Immigrants typically have more favorable health outcomes than their U.S.-born counterparts of the same race-ethnicity. However, little is known about how race-ethnicity and region of birth moderate the health outcomes of different immigrant groups as their tenure of U.S. residence increases. We study the association between time spent in the United States and health outcomes among non-Hispanic Black, non-Hispanic White, Asian, and Hispanic immigrants using National Health Interview Survey data. Although all immigrant groups initially report better health outcomes than their U.S.-born counterparts, the association between U.S. tenure and reported health outcomes varies among immigrants by race-ethnicity and region of birth. Black immigrants have the worst hypertension profiles, and Black and Hispanic immigrants have the worst obesity profiles. The results suggest that acculturation cannot fully explain racial-ethnic differences in the association between U.S. tenure and health outcomes. We advance a more complete sociological theory of immigrant integration to better explain disparate immigrant health profiles.

Background: To describe the relationship between longevity and local access to preventive healthcare at the county level. Methods: We used Medicare outpatient reimbursement data from the 2010 Dartmouth Health Atlas and longevity data from Chetty et al. (2016) to identify the cross-sectional associations between county longevity, access to outpatient care, and the quality of primary care. Results: We find that the cost of outpatient care is inversely correlated with area life expectancy for individuals in the bottom income quartile. Much of this correlation is driven by men in the bottom income quartile. We also find that disaggregating a preventive care index produces significant relationships between components of the index and longevity where none were previously found. Conclusions: These results counter prior assertions that local health costs are not associated with life expectancy. Additionally, the results also suggest that the local cost of outpatient care and the quality of that care may influence the longevity of low-income populations, especially for low-income men. Keywords: Preventive care, Health access, Health quality, Longevity

As states and districts expand access to publicly funded PreK programs, researchers and policymakers have been grappling with experimental evidence demonstrating that the benefits of PreK on academic skills are not likely to last into early elementary school. A leading hypothesis to explain this phenomenon is that PreK and the elementary grades are not aligned with respect to content and mode of instruction. The Boston Public Schools Department of Early Childhood has begun to implement an aligned curriculum and professional development model called Focus on Early Learning to address this issue. The current study describes the components of this aligned model, identifies the facilitators and barriers to implementation, and examines the extent to which the model has been implemented to date. Findings demonstrate that a critical component of Focus on Early Learning is a combination of aligned structures and rich instructional content. A number of structural and process factors have facilitated implementation, but the district has also faced barriers, including funding and the challenge of creating a culture that supports alignment. Although survey and observational data suggest that PreK and kindergarten teachers are implementing the curriculum at moderate levels, there was significant variation in implementation across the study sample. In addition, teachers were less likely to receive professional development to support implementation. Although teachers generally supported the idea of aligning instruction across grades, they were less likely to engage in specific activities to do so, such as having common planning meetings with teachers across grades. Implications are discussed.