More than 20 percent of New Jersey’s population is foreign-born, and health care providers must recognize this multicultural population’s diverse and changing health needs in order to provide the best health care, Health and Senior Services Commissioner Dr. Poonam Alaigh said today in releasing The Health of the Newest New Jerseyans: A Resource Guide.

The state’s foreign-born population is relatively healthy overall – healthier than the native-born population in many areas, such as significantly lower rates for most leading causes of death.  Each group, however, comes to the U.S. with its own health advantages and health challenges which can change the longer they live here.

“The foreign-born have been New Jersey’s greatest source of population growth since 2000, and as the report notes, their health is having an increasing impact on the state’s overall health,” said Dr. Alaigh, who led a discussion with health care leaders at Rutgers University’s Institute for Health, Health Care Policy and Aging in New Brunswick.

 “Many hospitals and physicians are already breaking down barriers to effective patient care by tailoring their care to patients’ cultural needs,” she said.  “I hope this forum inspires all health care providers to share best practices and develop their own innovative approaches to delivering high-quality care for the state’s nearly 2 million foreign-born residents.”

Nationally, New Jersey has the third highest proportion of foreign-born residents after California and New York. The foreign-born are those born outside the U.S., Puerto Rico, Guam or the U.S. Virgin Islands, regardless of citizenship status.

About 45 percent of New Jersey’s foreign-born are from Latin America and the Caribbean, 31 percent are from Asia, 18 percent from Europe and 4 percent from Africa.  India, Mexico, Dominican Republic, Philippines and China are the leading countries of origin.

Hudson, Bergen, and Middlesex counties have the highest percentage of foreign-born residents, while Salem and Cape May counties have the lowest.   Bergen County has the most foreign-born whites, Essex the most foreign-born blacks, Middlesex the most foreign-born Asians, and Hudson the most foreign-born Hispanics.

            According to the report, compared with the U.S.-born, the foreign-born population overall has lower death rates for the 10 leading causes of death, with rates significantly lower for seven -- heart disease, cancer, chronic respiratory disease, diabetes, unintentional injury, bloodstream infection and kidney disease.  The foreign-born population overall also has:

• lower rates of  high blood pressure and asthma
• lower rates of obesity, smoking and binge drinking
• fewer days reported suffering from a mental or emotional problem, and
• lower infant mortality rates and rates of low birth weight babies.

There are some exceptions to these trends.  For example, although their overall cancer death rate is lower, the foreign-born have higher death rates for two types of cancer -- stomach and liver – than do the U.S.-born.   Also, foreign-born Hispanics have the highest death rate due to work-related injury of any racial or ethnic group, regardless of country of birth. 

Some researchers in the U.S. and Canada have suggested the early health advantages of the foreign-born could be due to cultural practices that promote health.  Also, people who come to the U.S. are thought to be healthier on average than those who remain in their native country, and the foreign-born who develop health problems while here may be more likely to return to their place of birth than are those who are healthier.

As the foreign-born spend more time in the U.S., both their health behaviors and their health status can change. The report compares the foreign-born living in the U.S. less than 10 years, with those here 10 – 14 years.  Here are some highlights:

• High Blood Pressure -- Foreign-born Whites and Blacks are more likely to be diagnosed with high blood pressure the longer they live here, while hypertension prevalence decreases among Asians over time. It remains the same among Hispanics.
• Smoking – Smoking rates increase over time for all foreign-born racial and ethnic groups except Whites; their smoking rate declines.
• Obesity – Obesity rates for Whites and Black decline over time, while the percentage of Asians and Hispanics who are obese increases. 
• Binge Drinking – Binge drinking, or having five or more drinks on one occasion, increases over time for all foreign-born racial/ethnic groups, although it remains relatively uncommon.

Much research nationally has noted increased smoking and drinking, and a deteriorating quality of diet the longer the foreign-born live in the U.S. 

Each foreign-born racial and ethnic group brings its unique combination of culture, language, health status, and health beliefs to New Jersey’s health care system, the report notes.  As the foreign-born and their descendants are likely to comprise an increasing share of the state’s population in the years to come, it is important that health care providers understand this diversity and use it to tailor their care in ways that will improve the health of all New Jersey residents.

The report was prepared by the DHSS Center for Health Statistics based on data from the American Community Survey, an ongoing survey by the U.S. Census Bureau; the 2000 U.S. Census; the New Jersey Bureau of Vital Statistics and Registration; and the New Jersey Behavioral Risk Factor Survey. The report is available online at: www.nj.gov/health.

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