Gender and Health in Mexico: Differences between Returned Migrants and Nonmigrants

• Published date: 01 July 2019
• Date: 01 July 2019
• DOI: http://doi.org/10.1177/0002716219857964

857964ANN
THE ANNALS OF THE AMERICAN ACADEMYGender and Health in Mexico
research-article2019
this study considers gender differences in the health of
Mexican migrants who return to Mexico from the
United States, and Mexican nonmigrants. We use
health data before and after migration to examine dis-
parities in women’s and men’s childhood and adult
health, comparing returned migrants and nonmigrants
in Mexico. Using data on more than 14,000 household
heads and their spouses interviewed between 2007 and
2016 in the Mexican Migration Project, we find evi-
Gender and dence of only a few gendered patterns of health among
migrants. Specifically, women migrants are more posi-
Health in
tively selected on height than are male migrants. We
also find a stronger, positive association between migra-
tion and smoking among women: although women are
Mexico:
less likely to smoke than men, the difference is smaller
among returned migrants than among nonmigrants. In
Differences contrast, we find no evidence that the positive migrant
selection on self-rated health at age 14, or negative
migrant selection on emotional disorders, varies by
between
gender, or that there is an association among migration
and obesity, hypertension, diabetes, and heart disease.
Returned
Keywords: health; gender; migrants; Mexico; selec-
Migrants and
tion; nonmigrants
Nonmigrants For more than 100 years, Mexico-U.S. migra-
tion has been a gendered process, whereby
substantially more men than women have
migrated northward (Donato 1993; Arias 2000,
2013; Donato and Gabaccia 2015). When
women migrated, they were more educated and
By
less likely to live in communities with higher
KAtHARINe M. DONAtO,
rates of female employment (Kanaiaupuni 2000;
eRIN R. HAMILtON,
Hamilton 2015). they were also more likely to
and
enter with legal documents, reside in the United
ANtHONy
BeRNARD-SASGeS
Katharine M. Donato is the Donald G. Herzberg
Professor of International Migration and director of
the Institute for the Study of International Migration
in the Edmund A. Walsh School of Foreign Service at
Georgetown University. She is the author of Gender
and International Migration: From the Slavery era to
the Global Age (Russell Sage Foundation 2015).
Correspondence: kmd285@georgetown.edu
DOI: 10.1177/0002716219857964
ANNALS, AAPSS, 684, July 2019 165

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tHe ANNALS OF tHe AMeRICAN ACADeMy
States for longer durations, and cross the border with friends and family (Donato
1994; Donato, Wagner, and Patterson 2008); and they were likely to follow male
family members (Donato 1993; Cerrutti and Massey 2001). Health is also a gen-
dered process. Women live longer but they live with more pain, impairment, and
chronic illness than men (Case and Paxson 2010; Read and Gorman 2010;
Verbrugge 1989). Men are less likely to report having a place to go when they
need medical services or a regular service provider, and they are less likely to use
prescription drugs to manage health issues than women (Kaiser Family Foundation
2013).
If migration and health are gendered processes, it is likely that the relationship
between migration and health varies between women and men. However, few
studies consider whether, and how, the health of men and women migrants dif-
fers prior to migration to the United States or upon return to Mexico. What is
known is that migrants are healthier, on average, than nonmigrants, a finding that
reflects how the costs and risks of migrating demand good health, and that the
rewards of migration increase with good health, resulting in positive health selec-
tivity of international migrants (Markides and Coreil 1986; Singh and Siahpush
2002; Hummer et al. 2007; Palloni and Morenoff 2001). Studies also show that
foreign-born health advantage is related to the negative health selection of
returned migrants (Palloni and Arias 2004; turra and elo 2008).
In this study, we examine gender differences in the health of Mexican migrants
who return to Mexico from the United States and nonmigrants in Mexico.
Considering the health of returned migrants is especially important now, given
the growing number of migrants who are returning to Mexico. In 2010, 985,000
U.S. migrants returned to Mexico, three times as many as in 2000 (Masferrer and
Roberts 2012). As more Mexicans return, health differences between them and
nonmigrants are likely to grow in light of studies that reveal complex, often nega-
tive, impacts of mobility on health and health care access (Kanaiaupuni and
Donato 1999; Donato et al. 2003; Donato and Duncan 2011; Martinez-Donate
et al. 2017). However, understanding the health of returned migrants is complex
because it is likely affected by selection into both emigration and return, as well
as by cumulative exposure to migration experiences and risk factors while
migrants reside in the United States, as they return, and after return (Davies
et al. 2011). Updating Ullmann, Goldman, and Massey (2011), we use health data
before and after migration from the Mexican Migration Project (MMP) to exam-
ine disparities in women’s and men’s childhood and adult health, comparing
returned migrants and nonmigrants in Mexico.
Erin R. Hamilton is an associate professor of sociology at the University of California, Davis.
She was a Fulbright-García Robles Scholar at El Colegio de México in spring 2019.
Anthony Bernard-Sasges graduated from Georgetown University’s School of Foreign Service
in 2018 with a degree in international political economics, concentrating on migration and
development.

