The Relationship Between Asthma and Smoking Essay

Health studies have often highlighted a relationship between asthma and smoking (Lee, Forey, & Coombs, 2012). Indeed, some researchers claim that most people who have asthma and smoke, at the same time are in double jeopardy because, as if tobacco smoke is not bad enough, their asthmatic condition could be triggered by irritants contained in the tobacco smoke, thereby leading to allergic inflammation of the bronchial tubes (Dutra, Williams, Gupta, Kawachi, & Okechukwu, 2014). The Relationship Between Asthma and Smoking Essay.

This condition could lead to excessive mucus production, chronic cough, and phlegm (Lee et al., 2012). For many asthmatic patients, tobacco irritants not only manifest in the aforementioned symptoms, but also make breathing difficult (Gilreath, Chaix, King, Matthews, & Flisher, 2012). The relationship between asthma and smoking explains why many adults who develop asthma past their 50^th birthdays often have a history of smoking tobacco (Dutra et al., 2014). My topic of study is centered on exploring the relationship between asthma and smoking among adult African Immigrants in California.

This study is important because African immigrants are a relatively understudied group. Furthermore, they are mostly underinsured than the general American population and experience significant variations, in terms of education and income outcomes, relative to other ethnic groups as well (Dutra et al., 2014). Because of their low socioeconomic status, they often experience inadequate medical care, which is often characterized by a lack of access to health care (Dutra et al., 2014; Gilreath et al., 2012).

This problem often creates an inadequate recognition of asthma severity and the under-prescription of controlled medications by health care service providers. The Relationship Between Asthma and Smoking Essay. Besides poor socioeconomic conditions, African immigrants also suffer from other risk factors such as environmental exposures (because of the difficult working conditions they are often subject to) and respiratory tract infections that are often associated with low-income living (Dutra et al., 2014).

This study would have a positive impact on social change because it could help to reduce the impact of asthma incidences within the target population. Such an outcome would come, in part, from understanding the relationship between smoking and asthma. Understanding the relationship between the two variables could also help to improve the health outcomes and wellbeing of immigrant populations in California.

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The process could also shed more light on the factors that affect the relationship between the same. The insights drawn from this study could also be instrumental in understanding the social, economic, and political factors associated with Africans as an immigrant population in California. This analysis would provide a better understanding of their health outcomes and overall wellbeing. Additionally, the findings of the study would help to expand the body of research explaining the relationship between asthma and smoking among African immigrants in California, and, by extension, immigrants. Thus, this study could promote positive social change by informing health policy decisions regarding smoking and asthma management in the state of California.

This first section of the study starts with a background review of the research topic and focusing on the research gap. That is followed by the problem statement, the purpose of the study, the research question, and the research hypothesis. I will then present the theoretical framework which this study is grounded on. The next topic will be the approach or nature of the study. The literature review starts with the literature search strategy followed by an extensive review of literature related to key variables and concepts. Key definitions, study assumptions, scope and delimitations, and limitations of the study will then be presented. The final part of this section will be to explain the significance of this study followed by a brief summary and conclusion. The Relationship Between Asthma and Smoking Essay.

Problem Statement

Researchers and medical experts have investigated the relationship between asthma and cigarette smoking. This relationship is founded on the fact that cigarette smoking causes the settlement of irritating factors on the air pathways, thereby worsening asthma attacks, or causing their resurgence (Tamimi, Serdarevic, & Hanania, 2012). Similarly, smoking often damages small hair-like structures (cilia) on the air pathways rendering them ineffective, thereby triggering asthma attacks (Tamimi et al., 2012). According to Currie and Baker (2012), about 25% of asthma victims are cigarette smokers.

