title: Mortality outcomes for Chinese and Japanese immigrants in the USA and countries of origin (Hong Kong, Japan): a comparative analysis using national mortality records from 2003 to 2011.
abstract: With immigration and minority populations rapidly growing in the USA, it is critical to assess how these populations fare after immigration, and in subsequent generations. Our aim is to compare death rates and cause of death across foreign-born, US-born and country of origin Chinese and Japanese populations.
  
  
  
  We analysed all-cause and cause-specific age-standardised mortality rates and trends using 2003-2011 US death record data for Chinese and Japanese decedents aged 25 or older by nativity status and sex, and used the WHO Mortality Database for Hong Kong and Japan decedents in the same years. Characteristics such as age at death, absolute number of deaths by cause and educational attainment were also reported.
  
  
  
  We examined a total of 10 458 849 deaths. All-cause mortality was highest in Hong Kong and Japan, intermediate for foreign-born, and lowest for US-born decedents. Improved mortality outcomes and higher educational attainment among foreign-born were observed compared with developed Asia counterparts. Lower rates in US-born decedents were due to decreased cancer and communicable disease mortality rates in the US heart disease mortality was either similar or slightly higher among Chinese-Americans and Japanese-Americans compared with those in developed Asia counterparts.
  
  
  
  Mortality advantages in the USA were largely due to improvements in cancer and communicable disease mortality outcomes. Mortality advantages and higher educational attainments for foreign-born populations compared with developed Asia counterparts may suggest selective migration. Findings add to our limited understanding of the racial and environmental contributions to immigrant health disparities.
authors: Division of General Medical Disciplines, Stanford University School of Medicine, Stanford, California, USA.
authors: Katherine G
authors: KG
authors: Hastings
authors: Shorenstein Asia-Pacific Research Center, Stanford University, Stanford, California, USA.
authors: Karen
authors: K
authors: Eggleston
authors: Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, California, USA.
authors: Derek
authors: D
authors: Boothroyd
authors: Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, California, USA.
authors: Kristopher I
authors: KI
authors: Kapphahn
authors: Population Health Sciences Division, Stanford University School of Medicine, Stanford, California, USA.
authors: Mark R
authors: MR
authors: Cullen
authors: Center for Innovation in Global Health, Stanford University, Stanford, California, USA.
authors: Michele
authors: M
authors: Barry
authors: Division of General Medical Disciplines, Stanford University School of Medicine, Stanford, California, USA.
authors: Latha P
authors: LP
authors: Palaniappan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D002423:Cause of Death; D004522:Educational Status; D054242:Emigrants and Immigrants; D004641:Emigration and Immigration; D005260:Female; D054624:Health Status Disparities; D006723:Hong Kong; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D014481:United States / Q000453:epidemiology
keywords: EPIDEMIOLOGY; PUBLIC HEALTH; SOCIAL MEDICINE