The Intersection of Immigrant and Environmental Health: A Review of the Literature

BACKGROUND: Transnational immigration has grown since the 1950s. In countries such as the United States, immigrants now comprise over 15% of the population. Although differences in health between immigrants and non-immigrants are well-documented, it is unclear how environmental exposures contribute to these disparities. AIM: We systematically reviewed current knowledge on exposure to environmental pollutants for immigrants compared to non-immigrants. We also considered observational epidemiologic studies that estimated health effects associated with environmental exposures, separately for immigrants and non-immigrants. METHODS: We screened 3705 articles identified through Pubmed and selected those that fit our inclusion criteria. After abstract and full-text review, we summarized findings from 50 studies. RESULTS: We found a high degree of evidence for higher exposures to metals and fine particulate matter (PM2.5), as well as a moderate degree of evidence for higher exposures to select organic compounds and hazardous air pollutants in immigrants compared to non-immigrants. Among immigrants, there was some evidence for disparities by country of origin and time since immigration. Of the 50 studies, 43 were conducted in North America. There was a low degree of evidence for disparities in health effects from exposures in immigrants compared to non-immigrants. CONCLUSIONS: The environmental health of immigrants remains an understudied area, especially outside of North America. While most identified studies explored potential exposure disparities, few investigated subsequent differences in health effects. Future research should investigate environmental health disparities of immigrants, especially outside North America, and the role of country of origin, time since immigration, and combined effects with socioeconomic status, race/ethnicity, education, and related characteristics. KEYWORDS: Environmental Equity, Environmental Justice, Immigrant Health, Health Disparities, Systematic Review