correlated with better health.

Other research suggests that some of the difference has to do with variation among American-born Hispanics, most of whom still do better than the rest of the American population. Puerto Ricans born in the continental United States, for example, have some of the shortest life spans and even do worse than whites born in the United States, according to research by Professor Hummer, dragging down the numbers for American-born Hispanics. But Mexican immigrant men live about two years longer than Mexican-American men, according to the estimates by Ms. Arias.

Why is a harder question to answer, researchers say. Some point to smoking. Andrew Fenelon, a researcher at Brown University, found in 2011 that half of the three-year life expectancy advantage that Hispanic immigrants had over American-born Hispanics was because they smoked less. The children of immigrants adopt health behaviors typical of Americans in their socioeconomic group. For second-generation Hispanics, the group tends to be lower income, with higher rates of smoking and drinking.

Other researchers say culture contributes. Foreign-born Hispanics are less likely than American-born Hispanics to be raising children alone, and more likely to be part of large kinship networks that insulate them from harsh American economic realities that can lead to poor health.

“I’d love to have my wife at home taking care of the kids and making sure they eat right, but I can’t afford to,” said Camilo Garza, a 34-year-old plumber and maintenance worker whose grandfather immigrated from Mexico. “It costs money to live in the land of the free. It means both parents have to work.”

As a result, his family eats out almost every night, leaving his dining table abandoned.

“It’s a decoration,” said Mr. Garza, who is overweight and a smoker. “It’s a place where we set groceries before sticking them in the refrigerator.”

The lifestyle takes its toll. The county in which Brownsville is situated, Cameron, has some of the highest rates of obesity and diabetes in the country. The numbers are made worse by a lack of physical activity, including walking. Immigrants said they felt so conspicuous during early attempts to walk along the shoulder of the roads that they feared people would suspect they were here illegally. Ms. Angeles recalled that strolling to a dollar store provoked so many stares that she felt like “a bean in rice.”

“In Mexico, we ate healthily and didn’t even know it,” said Ms. Angeles, who has since developed diabetes. “Here, we know the food we eat is bad for us. We feel guilty. But we eat it anyway.”

Still, immigrants have better health outcomes than the American-born. A 2006 analysis by Gopal K. Singh, a researcher at the Department of Health and Human Services, and Robert A. Hiatt, a professor of epidemiology and biostatistics at the University of California, San Francisco, found that immigrants had at least a 20 percent lower overall cancer mortality rate than their American-born counterparts.

Mortality rates from heart disease were about 16 percent lower, for kidney disease 18 percent lower, and for liver cirrhosis 24 percent lower.

“When my daughter was born, my doctor told me that if I wanted to see her 15th birthday I needed to lose the weight,” said Gerry Ortiz, 37, a first-generation Mexican-American in Brownsville. He managed to lose 75 pounds, motivated in part by his grandfather, a farmer in rural Mexico who at 93 still rides his bicycle every day. He stares down at the family from a black-and-white photograph hanging in Mr. Ortiz’s living room. Four of the family’s six siblings are obese and have diabetes.

And health habits in Mexico are starting to look a lot like those in the United States. Researchers are beginning to wonder how long better numbers for the foreign-born will last. Up to 40 percent of the diet of rural Mexicans now comes from packaged foods, according to Professor Valdez.

“We are seeing a huge shift away from traditional diets,” he said. “People are no longer growing what they are eating. They are increasingly going to the market, and that market is changing.”

Joseph B. McCormick, the regional dean of the University of Texas School of Public Health in Brownsville, said, “The U.S. culture has crept across the border.”

Perhaps more immediate is the declining state of Hispanic health in the United States. Nearly twice as many Hispanic adults as non-Hispanic white adults have diabetes that has been diagnosed, a rate that researchers now say may have a genetic component, particularly in those whose ancestry is Amerindian from Central and South America, Dr. McCormick said.

Hispanic adults are also 14 percent more likely to be obese, according to 2010 data from the Centers for Disease Control and Prevention. The rate is even higher for Hispanic children, who are 51 percent more likely to be obese than non-Hispanic white children.

“We have a time bomb that’s going to go off,” said Dr. Amelie G. Ramirez, a professor of epidemiology and biostatistics at the University of Texas Health Science Center in San Antonio. “Obesity rates are increasing. Diabetes is exploding. The cultural protection Hispanics had is being eroded.”

But at least for now, the older generation is still enjoying its advantage. In the De Angeles snack bar, a favorite meeting place for elderly Brownsvillians, one regular who is 101 still walks across the bridge to Mexico. Maria De La Cruz, a 73-year-old who immigrated to the United States in her 40s, says her secret is raw garlic, cooked cactus and exercise, all habits she acquired from her father, a tailor who died at 98.

“He had very pretty legs, like mine,” she said, laughing. “You want to see them?”