African and Hispanic immigrants suffer a high risk of asthma fatalities compared to major ethnic groups in California (Findley & Matos, 2015). This is large because of socioeconomic disadvantages, poor housing conditions, and the lack of proper access to health care services (Findley & Matos, 2015). Smoking is also a contributor to this outcome because different studies have shown that many African immigrants often continue their smoking habits after arriving in the US (Amer & Awad, 2015). Researchers that have further investigated this issue point out that, West African immigrants experience fewer inhibitions to smoking because of a group-based cultural identity theory, which presupposes that they are free to smoke in America because of fewer social inhibitions that often prevented them from doing so in their home countries (Gatrell & Elliott, 2014). The Relationship Between Asthma and Smoking Essay. Nonetheless, this habit contributes to their poor health outcome.

Another set of contributors to the poor health outcome among African immigrants is the nature of jobs that they do in America. As shown by Braback, Vogt, and Hjern (2011), most immigrants often work in low-paying jobs that expose them to indoor and outdoor air pollution, which affects their overall health. Most of these jobs are concentrated in the agricultural, construction, and service sectors (Gatrell & Elliott, 2014).

Some of the materials used in these industries contain harmful chemicals that further jeopardize their general health. For example, glues, insulation, and wood products contain harmful chemicals that are known to negatively influence the health of people exposed to them (Braback et al., 2011). Paints, cleaning products, and carpets also contain similar harmful chemicals, such as formaldehyde, which cause respiratory health complications.

Researchers have investigated the relationship between asthma and smoking among different races and different genders. Corlin, Woodin, Thanikachalam, Lowe, and Brugge, (2014) assessed the relationship between asthma among Chinese immigrants living in Canada and their smoking behaviors. Other researchers have also investigated this relationship, relative to patients’ country of origin, area of residence, and education studies. Gatrell and Elliott (2014) explored the relationship between geographic differences and health status among immigrant groups in the US.

Most of the studies are based in developed countries that do not have many immigrant groups, and some of the studies are outdated. Few of these studies reflect the continuing changes in immigrant status or explain the relationship between smoking behaviors and asthma cases in regions that have multiple immigrant population groups, such as New York and California. The Relationship Between Asthma and Smoking Essay.

Although there are African immigrants residing in the US, many health studies have often categorized them as African-Americans, thereby failing to draw the distinction between the health outcomes African-Americans and African born US residents (Schenker, Casta-eda, & Rodriguez-Lainz, 2014). Furthermore, this population group is one of the understudied in the area of immigrant health because researchers have mostly focused on studying Hispanics and Asian immigrants. Citation The neglect of African immigrants, as a significant health cohort worth studying, betrays the spirit of public health, which promotes the provision of a holistic picture of health management (Moreland-Russell & Brownson, 2016). With this proposed study, I seek to fill this research gap by exploring the association between asthma and smoking among adult African immigrants in California.

Purpose of the Study

The purpose of this study is to determine the association between asthma and smoking status among adult African immigrants residing in California. I intend to use a quantitative correlational approach to explore the association between asthma and smoking status and selected demographic variables among adult African immigrants in California. The independent variables will be smoking status, age, sex, years since immigration, marital status, alcohol use, education level, income level, and employment status, and the dependent variable will be asthma.

As highlighted in this paper, this study is a secondary analysis of archived data relating to the incidence of smoking and asthma among immigrant groups (Africans) in California. The data are presented in the California Health Interview Survey, which is an annual health database in the state. The data were developed from a telephone interview of more than 20,000 Californians and is considered the largest in America (Elk & Landrine, 2012).

The CHIS database is appropriate for this study because it is not only free but also authoritative and easy to use. I also chose to use this database as the main source of data for this study because it is credible and reliable. In fact, different professionals have used it to conduct health needs assessments, health research, and grant proposals (Elk & Landrine, 2012). The Relationship Between Asthma and Smoking Essay. Others have used it in news reporting and policy-making with great success. This record of accomplishment affirms its reliability.

