Document Type


Date of Award

Spring 5-31-2010

Degree Name

Doctor of Philosophy in Urban Systems - (Ph.D.)


Joint Program in Urban Systems

First Advisor

Jeffrey Robert Backstrand

Second Advisor

Dula F. Pacquiao

Third Advisor

Jamie Lew

Fourth Advisor

Barbara Caldwell


A body of research suggests that immigrants arrive in the U.S. in good health, a healthy immigrant effect. As immigrants acculturate and absorb dominant cultural norms (measured by proxy variables such as language preference, employment, smoking and alcohol consumption), their health status deteriorates. There is a need to understand how immigrants adapt to a changed social and cultural environment and how this may influence health.

A study of pregnancy, childbirth and the postpartum period in immigrant Pakistani women living in New Jersey explored the interface of culture, immigration and health. The study employed a three pronged approach. Census data were analyzed to identify areas with the largest Pakistani immigrant populations in New Jersey. A sample of 26 women from urban (Jersey City) and suburban (Parsippany and Edison) towns were then interviewed, and tours of their neighborhoods were undertaken to describe their environments.

The in-depth interview data revealed that the pregnancy experience of these women was influenced by the timing of their pregnancy, the quality of their social networks, socio-economic status, and knowledge and ease of negotiation of the U.S. healthcare system. Initially, these women experienced a weakening of social networks and a fall in socio-economic status. Moreover, women who experienced a pregnancy soon after immigrating to the U.S. also encountered a healthcare system that was difficult to navigate. These women adapted by building new networks (friends and neighbors), strengthening kinship ties (in-laws), investing in relationships (exchange of favors) and consequently deepening embeddedness in these new networks. These new networks also functioned as conduits of information that facilitated the obtaining of healthcare. Social networks in Pakistan were linked via a range of transnational mechanisms.

Differences in socio-cultural adaptation occurred based on urban and suburban location, and these influenced the women's pregnancy experience. Urban and suburban networks differed in composition (e.g. urban networks were comprised of other Pakistani immigrants vs. suburban networks that were more diverse) and collective social capital, and these women used their social capital to address different needs and to achieve different goals. Urban women tended to be more conservative in their adaptations and maintained old social patterns, while suburban women were comparatively more flexible. Additionally, these individual adaptations have collectively shaped urban and suburban Pakistani immigrant communities.



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