Wily Cockroaches Find Another Survival Trick: Laying Off the Sweets

http://nyti.ms/12Q9xL5




May 23, 2013
Wily Cockroaches Find Another Survival Trick: Laying Off the Sweets
By JAMES GORMAN
Everyone knows that cockroaches are the ultimate survivors, with enough evolutionary tricks up their carapaces to have thrived for 350 million years and to have completely adapted to the human species.

But the nature of the adaptation that researchers in North Carolina described on Thursday in the journal Science is impressive even for such an ancient, ineradicable lineage, experts say. Some populations of cockroaches evolved a simple, highly effective defense against sweet-tasting poison baits: They switched their internal chemistry around so that glucose, a form of sugar that is a sweet come-hither to countless forms of life, tastes bitter.

The way the roach’s senses changed, experts say, is an elegant example of quick evolutionary change in behavior, and offers the multibillion-dollar pest control industry valuable insights into enemy secrets, perhaps even revealing some clues for the fight against malaria-carrying mosquitoes, which are far more dangerous to human health than roaches.

“This is a fantastic discovery,” said Walter S. Leal, the head of the entomology department in the College of Agricultural and Environmental Sciences at the University of California, Davis. (Dr. Leal was not part of the research.)

“Sometimes,” he said, “the science is beautiful but you don’t know whether there is going to be an application five years from now, 10 years from now or 100 years.” But in this case, he said, the impact is both fundamental and practical.

Ayako Wada-Katsumata, Jules Silverman and Coby Schal, all at North Carolina State University, who wrote the report in Science, set out to explain a well-known phenomenon: Some populations of German cockroaches (the ones that apartment dwellers see scurrying around in the kitchen at night) avoid poison bait that is laced with glucose, which is supposed to attract them.

This behavior, discovered by Dr. Silverman, “first appeared in the early ’90s,” said Jim Fredericks, chief entomologist at the National Pest Management Association, shortly after exterminators — who now prefer to be called pest management professionals — started using poison baits instead of spraying as the main method of battling roaches. To get around the problem, the industry developed new baits, but the change in roach behavior was a puzzle.

Grzegorz Buczkowski, an entomologist at Purdue University who was not involved in the research, said the industry was always developing new poisons, because roaches and other pests become resistant to their effects, just as bacteria become resistant to antibiotics.

“We lose baits all the time,” he said.

But in this case, the problem was not a poison that had become ineffective. The cockroaches just seemed to avoid any bait that had glucose.

Dr. Silverman showed that this behavior was inherited, not something an individual roach learned during its brief life. And a few years ago the North Carolina researchers decided to investigate what caused the change.

Instead of taste buds, roaches have taste hairs on many parts of their bodies. The three North Carolina researchers concentrated on those around the mouth area and on two types of nerve cells that sense tastes and respond by firing electrical signals to the brain. One responds only to sugars and other sweet substances; the other responds only to bitter substances. Whenever a molecule of something sweet attaches to a sweet detector, it fires electrical impulses and the roach brain senses sweetness, which makes it want to eat whatever it is tasting. Whenever a molecule of something bitter attaches to the bitter detector, that cell fires and the brain senses bitterness, which makes the roach want to avoid that substance.

But somehow the roaches had changed so that the glucose made the bitter detector fire.

“Basically,” said Dr. Buczkowski, “when cockroaches taste glucose, they’re repelled by it because it tastes bitter to them.”

Dr. Schal said the next step was to figure out the details of the genetic mutation that had occurred. Perhaps a mutation changed the molecules that detect bitter substances so that they would be sensitive to glucose, too. Or a different sort of mutation could have caused the dedicated bitter neurons to have lots of standard glucose detectors, which did not exist on those neurons before — a shift that also would have made the insects register sweet glucose as bitter.

The research may be relevant far beyond roach control, perhaps helping to explain the behavior of mosquitoes that spread malaria, Dr. Schal said.

“The mosquito changed its behavior,” he said, “and no longer rests on walls that are treated with insecticide. Instead it tends to rest on the ceiling, or it tends to rest on the outside walls that are not treated with insecticide.

“We still don’t understand the cellular, the neural mechanism responsible for this change in behavior of the mosquito,” he said, so the approach that yielded results with the cockroach could offer useful insights.

Young Americans Lead Trend to Less Driving

http://nyti.ms/YSaUKM

CHARLOTTE, N.C. — Dan Mauney keeps misplacing his car.

Mr. Mauney, 42, lives in an apartment tower in this city’s Uptown neighborhood, a pedestrian-friendly quarter with new office buildings, sparkling museums and ambitious restaurants. He so seldom needs to drive that when he does go to retrieve his car in his building’s garage, he said, “I always forget where I parked it.”