Research Question and Hypotheses

The quantitative research question, hypotheses, and research variables for the proposed study are stated below:

• RQ–: What is the association between asthma and smoking status among adult African immigrants in California?
• Null Hypotheses (H₀): There is no association between asthma and smoking status among adult African immigrants in California.
• Alternative Hypothesis (H₁): There is an association between asthma and smoking status among adult African immigrants in California.
• Dependent Variable (DV): Asthma.
• Independent Variable (IV): Smoking status.
• Mediating Factors: Age, sex, years since immigration, marital status, alcohol use, education level, income level, and employment status.
• Study Group: Adult African immigrants in California. The Relationship Between Asthma and Smoking Essay.

Theoretical/Conceptual Framework

The socio-ecological theory will be the main conceptual framework for this study. Introduced in the 1970s by sociologists coming from the Chicago School, and revised by Bronfenbrenner throughout the 1970s and 1980s, this theory has been used to merge behavioral issues and anthropology issues in health studies (Moore, de Silva-Sanigorski, & Moore, 2013). The theory has five nested levels of interlocking behavioral and anthropological factors – interpersonal, organization, community, individual, and policy enabling environments. The interaction of these levels is summarized in the diagram that follows:

A key contribution of this theory to different fields of health and psychology is the understanding that the true comprehension of human growth should occur through a complete understanding of the ecological system, which supports or influences their behaviors (Yakob & Ncama, 2016).

The rationale for using this theoretical framework in this study stems from its ability to show different levels of personal and environmental factors affecting human behaviors and health outcomes. It does so by considering the complex interplay between the five layers of personal and environmental factors mentioned. This also justifies its application in this study because it has been used to successfully prevent domestic violence, child abuse, and promote community health (among other contributions in public health) (Gilioli, Caroli, Tikubet, Herren, & Baumgärtner, 2014). Its success in community health promotion is the main motivator for applying the theory in this study.

The socio-ecological model is ideal because it provides a holistic understanding of my research topic. Moreover, it takes into account the environmental factors that could affect the relationship between asthma and smoking (Sharma, 2016). The Relationship Between Asthma and Smoking Essay. The multifaceted nature of the model is appropriate for the study because I will explore the impact of several mediating factors, such as education, work, age, sex, and income (among other factors) in exploring the association between asthma and smoking among adult African immigrants in California (Coutts, 2016). In this regard, the model aligns with the variables of the study.

The socio-ecological model also incorporates our understanding of sociocultural factors that affect smoking behaviors among African immigrants because, as shown by previous studies, the smoking habits of this group of immigrants is partly caused by cultural factors (Bosdriesz et al., 2013). The socio-ecological model would help me to understand this bit of the analysis as well. Lastly, this model fits with the significance of the study, which is to inform public health policies and strategies regarding asthma management because the theory can provide a framework for preventing health problems.

This theoretical framework is relevant to my research issue because it would help me to uncover the personal and environmental factors that could explain an association between asthma and smoking among African immigrants (Onono et al., 2015). Marshall (2016) says smoking is a personal issue that is often associated with environmental factors, such as culture, peer influence, stress, and such factors. Similarly, asthma is a personal and environmental issue because it could be triggered or exacerbated by biological or environmental factors. Immigration also changes the environmental context that could affect human health outcomes (Arsen, 2013).

In this regard, this framework could help to explain the environmental issues of African immigrants in California that could affect their health status. This way, this theory is useful to my research study because it provides a holistic perspective of our research issue. More specifically, it incorporates all my research variables because smoking is a sociological (behavioral) issue, while the health issue (asthma) affecting African immigrants living in California could be moderated by environmental factors. The Relationship Between Asthma and Smoking Essay.

Nature of the Study

I will use the quantitative correlational approach in the proposed study. This quantitative correlational approach aligns with the primary research question, investigating if there is an association between asthma and smoking among adult African immigrants in California. The asthma status is a quantitative measure because data on asthma reporting is usually presented in numbers. Similarly, smoking is often measured in terms of the number of people who do it. These two sets of data for the research variables are quantitative in nature. Therefore, the selection of the quantitative technique is a natural process, based on the nature and characteristics of the variables that are measured (Creswell, 2014).

