Posted by on December 01, 2014 in Blog
By Kristyn Acho
Fall Intern, 2014
Although Arab Americans are featured prominently in the media and public discourse, there is still limited research available on the health of Arab Americans. This dearth in information exists largely because large statistical projects to quantify the health of Arab Americans have not been undertaken. These projects are hindered by the lack of data on the Arab American population due to a massive undercount of the community by the Census Bureau, which identifies only a portion of the Arab American population through a question on “ancestry” on the American Community Survey. Reasons for the undercount include the placement of and limit of the ancestry question (as distinct from race and ethnicity); the effect of the sample methodology on small, unevenly distributed ethnic groups; high levels of out-marriage among the third and fourth generations; and distrust or misunderstanding of government surveys among recent immigrants. Next year, the Census Bureau will begin to test a MENA (Middle East and North Africa) category for possible inclusion on the 2020 Census, which would ultimately provide a more accurate account of the number of Arab Americans living in the United States.
To gain more insight into the prevailing health issues affecting the Arab American community, we spoke to Dr. Abdulrahman M El-Sayed, an Assistant Professor of Epidemiology at Columbia University and population health scientist whose research often focuses on Arab Americans.
In the research article “The health of Arab-Americans living in the United States: a systematic review of the literature” (2009), you reveal that, between 1980 and 2008, only 34 empirical studies on the health of Arab Americans were published. Has there been a significant increase in literature focused on Arab American health since then?
There has, there are certainly more scientists interested in the health of Arab Americans for a number of important reasons. First, it's rather clear that Arab Americans present an important test case for health inequalities in and of themselves – we recently wrote a paper showing about a 2-year gap in life expectancy relative to non-Arab whites. Also, Arab Americans present a unique opportunity to consider the roles of discrimination, immigration, and acculturation for health.
Among the 34 studies, 26 sampled Arab Americans in Michigan. You argue that these samples cannot be used to make generalizations about the Arab American population, as it is possible that the health of Arab Americans in Michigan “differs meaningfully” from the health of Arab Americans in other areas of the United States. Have studies that sample Arab Americans in other locations been published in recent years?
Yes, although the preponderance of the literature continues to focus on the Arab American community in Michigan.
In the seven years following the September 11 terrorist attacks, only two studies focused on the relationship between post-9/11 discrimination and the health of Arab Americans. This is surprising, as Arab Americans were pervasive in the media and public discourse during this period. Do you think that the paucity of studies is due to a lack of interest in the topic, or because sizable efforts to measure the health of Arab Americans had not yet been taken?
Unfortunately, good data is a limiting factor. There's relatively little data collected about Arab Americans specifically, and of the available data, little was available before September 11th, which is necessary to provide a meaningful contrast.
In your 2011 empirical study “Suicide among Arab Americans,” you found that suicide rates were lower among Arab Americans than non-ethnic white Americans, and you concluded that qualities like strong family bonds, communalism, and positive ethnic group identity protect Arab Americans against suicide. Did you still find the comparatively low rates of suicide among Arab Americans surprising given the high levels of discrimination and acculturative stress this community is often exposed to?
Yes, that is surprising, although ethnic minorities, including Black Americans and Latino Americans commonly have lower rates of suicide than Whites – even despite higher levels of discrimination and acculturative stress. It's likely that although these factors do contribute to poor mental health generally, they are processed and coped with in qualitatively different ways, and may not lead to the suicide consequences that similarly traumatic experiences lead to in Whites.
In the past five years, has new research been published to systematically assess the effects of immigration and acculturation on the health of Arab Americans?
There are certainly research teams that are actively working in this area, with really interesting results. However, because of the lack of high-quality available data, we still know relatively little about the effects of these exposures on the health of Arab Americans more generally.
What are the main health issues affecting today’s Arab American community?
Most importantly, Arab Americans suffer higher rates of common non-communicable disease, including obesity, diabetes, and cardiovascular disease. Smoking also continues to be a serious problem in our community – particularly hookah smoking which for obvious cultural reasons, continues to be prevalent. Another challenge in our community is violence, particularly among young men. Relative to White men of the same age groups, we found that Arab Americans were six times more likely to die of homicide, for example.
Dr. Abdulrahman M El-Sayed is a population health scientist and Assistant Professor of Epidemiology at Columbia University. He is also a Fellow at Demos, a public policy organization based in New York. Dr. El-Sayed is a frequent commentator on health policy and public health issues. His work has been published in the New York Times, the Guardian, Al Jazeera, CNN, and the Huffington Post. He appears regularly on Al Jazeera America to discuss public health challenges.
Dr. El-Sayed completed his medical degree at Columbia University as a Soros Fellow. He holds a DPhil in Population Health from Oxford University, where he was a Rhodes Scholar.