Charlotte and other American cities have not abandoned their cars or their sprawling growth. But people like Mr. Mauney are part of the reason that American driving patterns have downshifted — perhaps for years to come.

For six decades, Americans have tended to drive more every year. But in the middle of the last decade, the number of miles driven — both over all and per capita — began to drop, notes a report to be published on Tuesday by U.S. Pirg, a nonprofit advocacy organization.

People tend to drive less during recessions, since fewer people are working (and commuting), and most are looking for ways to save money. But Phineas Baxandall, an author of the report and senior analyst for U.S. Pirg, said the changes preceded the recent recession and appeared to be part of a structural shift that is largely rooted in changing demographics, especially the rise of so-called millennials — today’s teenagers and twentysomethings. “Millennials aren’t driving cars,” he said.

In fact, younger people are less likely to drive — or even to have driver’s licenses — than past generations for whom driving was a birthright and the open road a symbol of freedom. Research by Michael Sivak of the Transportation Research Institute at the University of Michigan found that young people are getting driver’s licenses in smaller numbers than previous generations.

Online life might have something to do with the change, he suggested. “A higher proportion of Internet users was associated with a lower licensure rate,” he wrote in a recent study. “This finding is consistent with the hypothesis that access to virtual contact reduces the need for actual contact among young people.”

Baby boomers, too, are aging out of the daily work force and need to commute less. If the decline continues, the U.S. Pirg report states, driving could remain below its 2007 peak through 2040, even though the population is expected to grow by 21 percent.

If Jacob Curtis is any indication, the change in driving habits should be with us for some time to come. Mr. Curtis, 29, moved to Charlotte in recent months to take a job as a cameraman at a local television station, and was pleased to find a home close to rail and bus lines, and that he could ride his bike to the office along a no-traffic greenway. He can shower when he gets to work, and drives to assignments in one of the station’s vans.

During his off hours, he finds Charlotte easy to navigate thanks to his smartphone, which helps him plot routes that blend biking and mass transit options. “You don’t have a lot to figure out,” he said. “We all have navigators in our pockets.”

Ted Boyd, whose job involves helping develop the city’s South End into a Brooklynesque neighborhood — Mr. Mauney is opening two stores there, one to sell women’s shoes and another men’s underwear — often rides the bus to work. He decided to drive less after a trip to New York, with its extensive options for mass transit, but admits “it’s a little trickier in Charlotte.” Office wear still stands out on the city buses, and “you get some interesting looks sometimes,” he said, that seem to assume an unpleasant reason for why he isn’t behind the wheel: “Is this a D.U.I.?”

Charlotte, whose success as a financial center has helped its population grow toward 800,000, takes transit seriously, said David Howard, a member of the City Council and chairman of its transportation and planning committee. The city tries to channel growth into manageable areas, he said, by filling in the urban core with new development and encouraging new construction along major transportation corridors, including an expanding rail line. “It didn’t happen by mistake,” he said.

The rail line was projected to reach a ridership of 12,000 people within 7 to 10 years; it hit that level in the first month and a half, he said. President Obama has nominated the city’s mayor, Anthony R. Foxx, to be the next transportation secretary.

The drop-off in driving is already having wide-reaching effects across the country. It means that gasoline taxes, which help finance transportation investment, are bringing in less revenue. The U.S. Pirg report suggests that the nation’s shift in driving trends calls for a change in the things the nation spends that money on. “When dollars are so scarce, we need to be sure we’re not building highways that aren’t really needed — especially if doing so means neglecting repairs of existing highways, and neglecting to build transit projects when transit ridership is soaring,” Mr. Baxandall said

Kenneth Orski, a transportation consultant, offered a skeptical view of the permanence of the driving trend. “When twentysomethings get older and start having kids, they move to the more affordable suburbs in search of more space and better schools — and start driving,” he said.

Robert W. Poole Jr., director of transportation policy for the Reason Foundation, a libertarian research organization, also viewed the new report with a measure of incredulity, calling its conclusions “exaggerated.”

Young people have been slow to buy cars, he said, in part because of “the very large degree of youth unemployment and underemployment,” a situation that might change with an improving economy. He added that the emergence of self-driving vehicles “may re-empower elderly people to continue using cars far into their last years,” offsetting any potential decline from younger adults.

Arguments about the future of transportation will continue as the demographics and economics play out. But at the moment, Mr. Curtis had a more pressing problem. He was showing off his bright red Diamondback bicycle to a visitor and suddenly said, “Whoa — a flat!” A construction nail had pierced the tire, a common problem in the booming city. In an earlier time, it would have meant an irksome trip home. But not in Charlotte.

“Guess I’ll take the bus,” he said.

He walked the bike to the city’s transit center, and chained it onto one of the racks that can be found on every bus in Charlotte and many other cities. The digital route readout repeated the same message over and over: “Route 9-S Central Avenue to Sav-A-Lot.”

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