The quantitative approach is applicable to this research because my main source of research information – the California Health Interview Survey (CHIS) dataset and codebook is quantitative in nature. There are different types of research approaches in quantitative studies. The main ones include descriptive research, correlation research, quasi-experimental research, and experimental research (Jacobsen, 2016).

The correlation approach is the main approach to this study because it focuses on determining the existence and extent of a relationship between two or more variables. It aligns with my research topic because I also strive to investigate the association between asthma and smoking among adult African immigrants in California. Thus, the justification for using the correlation approach rests in the fact that it seeks to find out and interpret relationships between different variables (Guest, 2014).

The California Health Interview Survey (CHIS) is a statewide survey that contains quantitative data about different health issues in California. Supported by the California Department of Public Health and the Department of Health Care Services, this database contains health data obtained from telephone surveys that include the views of thousands of California residents (UCLA Center for Health Policy Research, 2017).

As highlighted in this paper, my research topic is centered on investigating the association between asthma and smoking among adult African immigrants in California. The Relationship Between Asthma and Smoking Essay. The research variables for this study include asthma, as the dependent variable, smoking as the independent variable, and age, sex, years since immigration, marital status, alcohol use, education level, income level, and employment status as mediating variables, or covariates.

Literature review

Literature Search Strategy

I conducted the literature review using reputable sources of peer-reviewed articles available from Google Scholar, Google Books, NCBI, and MEDLINE. Most of the articles sourced from these databases are openly available. The key research terms used to get the articles were “African,” “Immigrants,” “Asthma,” and “Smoking.” Most of these terms were derived from the variables under study and the nature of the research topic. All the sources consulted in this review are not more than five years old (they are published between 2012 and 2017). Excluded from the review were research articles that were published earlier than in 2012. I also excluded articles that came from commercial websites, blogs, and other online sources that were unreliable.

Literature Review Related to Key Variables and Concepts

Prevalence and Incidence of Asthma

The prevalence and incidence of asthma worldwide vary across different regions and countries. According to the American Academy of Allergy, Asthma, and Immunology (2017), about 300 million people suffer from the condition globally. Similarly, there are 250,000 annual deaths attributed to the same condition, globally (American Academy of Allergy, Asthma, and Immunology, 2017). The number of people suffering from the condition is expected to increase dramatically by more than 100 million (American Academy of Allergy, Asthma, and Immunology, 2017). Thus, experts estimate that in 2025, the global population of people who will be suffering from asthma would be 400 million (Naturopath, 2013). Researchers claim that poor workplace conditions, such as exposure to toxic fumes, are responsible for the increase in asthma incidences (Naturopath, 2013).

In the US, it is estimated that one in 12 people suffer from the condition (Naturopath, 2013). This figure is equivalent to 25 million people and it represents 8% of the country’s population.The Relationship Between Asthma and Smoking Essay.  Reports show that 53% of the American population, which suffers from asthma, had suffered an attack as well (Naturopath, 2013). However, this number is skewed towards children because there are more asthma attacks among children than in adults. However, statistics from 2008 to 2010 show that the incidence of asthma is higher among minority racial and ethnic groups in America, compared to the white population (Naturopath, 2013).

In California, it is estimated that more than 5 million adults suffer from asthma (CDC, 2014). Health agencies also point out that more than 1.7 million children suffer from the condition in the state (CDC, 2014). The state reports more than 500 deaths associated with this condition. The CDC (2014) adds that 145,000 annual emergency room visits in California are associated with this condition. Based on these statistics, asthma is not only a significant health problem in California but also a national problem for America and a global health issue for many countries.

Prevalence and Incidence of Smoking

According to the World Health Organization (2016), more than 1 billion people smoke tobacco worldwide. Statistics show that more men than women make up this number of smokers (World Health Organization, 2016). Similarly, they show that although the incidence of smoking is declining globally, the Mediterranean and African regions are still recording an increase in the incidence of smoking (World Health Organization, 2016).

