Investing in the Homeland: Foreign Assets and Patterns of Immigrant Economic Incorporation

This dissertation consists of three separate studies that examine patterns of immigrant incorporation in the United States. The first study tests competing hypotheses derived from conflicting theoretical frameworks−transnational perspective and cross-national framework− to determine whether transnational engagement and incorporation are concurrent processes among Chinese, Indian, and Mexican immigrants. This study measures transnational engagement and incorporation as home and home country asset ownership using multi-panel, nationally representative data from the New Immigrant Survey (NIS) collected in 2003 and 2007. Results support a cross-border framework and indicate that transnational asset ownership decreases among all immigrant groups, while U.S. asset ownership increases. Findings from this study also indicate that due to disadvantaged pre-migration SES and low human capital, Mexican immigrants are less likely than other immigrants to own home country assets during the year after receiving their green card.

The second study examines the doubly disadvantaged position of elderly immigrants in the U.S. wealth distribution by applying the life course perspective to the dominance-differentiation theory of immigrant wealth stratification. I analyze elderly immigrant wealth in respect to U.S.-born seniors and younger immigrant cohorts using two data sets: the Survey of Income and Program Participation (SIPP) and the New Immigrant Survey (NIS). The Survey of Income and Program Participation (2001 to 2005) is a nationally representative survey of U.S. households. The first series of analyses reveals a significant wealth gap between U.S.- and foreign-born seniors which is most pronounced among the wealthiest households in my sample; however, U.S. tenure explains much of this difference. The second series of analyses suggests that elderly immigrants experience greater barriers to incorporation compared to their younger counterparts.

In the third study, I apply a transnational lens to the forms-of-capital and opportunity structure models of entrepreneurship in order to analyze the role of foreign resources in immigrant business start-ups. I propose that home country property use represents financial, social, and class resources that facilitate immigrant entrepreneurship. I test my hypotheses using survey data on Latin American immigrants from the Comparative Immigrant Entrepreneurship Project. Findings from these analyses suggest that home country asset ownership provides financial and social capital that is related to an increased likelihood of immigrant entrepreneurship.

Neurosurgical Needs and Assets Assessment of Public Hospitals in Uganda: An Eevaluation of Mulago Hospital to Inform Neurosurgical Program Planning at Mbarara

Background: Since 2007, there has been an ongoing collaboration between Duke University and Mulago National Referral Hospital (NRH) in Kampala, Uganda to increase surgical capacity. This program is prepared to expand to other sites within Uganda to improve neurosurgery outside of Kampala as well. This study assessed the existing progress at Mulago NRH and the neurosurgical needs and assets at two potential sites for expansion. Methods: Three public hospitals were visited to assess needs and assets: Mulago NRH, Mbarara Regional Referral Hospital (RRH), and Gulu RRH. At each site, a surgical capacity tool was administered and healthcare workers were interviewed about perceived needs and assets. A total of 39 interviews were conducted between the three sites. Thematic analysis of the interviews was conducted to identify the reported needs and assets at each hospital. Results: Some improvements are needed to the Duke-Mulago Collaboration model prior to expansion; minor changes to the neurosurgery residency program as well as the method for supply donation and training provided during neurosurgery camps need to examined. Neurosurgery can be implemented at Mbarara RRH currently but the hospital needs a biomedical equipment technician on staff immediately. Gulu RRH is not well positioned for Neurosurgery until there is a CT Scanner somewhere in the Northern Region of Uganda or at the hospital. Conclusions: Neurosurgery is already present in Uganda on a small scale and needs rapid expansion to meet patient needs. This progression is possible with prudent allocation of resources on strategic equipment purchases, human resources including clinical staff and biomedical staff, and changes to the supply chain management system.

The life of leaders: an intensive health program for clergy.

Clergy suffer from chronic disease rates that are higher than those of non-clergy. Health interventions for clergy are needed, and some exist, although none to date have been described in the literature. Life of Leaders is a clergy health intervention designed with particular attention to the lifestyle and beliefs of United Methodist clergy, directed by Methodist LeBonheur Healthcare Center of Excellence in Faith and Health. It consists of a two-day retreat of a comprehensive executive physical and leadership development process. Its guiding principles include a focus on personal assets, multi-disciplinary, integrated care, and an emphasis on the contexts of ministry for the poor and community leadership. Consistent with calls to intervene on clergy health across multiple ecological levels, Life of Leaders intervenes at the individual and interpersonal levels, with potential for congregational and religious denominational change. Persons wishing to improve the health of clergy may wish to implement Life of Leaders or borrow from its guiding principles.