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GeNDeR AND HeALtH IN MexICO
167
Prior Studies
In this article, we extend prior work about Mexican migrant health selection, the
idea that migrants differ from nonmigrants in terms of health and characteristics
associated with health as a result of the costs and benefits of migration (Jasso
et al. 2004). We focus on gender differences in child and adult health between
returned migrants and nonmigrants and examine whether, and how, early life
health and current living conditions account for such differences.
As Ullmann, Goldman, and Massey (2011) point out, most studies about U.S.
immigrant health focus on Mexican migrants. As the largest immigrant group,
Mexicans are of interest because of the well-documented Hispanic health para-
dox, i.e., the mortality advantage of foreign-born Hispanics compared with non-
Hispanic whites despite low levels of education, income, and limited access to
health care—a pattern documented most clearly for Mexican immigrants
(Hummer et al. 2000, 2007; Hummer, Melvin, and He 2015; Riosmena, Wong,
and Palloni 2013; Palloni and Arias 2004; turra and Goldman 2007). Prior studies
also reveal complex relationships between Mexican migration and infant health
and mortality (Kanaiaupuni and Donato 1999; Hamilton et al. 2009; Hamilton
and Choi 2015). these and other studies suggest that healthy migrant selectivity,
selective return migration, data inconsistencies, and cultural protection may all
help to explain paradoxical health outcomes among Mexican migrants.
evidence of healthy migrant selectivity is mixed. Some studies that compare
migrants in the United States to nonmigrants in sending communities find that
Mexican migrants are positively selected on the basis of good health (Barquera
et al. 2008; Crimmins et al. 2005), while others find evidence of no or negative
health selection (Ro, Fleischer, and Blebu 2016). Riosmena, Kuhn, and Jochem
(2017) examined selection related to height and smoking by comparing Mexican
migrants in the U.S. National Health Interview Survey with their nonmigrant
counterparts in Mexico using World Health Survey data. they found that both
female and male migrants are taller and less likely to be smokers than nonmi-
grants in Mexico. However, studies that compare migrants in the destination
country to nonmigrants in the country of origin cannot easily disentangle migra-
tion effects (the impact of migrating on health) from selectivity.
In a study that observed the health of Mexico-U.S. migrants prior to migration
compared with the health of similarly aged nonmigrants, Rubalcava et al. (2008)
found weak and heterogeneous evidence of positive health selection. In that
study, rural men were more likely to migrate if they were not overweight and had
normal blood pressure, but there was no evidence of migrant selection on four
other measures of health among urban men. Rural migrant women were posi-
tively selected on iron repletion but negatively selected on self-rated health
(SRH), while urban migrant women were positively selected on height and SRH.
However, the study did not report whether gender or rural-urban differences in
patterns of health selectivity were significant.
Several studies have examined the health of returned migrants in Mexico.
these studies generally find that there is no difference in the health between

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returnees and stayers, or they find negative health selection on return migration
(Arenas et al. 2016; Diaz et al. 2016; Riosmena et al. 2013; turra and elo 2008;
Van Hook and Zhang 2011). For instance, Diaz, Koning, and Martinez-Donate
(2016) pool data from the California Health Interview Survey and the Migrante
Survey to examine the health status of men as they cross the border to return to
Mexico. Although migrants who report health limitations and frequent stress are
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