This finding means that smoking is primarily a problem that is concentrated among developing countries and within lower socioeconomic groups. Indeed, out of 5 million deaths that occur globally because of smoking, more than two-thirds of them are concentrated in developing countries (World Health Organization, 2016). These deaths are projected to increase because the number of smokers is expected to grow to between 1.5 billion – 1.9 billion in 2025 (World Health Organization, 2016). The Relationship Between Asthma and Smoking Essay.

In the US, cigarette smoking is attributed to be the leading cause of preventable diseases (CDC, 2015). Statistics show that it accounts for more than 480,000 deaths annually (CDC, 2015). Additionally, the CDC (2015) says there are about 15 smokers out of a population of 100 Americans. This figure translates to 15% of the population being smokers. Generally, there is a decline in the incidence of smoking in America because the above figure represents statistics reported in 2015. In 2005, the figure was 21% (CDC, 2015). Nonetheless, based on the current incidence of smoking, the CDC (2015) says that 16 million American smokers live with a smoking-related disease.

The prevalence of smoking in California follows a decline in the number of smokers nationally. However, researchers estimate that the state has a tobacco smoking prevalence of 11% (Walters, 2015). This is below the Healthy 2020 goal of 12%; meaning that California is among the few states that have met its Healthy 2020 goal of reducing the smoking prevalence to less than 12%. Statistics show that black Californians have the highest prevalence rate of smoking in the state (Walters, 2015). The incidence of smoking is also more prevalent among low-income populations than in other socioeconomic groups. These findings show that smoking is a state, national, and global health problem.

Conceptual Framework

The socio-ecological model will be the main conceptual framework for this study. However, other researchers have used other types of conceptual frameworks to explore the interaction between human factors and environmental factors while trying to assess or predict health outcomes. Kapp, Simoes, DeBiasi, and Kravet (2016) used the systems theory to investigate how immigration patterns affect health outcomes in America.

Jayasinghe (2015) also used the same conceptual framework to explain how social issues affect health outcomes. Both researchers said that the systems theory provided a reliable conceptual framework for understanding how natural and social systems interact. They also said that the same framework properly conceptualized population health outcomes as dynamic, open, and adaptive systems. Broadly, these researchers have managed to demonstrate that human health outcomes are products of interrelated parts of subsystems, thereby enhancing our understanding of interactions between micro-meso-macro levels of health (Jayasinghe, 2015). The Relationship Between Asthma and Smoking Essay.

Researchers have also used the social construction theory as another conceptual framework for understanding the interrelations between different health variables. As highlighted in the works of researchers such as Onono et al. (2015), this theoretical foundation explains how socio-cultural and historical factors often shape people’s health outcomes. This theory would have been relevant to our research issue because it has been used by many researchers to explain the lived experiences of oppressed or minority communities. However, the main flaw of this theory (regarding its use in our research study) is its excessive bias on cultural and historical factors as a predictor of health outcomes. In this regard, it has no proper consideration of other factors that could affect health outcomes.

The main issue to point out in this analysis is that these conceptual frameworks have mostly been used to effect change or institute human behavioral changes as a prerequisite for their use. This focus does not explain the nature of this study because it does not institute change. Instead, it merely strives to describe a health phenomenon. The socio-ecological model adopts a broader view of health issues. This is why it was the most appropriate model for quantitative research.

Effects of Immigration on Health

Different researchers have explored the relationship between immigration and asthma. Such is the case of Cabieses, Uphoff, Pinart, Antó, and Wright (2014) who conducted a systematic review to analyze the effect of immigration on the relationship between asthma and smoking. The Relationship Between Asthma and Smoking Essay. They conducted this review according to the guidelines stipulated in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and found that there were significant differences in allergic reactions for populations that lived in their countries of origin and those that emigrated to other countries (Cabieses et al., 2014).

