The socio-political context of migration and reproductive health disparities: The case of early sexual initiation among Mexican-origin immigrant young women

https://doi.org/10.1016/j.socscimed.2017.03.011Get rights and content

Highlights

  • Uses innovative mixed methods to examine reproductive health among Mexican immigrants.

  • Moves beyond a culturalist approach to explore gender inequality and sexuality.

  • Links structural factors, e.g. access to resources, to gender and sexual expectations.

  • Reveals that gender and sexual expectations influence sexual initiation differently.

Abstract

Prior research often explains the lower risk of early sexual initiation among foreign-born Mexican-origin young women by a patriarchal and sexually conservative “traditional Latino culture.” This definition overlooks structural factors such as exploitation of migrant workers, and conflates gender inequality and sexual expectations. I use an intersectional framework and the theory of gender and power to explore how gender inequality and sexual expectations are both influenced by structural factors and affect reproductive health outcomes. I integrate data from qualitative interviews with 21 first and second generation Mexican-origin women in 2013–2014 with data from discrete time hazard models with 798 Mexican-origin young women in the National Longitudinal Study of Adolescent to Adult Health. Qualitative results demonstrate that gender inequality and sexual expectations in Mexican-origin immigrant households are associated with structural factors. Gender inequality occurs more often in households with family instability, greater poverty, and among parents who migrated independently. Qualitative data also demonstrate that parental gendered expectations are sometimes at odds to what parents are actually doing in the household. Finally, contrary to assumptions that a patriarchal “traditional Latino culture” protects against early sexual initiation, qualitative and multivariate quantitative data suggest that household gender inequality increases risk of early sexual initiation. These findings challenge the utility of a culturalist approach that views culture as determining health behavior among immigrants and demonstrate the need to incorporate an intersectional framework that includes structural factors. This approach may reduce stereotypes and identify meaningful interventions to reduce reproductive health disparities.

Introduction

Public health and medical research often theorize that a “traditional Latino culture” explains distinct reproductive health outcomes among Latina and Mexican-origin adolescents in the U.S., such as later ages at sexual initiation among the foreign-born (e.g. Driscoll et al., 2001, Guarini et al., 2011, Killoren and Deutsch, 2013, Lee and Hahm, 2009, Russell and Lee, 2004). This culturalist approach, that culture determines behavior, inadvertently perpetuates the stereotyping of Latino families as patriarchal, pronatalist, and sexually conservative by describing a “traditional Latino culture,” without attention to structural factors, such as restricted access to economic resources and employment exploitation, within the socio-political context of migration. In this paper, instead of a culturalist approach, I build upon the work of social scientists (García, 2012, González-López, 2005, Hirsch, 2003) who consider culture and structure as intertwined and mutually reinforcing to examine reproductive health. I use an intersectional framework with an innovative mixed methods approach integrating qualitative data from 21 in-depth interviews with first and second generation Mexican-origin women with quantitative data from Mexican-origin women in the National Longitudinal Study of Adolescent to Adult Health (Add Health) to address two research aims: (1) to explore how migration patterns, family stability, and socioeconomic status (SES) are associated with gender inequality and sexual expectations within Mexican-origin immigrant families, and (2) to then examine how these factors influence reproductive health behaviors of Mexican-origin young women.

Section snippets

Reproductive health literature

First and second generation adolescents have later ages at sexual initiation (Guarini et al., 2011, McDonald et al., 2009), but are less likely to use contraception than third (U.S.-born to U.S.-born parents) generation adolescents (McDonald et al., 2009). Investigations into the risk of adolescent birth remain inconsistent; some studies have found no difference (McDonald et al., 2009), others found U.S.-born Latinas have the highest risk (Minnis and Padian, 2001), and another found

Data and method

I used an iterative process integrating qualitative life history interviews with Add Health data to “explicate some of the ways that structural and cultural factors can act together to influence” reproductive health of Mexican-origin young women (Browner, 2000, p. 775). In order to draw inferences between samples, qualitative participants were in the same birth cohort as Add Health participants. The study was approved by the Colorado Multiple Institutional Review Board.

Sample demographics

Among Add Health participants, mean age at migration for first generation participants is 8 (Table 1). The second generation is most likely to live with two parents and SES improves with each subsequent generation. The third generation is most likely to have equal gender parental expectations. However, second generation parents are most disapproving of their daughters having sex. Mean age of sexual initiation is earliest for the third generation.

Among qualitative participants, first generation

Discussion

Integrating qualitative and quantitative data and deconstructing a “traditional Latino culture,” findings demonstrate that structural factors associated with migration, e.g., migration patterns and access to resources, shape gender inequality and sexual expectations within immigrant families and suggest that gender inequality and sexual expectations have distinct influences on the reproductive health of Mexican-origin young women. These findings advance prior research that relies on the

Data source

This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill, and funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. Special acknowledgment is due Ronald R. Rindfuss and Barbara Entwisle for

Acknowledgements

Research funding was provided by the National Institute of Nursing Research (1F31NR013821-01A1), Sigma Theta Tau International, Alpha Kappa Chapter-at-Large, and the Department of Health and Behavioral Sciences, University of Colorado Denver. The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) funded Population Research Center, University of Texas at Austin (R24 HD42849) provided administrative support. I am grateful to the organizers and participants of

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    Present address: College of Nursing, University of Colorado Denver, Mail Stop C288, 13120 East 19th Avenue, Aurora, CO 80045, United States.

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