Dynamics of Ghanaian immigrants' health in the US: Critical life-stage experiences, social networks, acculturation and selection (GMHeS)

Sub-Saharan Africa (SSA) has the world’s fastest-growing population and SSA-US migration is growing rapidly, contributing to greater demographic heterogeneity and aging of US immigrants. Our knowledge of SSA immigrants’ health comes primarily from analyses of US-based cross-sectional surveys that often combine Black SSA immigrants with those from Latin America and the Caribbean (LAC), and compares them with US-born Blacks. SSA immigrants’ physical health tends to be better than US-born Blacks, positing selective in- and out-migration, lifestyle, health behaviors, family and support networks, and cultural and racial contexts of origins. However, immigrants’ mental health, especially depression, tends to be worse than for native- born with evidence that greater exposure to US environments undermines immigrants’ health. Current US data, however, are limited for understanding the countervailing forces promoting and undermining SSA immigrant health over time. We need data that: provide information on migrants’ pre- migration sensitive life-stage exposures and origin households (HHs); allow comparisons among migrants, return migrants and non-migrants at origin; map migrants’ social contacts at destination with kin and non-kin; measure post-migration exposure to acculturative and other sources of stress; and follow SSA immigrants and similar non- migrant Ghanaians over time to see how incorporation processes shape health behaviors and outcomes. This project, with the short title of Ghanaian Migrant Health Study (GMHeS), proposes to collect and analyze such data for the case of Ghana where the research team has strong partnerships and prior and ongoing formative studies. The project will:(1) recruit linked binational samples of Ghanaians in Ghana and of Ghanaian immigrants in the US using multiple sample recruitment approaches (conventional probability and link-tracing sampling designs) and data sources (census, survey and administrative); (2) follow migrants over time; (3) use these unique multi-sited data to analyze the physical and mental health of Ghanaian immigrants in the U.S, how their health compares with health of native-born Blacks in the U.S., and comparable Ghanaians at origin, and (4) improve the understanding of the roles of sensitive life-stage exposures pre- and post-migration, social networks, acculturation and selection in predicting their health outcomes in the US. This innovative project promises considerable gains in understanding of migration and health among the rapidly growing Ghanaian immigrant population in the US, with important implications for the development of new approaches to study rigorously other immigrant populations in the US and their contributions to life-course health and aging.