They also found that the level of development in the host countries significantly affected the level of asthma developed by the immigrants. Fox, Entringer, Buss, DeHaene, and Wadhwa (2015) have also demonstrated that immigrants who lived in developed countries had higher rates of asthma compared to those who lived in less developed countries. The researchers also established that there was a strong influence of the environment on the development of asthmatic conditions among the sample populations (Fox et al., 2015). Additionally, they established a higher prevalence of asthma among second-generation immigrants compared to first-generation immigrants because the latter group was not exposed to the environmental conditions of the host countries as much as the former group.

This assertion showed that the length of stay in the host country was directly related to the development or seriousness of asthmatic conditions. These findings were consistent with research studies conducted by Ro (2014), which upheld the same conclusion across sample groups of different nationalities, study populations, and age groups. However, he established differences across these social groups when the linear model was used (Ro, 2014). The differences also emerged when the respondents compared the findings across the early and later stages of immigration. Differences in time of residence also yielded the same outcomes.

In a different study to investigate asthma incidences among Asian immigrants living in America, Becerra, Scroggins, and Becerra (2014) established that Chinese, Filipino, South Asian, and Japanese immigrants reported a positive relationship between asthma and immigration. The same was true for Korean immigrants because the study showed that there was a positive relationship between asthma prevalence and immigration status (Becerra et al., 2014). The researchers used a linear regression model to come up with the findings after relying on data prepared by the California Health Interview Survey 2001-2011. The Relationship Between Asthma and Smoking Essay.

Garcia-Marcos et al. (2014) also conducted a study to investigate whether immigration affects asthma incidences among immigrants and came up with the same findings. In other words, they established that immigrants to western countries often adopt the same allergic reactions that host populations suffer from. The researchers used a mixed-method approach to conduct the review by first gathering data using questionnaires from 13-14-year-old immigrants living in the USA. They also gathered the views of parents who had children aged 6-7 years old using secondary research data (Garcia-Marcos et al., 2014).

Their findings showed a weak association between immigration and higher incidences of asthma. Thus, they believed that the reduced risk of asthma was often related to immigrants who had lived in America for the shortest time. This finding is consistent with the views of Lopez and Golden (2014) who say an increased stay in the host countries, often leads to the loss of a protective pre-immigration environment that would have otherwise helped immigrants to lower their risk of asthma.

Corlin, Woodin, Thanikachalam, Lowe, and Brugge (2014) investigated how immigration affected the health outcomes of Chinese immigrants and after sampling the health outcomes of more than 147 immigrants, they established that the immigrant population had better health outcomes compared to the native populations. The researchers also used bivariate and multivariate models to compare the prevalence of diseases among the two population groups, as well as the clinical biomarkers associated with the study focus (Corlin et al., 2014). To explain their findings, the researchers said that healthier diets, minimal exposure to cigarette smoke, and increased physical activity among the Chinese immigrants were mostly responsible for their positive health outcomes.

Also, Corlin and Brugge (2014) conducted an independent research study to investigate the incidence of asthma among immigrant populations and found that there is a “silent epidemic” of asthma among immigrant subpopulations in America. The authors said the epidemic was largely unreported because of poor access to health care services within this immigrant population.

Camacho-Rivera, Kawachi, and Bennett (2015) also investigated the relationship between immigration and health outcomes by exploring the effect of race, ethnicity, and country of origin on the risk of developing asthma. The researchers used 2,558 non-Hispanic white and Hispanic children to investigate this research phenomenon and found that lifetime asthma incidence was prevalent in less than 9.1% of the population (Camacho-Rivera et al., 2015). They also found no significant differences in asthma rates between Hispanic and non-Hispanic respondents. The Relationship Between Asthma and Smoking Essay. This study highlighted the importance of moving beyond racial or ethnic classifications to develop policies surrounding asthma management because these classifications often mask different subgroups of people who are at high risk of asthma.

Barr et al. (2016) conducted a study to test whether ethnicity is a dependent variable in the prediction of asthma incidences among immigrant populations in the US by analyzing whether the condition was prevalent among Hispanics and Puerto Ricans more than other immigrant groups. They found that asthma was more prevalent among second-generation Hispanic and Puerto Rican immigrants than first-generation immigrants were (Barr et al., 2016). They partly explained this finding using differences in smoking patterns among the sampled population groups. Their study included a sample of 16,415 Hispanics and Latinos (Barr et al., 2016).

In a different study to evaluate asthma admissions using ethnic variations, Sheikh et al. (2016) found that South Asian immigrants reported the highest hospital admissions attributed to asthma. These findings were developed after evaluating two main ethnic groups – whites and South Asian immigrants. However, the researchers failed to take into account sex-related differences that would have affected health outcomes.

Benchimol et al. (2015) also used South Asian immigrants as a sample group to estimate the incidence of asthma and immune-mediated diseases among immigrants in western countries. They used population-based cohorts of respondents who suffered from asthma and diabetes to undertake the review and found that adults from South Asia had a higher predisposition to asthma compared to other ethnic immigrant groups (Benchimol et al., 2015). This finding contradicted the view of many studies highlighted in this literature review because other studies have consistently shown that immigrants from other countries had a lower risk of developing asthma compared to host populations. However, the explanation for this inconsistency could stem from the fact that the findings of Benchimol et al. (2015) are mostly attributed to a genetic predisposition to the disease among South Asian immigrants.

Mahmoudi (2016) conducted a broader review involving more than 40 countries to understand the effect of immigration on asthma incidences and found that immigration was associated with a low incidence of asthma. He developed these findings after conducting a survey of more than 326,000 adolescents from more than 40 countries. The survey also included a population of 207,000 children from 30 countries (Mahmoudi, 2016). However, the association between immigration and asthma incidence was limited to affluent countries. The findings of Hamilton, Cardoso, Hummer, and Padilla (2011) would be useful to our proposed study because they would explain how immigration affects the health outcomes of immigrants in California. Their findings stem from a review of how assimilation has affected the health outcomes of immigrant children in America. The Relationship Between Asthma and Smoking Essay.

Reed and Barosa (2016) have also explored the role of the nativity in explaining the advantage enjoyed by immigrants compared to their host populations when it comes to asthma prevalence. To explain this advantage, they explored the health outcomes of two groups of immigrants – refugees and non-refugees. The findings revealed that refugees were disadvantaged when it came to accessing health care services, thereby suffering poor health outcomes compared to their non-refugee counterparts. Comprehensively, these studies show there is an association between asthma and immigration, with immigrants suffering lower incidences of asthma compared to host populations.

Effect of Environmental Exposures on Health

In an effort to understand the effects of environmental exposures on health, Im et al. (2015) outlined the case of a researcher, Johnson, who used an innovative framework to separate a host of factors affecting asthma incidences into different constituents. His analysis concentrated on factors that affect the design, construction, and conditions of the dwellings, which immigrants lived in. The researcher found that the risk of developing asthma was directly correlated to the nature and type of dwelling (Im et al., 2015). Im et al. (2015) said this relationship was a product of the interaction between culture and environment.

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In a separate study, Rumrich and Hänninen (2015) found that the complexity associated with asthma management was directly associated with the immigrants’ ability to communicate fluently in English and partly on whether they were born in the U.S, or not. They also established that asthma was more severe for immigrants who were relatively acculturated to their host countries, compared to those who were not (Rumrich & Hänninen, 2015).

Their findings correspond with a similar study by Chiu et al. (2016), which highlighted the lower incidence of asthma among new immigrants compared to those who had been in the host nations for a long time. This comparison implies that western risk factors increased the risk of developing asthma. This fact was supported by studies, which investigated the same issue among Arab-Americans (Im et al., 2015).

Rottem, Geller-Bernstein, and Shoenfeld (2015) established that environmental factors and the age of immigration affected people’s predisposition to asthma. The researchers went further to explain that the level of immunoglobin E was relatively higher among immigrants compared to the local population, thereby decreasing their predisposition to asthma (Rottem et al. 2015). The researchers also explored the possibility of a reversal of allergies because of parasitic infections. In this regard, they proposed that secondary prevention guidelines should be introduced to immigrants before they settle in their host nations, as a strategy to prevent asthma attacks (Rottem et al. 2015).

Gatrell and Elliott (2014) also conducted a similar study by exploring the relationship between geographical location and health status among immigrants. The Relationship Between Asthma and Smoking Essay. Although the study assessed different health variables, it found that geographical differences significantly affected the incidences of asthma among immigrants.

Studies that have tried to explore the impact of the environment on the health of immigrants have found it difficult to isolate the environment from other socioeconomic factors affecting immigrants that would ultimately affect their health as well (Okechukwu, Souza, & Davis, 2014). For example, a study by Guruge, Birpreet, and Samuels-Dennis (2015) to investigate the impact of environmental conditions on older women immigrants in Canada found that SES, cultural beliefs, gender norms, and influences of the physical and social environment weighed heavily on immigrant health. The studies also showed that older immigrant women were more likely to have health problems because of poor access to health care services and the underutilization of preventive health services (Guruge et al., 2015).

Martinez et al. (2015) contend that some of the problems faced by immigrants living in America are partly caused by unfavorable immigration policies. For example, they say unfavorable immigration policies often affect access to health care issues (Martinez et al., 2015). They arrived at these conclusions after reviewing eight health databases, which showed that anti-immigrant sentiments often affected the health outcomes of immigrants because it limited their ability to access health care services. Rhodes et al. (2015) have also come up with similar findings after investigating the effect of immigration policies on immigrant health in America.

Flynn, Carreón, Eggerth, and Johnson (2014) say that understanding the impact of someone’s work environment on their health goes beyond merely understanding how their work presents social hazards and risks to their wellbeing. Indeed, as explained by Arcury (2014), someone’s work also affects other aspects of their social wellbeing, and by extension, their health (work is the major incentive for many people who emigrate to the U.S).

According to Pichardo-Geisinger et al. (2014), many immigrant groups often experience deteriorating physical health after working in the US for some time. They made this finding after reviewing the physical health of a group of Latino immigrants working in the US. The link between work and immigration occurs through the understanding that work often alters the physical environment of immigrants, thereby putting their physical health and those of their family members at risk of deterioration. The Relationship Between Asthma and Smoking Essay.

Shani et al. (2013) explored the relationship between Asthma among Ethiopian born immigrants and of those living in western countries. They found that the intensity of asthma increased after their travel to western countries. The researchers used 1,217 matched controls for a population sample of the same number of immigrants and found that asthma incidences among second-generation immigrants did not significantly differ from those of the native population. The findings affirm the view that environmental exposures affected asthma incidences.

Socioeconomic Status and Asthma

The effect of socioeconomic status (SES) and asthma have emerged in several research studies that have tried to investigate the relationship between immigration and asthma incidences. Most of these studies have developed findings that have overlapped with similar findings from researchers who have studied the influence of the environment on the incidence of asthma attacks. According to Acton (2012), most immigrant groups living in America have a lower socioeconomic status. In fact, he says that most of them have household incomes that are below $50,000 (Acton, 2012). Most of the houses or dwellings that these immigrants live in are overcrowded.

Kelly, Glick, Kulbok, Clayton, and Rovnyak (2012) estimate that one-quarter of them are this way. Owing to these conditions, most of these homes create adverse environmental conditions, such as dampness or molds (44%), pests (28%), and poor ventilation (26%) (Acton, 2012). These conditions are known to increase the incidence of asthma and atopic diseases. Similar studies have shown that at least one of the aforementioned adverse conditions was found in at least 67% of homes inhabited by immigrants (Kelly et al., 2012). Furthermore, they found that multiple hazards were present in more than 27% of similar homes inhabited by immigrants. Grzywacz et al. (2012) say that children of recent immigrants showed symptoms of asthma one year after immigration. In detail, these symptoms were suggestive of asthma (4%) and atopic disorders (10%). Nonetheless, they often suffered from poor diagnosis because only 2% of this .  The Relationship Between Asthma and Smoking Essay.